A national study of 1,700 patients on medical billing released by VisitPay at the HIMSS19 Global Conference shows the majority of health systems don't discuss costs with patients, yet an even larger majority of respondents indicated that cost strongly influences their overall satisfaction with their hospital or their physicians.
In cultivating the information and responses, clustering and machine learning techniques from other consumer-facing industries were adapted and applied to the consumption habits, communication preferences and behavioral tendencies of the respondents to paint a more complete picture.
Revenue cycle is an area of healthcare operations that is ripe for the use of analytics, AI and machine learning to cultivate an understanding of a patient's financial needs, preferences and propensity to pay based on their historical habits such that money can be collected more effectively. The addition of "behavioral insights" lends additional perspective to a patient's financial profile and can inform the methods used to collect money, increasing revenue for a health system.
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According to VisitPay, a third of respondents said growing healthcare costs impacted their ability to seek care, a result supported by separate Gallup researched that showed 29 percent of patients have delayed care due to costs, 63 percent of those saying their conditions were serious, VisitPay reported.
Communication around costs is still lacking, with 57 percent of health systems saying they do not discuss costs with patients. However, 65 percent said cost strongly influences their overall satisfaction with their hospital or physician, creating a glaring contradiction adversely affecting patients and illustrating the need for transparency.
Unplanned care creates financial challenges for both providers and patients, as the study indicated 56 percent of patient visits are unplanned. Unplanned or surprise bills are a major issue for patients, and that goes for bills that are even under $1,000. In 2016, 68 percent of patients with bills $500 or less didn't pay off the full balance and that number is forecasted to rise to 95 percent by 2020, creating the potential for serious impact to provider revenue cycles and the need for more payment options for patients so they are more likely to pay, even if it takes longer.
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"Patient Financial Mapping is a blueprint for health systems to alleviate confusion, reduce stress and help patients anticipate, plan and pay for medical expenses...These segments can be integrated with localized patient information within a health system's own databases and analyzed to uncover new ways to help consumers sustainably manage payments in the wake of high deductibles, steep premiums and unexpected medical expenses," VisitPay said.
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