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Change Healthcare unveils patient-centric payment model

High-deductible plans have made patients major payers of their healthcare, putting a strain on providers dependent on this out-of-pocket revenue.

Susan Morse, Senior Editor

Healthcare technology company Change Healthcare has unveiled an IT and services solution to reduce hospital bad debt by generating upfront out-of-pocket cost estimates that make the self-pay process faster and easier to understand.

The Patient Liability Management solution works in real time to screen patients for eligibility and obtain pre-authorization prior to service. It detects undisclosed, existing insurance coverage, which can reduce self-pay volume by 3-15 percent, equating to millions of dollars in revenue, Change said.

It generates an upfront out-of-pocket cost estimate at the time the patient submits his or her insurance card.

Patients have a choice of paying through traditional methods by mail or credit or debit card, and also electronically or via interactive voice response, or IVR.

The suite was developed in partnership with health systems, combining revenue cycle management solutions with expert advisory and patient engagement services, Change said.

WHY THIS MATTERS

High-deductible plans have made patients major payers of their healthcare, putting a strain on providers dependent on this out-of-pocket revenue.

A recent report said that close to half of those in a plan with at least a $3,000 individual deductible or a $5,000 family deductible struggled to afford healthcare in the past year.

The current payment system is generally based on patients receiving a bill in the mail. It may take weeks or months for patients to pay, causing hospitals to write-off bills to bad debt.

Hospitals are addressing this challenge to realize greater revenue collection.
 
Change said that by implementing its solution, Halifax Health, a large multi-hospital system, realized more than $69 million of self-pay revenue in the initial phase of implementation that was focused on coverage discovery and Medicaid enrollment. The second phase will concentrate on patient engagement and communications to increase collections, Change said.

Halifax Health worked with Change to streamline operations and create synergies between siloed departments, said Steve Mach, director of Patient Financial Services.

TREND

Getting paid upfront has become key in revenue cycle management.

Payments technology company InstaMed, which was recently bought by JPMorgan Chase, has an electronic solution at the time of registration to increase collections.

St. Luke's Health System in Idaho still works with paper as patients there prefer that method, but revised its mailed statement to realize a 10-12 percent increase in the percent of patients who paid.

ON THE RECORD

"In this era of high-deductible health plans, providers are spending more and collecting less because they feel they need to invest in multiple solutions and costly consultants to close myriad gaps in patient self-pay liability," said Kelley Blair, senior vice president and general manager, Health Systems & Corporate Revenue Cycle Services, Change Healthcare. "Implementing this suite of solutions will empower providers to improve their revenue cycle operations and create a more streamlined process that will reduce patient friction and provide better coordination for resolving patient balances."

Twitter: @SusanJMorse
Email the writer: susan.morse@himssmedia.com

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