It’s no secret that COVID-19 and the
corresponding near-immediate economic catastrophe will be felt for
significantly longer than the few short months it took to wreak its initial
havoc. While losses hit businesses from “a to z” (…except maybe Amazon, ironically),
hospitals and health systems tasked with treating the victims of this pandemic
bear a particularly harsh dose of the financial fallout — $72 billion in CARES
Act hospital grants barely serving as a band-aid to the financial machete-wound
that’s now bleeding out.
For patients, the pain just became more acute as well.
Beyond the fact that we face a once-in-a-century public health crisis impacting
family, friends, and each of us personally, nearly 15% of Americans have also
lost jobs, along with access to the employer-provided health insurance that we
need now more than ever. It’s a grim picture across the board with very few, if
any of us, emerging completely unscathed. We’ve lost loved ones, we’ve lost
jobs, and we’ve lost some level of human connection.
But we don’t have to lose our humanity. If this virus has
shown us anything, it’s that the health of some of us is the health of all of
us. Empathy and compassion has never been more important.
Medical Billing: From Bad to Worse
Even in the best of times (circa: January 2020), healthcare
providers tend to have an NPS below most other industries (including
insurance!), no doubt due to similarly cumbersome administrative and financial
experiences. With antiquated paper statements, indecipherable billing codes,
one-size-fits-all payment terms, and opaque pricing methodologies, it’s no
But now is not the best of times. Not by a long shot. The
current crisis is compounding the confusion and frustration, adding unique
difficulties to billing and coding, patient financial responsibility and
resource allocation, at a time when patients are particularly vulnerable. And
around what COVID costs, from testing to treatment, has put a spotlight on
the need for price
transparency and highlighted the importance of improved digital patient
engagement in all areas of healthcare–especially the financial experience.
Meanwhile, as hospitals confront a major decline in revenue
from the slowdown of elective procedures and routine visits, they anticipate a massive
increase in visits after COVID-19. A recent telephone survey of 323
hospitals across 46 states conducted by the Office of Inspector General found
that increased costs and loss of revenue were quickly depleting hospitals’ cash
reserves and could be disruptive to ongoing hospital operations. It has never
been more critical for healthcare providers to have the best billing practices
in place to ensure financial viability going forward.
A Shared Path to Recovery
Amidst outrage, some healthcare organizations have been
heavily criticized (and faced regulatory
scrutiny) for continuing to file lawsuits and garnish wages against
patients with overdue medical bills during the pandemic. While certain
healthcare providers have deployed these tactics for decades, this approach not
only stands to alienate patients at a time when they need care and support the
most, but studies have shown that these efforts actually yield only a
tiny fraction of revenue for the hospital system. Instead, healthcare
leaders should prioritize mutually-beneficial, digital forward engagement
strategies that start before care is received so that they are building a
better patient relationship that lasts throughout the care journey and has
proven to deliver better financial results.
Those same burgeoning digital solutions that began to
improve patient billing and financial engagement before the pandemic, can
quickly provide an answer to some of the urgent demands of today. The key is to
provide patients with a flexible, convenient financial experience tailored to
their needs, but it goes beyond simply moving from paper to email or text
(though this is essential). The transformation in a post-COVID world must also
include processes and an expansive, empathetic patient engagement approach to
support any technology that might rise to the top.
To make it easy for patients to understand and resolve
bills, particularly now, they need:
1. Empathetic communication that drives engagement
COVID-19 costs are new and confusing. Between regulatory stipulations, testing requirements, and commercial cost-sharing waivers, it’s hard to decipher. And we’re already seeing mistakes abound. Education and empathetic communication with patients (via the channels they prefer) is likely to lead to better outcomes, whether that involves highlighting alternative resolution options such as payment plans and financial assistance, proactively helping patients navigate insurance denials, or offering easy access to COVID-related education and support resources.
Moreover, clear service explanations and readable bills can help empower patients to understand their responsibility and feel confident about resolving outstanding balances. A 2019 study showed that 45% of patients fail to fulfill their financial obligations because of the difficulty level associated with understanding bills and methods of payment; outdated billing and notification processes were cited by 24% of respondents as a reason for non-payment. Indeed, more readable bills have the potential to capture more revenue, potentially supplanting the need for more aggressive collections tactics and the costs associated with them.
2. End-to-end convenience that facilitates social distancing
Powerful and effective patient engagement starts before a patient even walks into the hospital or clinic. This has never been more clear as drive-through COVID-19 testing facilities and online telemedicine initiatives popped up around the country, seemingly overnight. Digital platforms can support patient triage, eliminate wait times, and enable contactless engagement.
If a patient can complete registration forms, input insurance information, and resolve a co-payment before driving into the hospital parking structure, think how much better (and safer) the experience will feel. This applies to post-visit billing as well. In case we needed one more reason to eliminate paper bills and move toward digital, contactless billing processes, this coronavirus and the mechanisms it uses to spread among the population has tipped the scale.
3. Transparency that helps to inform and prepare
By helping patients to understand their expected costs up-front, hospitals give patients a chance to plan and make critical choices earlier in the healthcare journey. It also opens the opportunity to working out solutions like payment plans (an estimated 39% of Americans said in 2019 that they wouldn’t be able to pay a $400 emergency expense without taking out a loan), and this is even more pertinent for COVID-19-related costs. Some payers have waived cost-sharing for COVID-19 treatment (including Aetna, Cigna, and Humana), while true self-pay patients and those under other commercial payers remain vulnerable to treatment costs
Though daunting, the upcoming federal mandate requiring healthcare price transparency (set to go into effect in January 2021) will actually go a long way towards mitigating confusion for consumers, and the most forward-thinking organizations understand that compliance (done well) can actually become a competitive advantage for hospitals, with the right technology and attitudes in place for billing.
While the battle against COVID-19
continues, it’s not yet possible to calculate the true human and financial toll
of the pandemic. This ongoing uncertainty facing patients and healthcare
providers doesn’t make thinking about (much less settling) the bill any easier.
That said, promoting the highest level of
engagement throughout the patient experience involved with COVID-19-related
care, using clear communication, end-to-end convenience and offering
transparency whenever possible will go a long way towards ensuring that our
healthcare system can move forward, even beyond what we knew in “the best of
times,” to remain both solvent and solution-oriented
About Florian Otto, MD, DDS, Co-founder, and CEO of Cedar
An accomplished entrepreneur and former
physician, Florian now drives growth and sets overall direction across all
facets of Cedar’s operations. Prior to
founding Cedar, Florian was an executive at Zocdoc where he drove the
commercial adoption of the platform. Florian also founded a daily deal company
in Brazil (ClubeUrbano) that was eventually acquired by Groupon. After the
acquisition, he became Chief Executive Officer of Groupon Brazil, growing the
company to one of Groupon’s top three international markets.