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HIMSS Revenue Cycle Task Force seeks case studies on patient experiences

Group will serve as a matchmaker between organizations that would like to develop and pilot solutions.

Susan Morse, Managing Editor

LAS VEGAS -- The HIMSS Revenue Cycle Improvement Task Force is asking for case studies of patient financial experiences to make recommendations for improvements that will help providers deal with the estimated 30 percent of bad debt that plagues health systems.

Consumer expectations to know their cost of care are growing, said Stuart Hanson, chairman of HIMSS Revenue Cycle Improvement Task Force, during HIMSS16.

The task force said a sound revenue cycle process should focus on the patient first, Hanson said.

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For instance, consumers are now used to getting texts when their retail order is shipped, but still have a tough time getting information from their doctor outside of office visits, he said.

"The Obamacare conundrum," Hanson said, is the high out-of-pocket costs created by Bronze plans of the Affordable Care Act marketplace. "If consumers can't afford a better plan, how likely can they afford a $10,000 deductible?" Hanson said.

In 2012, patient payments averaged 30 percent of provider revenue. A 2013 survey of providers, doctors and hospitals reported a 75 to 150 day wait for payment, and 50 percent of patient obligations going unpaid. By 2019, write-offs will exceed $189 billion.

The billing experience is important to overall patient satisfaction, with those 96 percent of fully satisfied consumers saying they would return for future services, compared to 49 percent of the unsatisfied, according to a study highlighted by Hanson.

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"We cannot create the patient financial experience of the future without the back office functionality to support it," Hanson said.

In 2016, to make vision more demonstrable, the task force is asking for feedback, said John Showalter, MD, CIO and assistant professor of Medicine for the University of Mississippi Medical Center.

The task force wants to identify the gaps by identifying categories of activity involved in a typical episode of care, and to that end, have asked for case studies. The HIMSS task force will serve as a matchmaker between organizations that would like to develop and pilot solutions, he said.

Case study submissions will reviewed by HIMSS senior management and the task force, and will be promoted on the HIMSS website, he said.