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Proactively sharing cost of care information

Jim Denny, Founder CEO Navicure
Written by: Jim Denny

As healthcare providers strive to more reliably collect patient payments, they are looking for ways to better communicate with patients about their financial obligations. Interestingly, however, many organizations are missing a key opportunity to be transparent about healthcare costs. According to a recent national survey conducted by HIMSS Analytics and sponsored by Navicure, even though 75 percent of healthcare organizations are able to provide cost estimates upon request, only about one out in four patients ask for this information and merely 16 percent actually receive it when they don’t ask. One likely reason for this disconnect is that patients are unaware that providers can develop and share estimates with them. Since providers aren’t exceedingly proactive in offering them, patients often remain in the dark. If patients were aware, however, they would probably more readily start asking for this information. More than half of survey respondents say they would request a cost estimate going forward.

Seizing the opportunity
There are several reasons why organizations should aim to deliver cost estimates more consistently and proactively. Fundamentally, it’s the right thing to do. Patients are being asked to pay more out-of-pocket for their healthcare than ever before, and organizations have an ethical responsibility to be as forthright as possible about how much the individual might owe.

This degree of openness can also encourage patients to pay. When an individual fully understands the total costs of services and what their specific outlay is going to be, there is a greater chance that they will make a payment, whether that is a partial or complete one. The cost estimate can serve as an entry point into a deeper conversation about the individual’s financial responsibility and how he or she will meet it. Organizations can use this information as a launching point to introduce other financial topics, such as potential payment plans, credit card on file options, additional insurance or other means to make the balance more manageable. Plus, adding estimates to the front-end of the patient billing process saves time with payment on the back-end, and helps organizations get paid faster.

Clarity around cost information also has the potential to significantly boost patient satisfaction. Think about it in terms of other service-based companies. A person would tend to be more satisfied with an auto mechanic that provides a detailed and upfront estimate of what a repair would cost than with a mechanic that does not share this information and just presents the bill upon completion of work, expecting the person to be satisfied with the level of service while they pay promptly and in full. In fact, the person may not return to the second auto mechanic because of the company’s lack of transparency. The same holds true for healthcare organizations. The more an entity can offer early cost information, the more the patient feels that the organization is on top of things and understands the patient’s needs. This can increase long-term patient retention and loyalty.

In addition to the benefits mentioned above, there is also the reality that the demand for cost estimates is not going away. As mentioned before, once patients become aware that such information is available, they are going to start regularly asking for it. Plus, as more millennials begin to seek complex and expensive care, they will—even more than previous generations—expect an equivalent level of customer service to that of other industries. Just like hotels provide upfront cost estimates and retail organizations supply details on price in advance of purchase, patients will continue to expect more cost information and transparency from their healthcare providers.

Making it part of business as usual
Once an organization appreciates the need for more proactive cost communication, the next step is to shift away from merely generating estimates to actually sharing them. Although some organizations may hesitate to do this for fear these approximations are not accurate enough, patients indicate that they would still appreciate a less-than-perfect estimate. According to the survey, even one that falls within 10 percent of final costs is helpful.

As a next step, review current processes and see where delivering a cost estimate could fit. If your organization doesn’t want to cause bottlenecks during onsite registration, perhaps staff can call patients one to two days prior to their appointments or procedures to share the information and answer any questions. Patients will then be more prepared to pay when they arrive for their treatment.

Finally, look for technology that enables the creation of quick and accurate cost estimates. These solutions must be easy to use and fit seamlessly with other front office or patient access technology. Note that if a solution is cumbersome or hard to access, then staff may not always use it, causing organizations to be inconsistent about providing cost estimates. The bottom line is that the more organizations can weave cost estimate delivery into day-to-day work, the more likely they are to provide timely and complete information to patients.