It’s no surprise that surprise bills are a problem in the U.S. 20 percent of Americans with credit, nearly 43 million people, have medical debt. There are numerous studies out there that illustrate just how bad this problem is.
- According to Yale researchers, one in 10 patients at in-network hospitals are treated by out of network physicians, leading to surprise bills.
- A University of Michigan study published in JAMA found that one in five operations lead to a surprise bill.
- Even if you’re under a large employer’s health plan, one in six ER visits or inpatient hospital stays result in at least one surprise bill.
If it’s this easy to get a surprise bill, it’s no wonder that patients get frustrated. A study published in Health Affairs found that when a patient gets a surprise bill from their hospital, they are more likely to switch from their preferred hospital the next time they need care.
Losing valuable market share is a problem in itself, but if hospitals tried reducing surprise bills, it would cut healthcare spending by $40 billion dollars. But where are we when it comes to this issue? We’ll go over the current legislation and what you can do in the meantime.
Surprise Bill Legislation
In 2019, efforts were made to stop surprise billing with Senate and House legislation in June and July, respectively. The Senate HELP Committee legislation focused on lowering healthcare costs by preventing providers from sending patients bills that are higher than the amount through in-network cost-sharing. The House Energy and Commerce Committee legislation focused on surprise bills and disallows providers from balance billing for out-of-network services.
By the end of the year, these entities came to an agreement on legislation for surprise billing, and in February 2020, two more acts were introduced: the Ban Surprise Billing Act from the House Education and Labor Committee and the Consumer Protections Against Surprise Medical Bills Act of 2020 by the House Ways and Means Committee. States are taking action on surprise billing as well, but it isn’t enough without help at the federal level since state protections don’t cover consumers with health coverage provided by employers.
What Providers Can Do
Although there has been some progress on legislation, there is still much that needs to be done to create affordable healthcare. To help consumers now, providers can do their part to prevent surprise billing in several ways.
Embrace Price Transparency
Patients are shopping around for their healthcare and they are looking for providers who are transparent on pricing. The vast majority of consumers, 92%, want to know what they’re going to pay before their appointment.
Instead of being perceived as hiding costs or making it much more difficult for them to find, make it known on your website. Include a calculator to help them determine costs and layout the costs clearly, either on the webpage or a downloadable PDF. This gives patients an idea of what their costs could be so there can be fewer foreseeable issues.
Improve the Billing Cycle
A 2016 Kaiser Family Foundation survey found that 26% of participants have trouble paying their medical bills. Healthcare reform still has a ways to go and consumers are looking to providers to offer better options now, such as payment plans, pre-payment options and multiple forms of payment.
You can also incorporate psychographic messaging into your communications to encourage patients to take action on their bills. Psychographics pertain to the beliefs, values, attitudes and lifestyles a patient has and categorizes them a specific segment based on those parameters. That segment determines the messaging directed at patients so that they are more likely to follow through on action steps they’re presented. This results not only in better patient engagement but also in better health outcomes.
Utilize Digital Health Platforms
An all-encompassing platform is the best way to keep patients engaged and to put everything in one place. PatientBond’s Digital Health Platform provides a digital triage of services that engage patients from the moment they’re aware of your practice to when they are a loyal patient, all in a HIPAA compliant platform. PatientBond’s platform includes video consults, two-way messaging, remote monitoring and psychographic-focused patient engagement services tailored to the patient. While other services use general tactics to engage patients, PatientBond’s digital health platform is hyper-focused so that patients are more willing to engage and take action on their health, including their patient responsibility payments.
There is still more work to be done to prevent surprise billing, but by communicating with patients throughout the process, you will be much more successful at getting all of your patients to pay their bills.
Get a step-by-step guide for increasing patient financial responsibility payments at your practice with our patient payments tip sheet.