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Better patient experience hinges on improving financial journey.

In an increasingly competitive and consumer-driven healthcare marketplace, it's no surprise that providers are working harder to acquire and retain consumers. Higher out-of-pocket costs combined with more choice and control in when and where consumers receive care is driving more retail-like shopping behavior.

As a result, healthcare organizations are looking for ways to slow or stop consumer churn, drive engagement, and redefine how they interact with their customers versus seeing them through a transactional lens. Providers understand they must deliver a positive overall experience to maintain a favorable brand in the community and earn customer loyalty--key factors in maintaining their financial solvency.

Prioritizing consumerism efforts in healthcare for the best ROI

With so much to consider when addressing the patient experience, where should providers start?

According to a national survey of more than 1,000 consumers and select providers conducted by Experian Health, addressing the financial experience during the healthcare journey seems to be the bull's eye. Findings show that of all the activities along a consumer's healthcare experience--from acquiring health insurance to making appointments with providers to receiving treatment--the top "pain points" relate to money matters. Whether it's confusion about what their health insurance covers, or not understanding medical bills, consumers' biggest dissatisfaction centers on the complex process of understanding costs and paying for their care.

More specifically, one of the most glaring opportunities for improvement in the healthcare consumer experience is early on in the journey around price transparency and understanding one's ability and options to pay for care, such as whether their insurance covers a procedure or how much their out-of-pocket charges will be.

Optimizing the revenue cycle improves satisfaction and bottom line

To meet the new demands of consumerism, a healthcare organization must implement a frictionless financial experience through a customer-centric revenue cycle. As consumers begin to shop for procedures at different facilities, providing accurate, up-front estimates is a necessity. Using automated technology that monitors claims data, realtime eligibility and benefits information, payer contracts, and charge description master information not only ensures payers are fully meeting their obligations, it also allows for accurate price transparency and consumer estimates for their cost of care.

In advance of their procedure, the customer-centric revenue cycle incorporates credit data to understand a customer's propensity to pay, helping to identify the best financial pathway (e.g., financial assistance, payment plans) for each customer. Additionally, healthcare organizations need to provide customers with direct access to their provider and their data, with a proactive, simple, and compassionate mobile-first experience. This will enable customers to easily activate payment plans, apply for financial assistance, estimate the cost of care, and review insurance benefits--immediately creating a better consumer experience, from the moment they begin interacting with their provider.

Using credit data improves the healthcare customer's satisfaction by personalizing the billing experience and assisting with funding sources, and can also improve financial performance for healthcare organizations by optimizing accounts-receivable performance. Experian Health has dozens of large health systems across the U.S. that leverage credit data throughout the revenue cycle process. In 2017, these customers confirmed that the use of the credit data provided over $230 million in tangible return on investment to their organizations.

When healthcare organizations incorporate this type of credit and reference data into their revenue cycle workflows, they will also be able to address clinical, administrative, and quality improvements like preventing inappropriate care, redundant tests, and medical errors, as well. Reference data from a credit bureau can assign a Unique Patient Identifier to help create a complete, longitudinal patient record across an enterprise and continuum of care. This type of reference data can also reduce the duplicate medical record rate by finding matches that traditional MPIs/EMPIs miss.

Ultimately, data is what will drive better consumer experiences in healthcare, as it gives patients a more pleasant and engaging experience because they are well-informed. Consumers will feel they can make better decisions about their care--and have a better financial experience, too. Addressing two key major pain points of (1) providing transparency of healthcare out-of-pocket costs and (2) providing consumers with personalized payment plans and access to alternate funding sources are the arrows healthcare organizations need today to hit that consumer bull's eye. Providers can holistically improve the patient journey through price transparency and payment options, while harnessing data to proactively and strategically streamline operations, improve collections, and measure performance.


(1.) Change Health, ORC 2017 Study: "The Engagement Gap: Healthcare Consumer Engagement in 2017"

(2.) Black Book Research press release: "Improving Provider Interoperability Congruently Increasing Patient Record Error Rates, Black Book Survey," April 12,2018

By Jason Considine

Jason Considine

SeniorVice President, Patient Access Collections & Engagement, Experian Health

According to a 2017 survey from 0RC International, 72% of providers said consumer-centric strategies are very important, and 88% made staffing changes related to consumer-centric initiatives. (1)

Approximately 33% of all denied claims are associated with inaccurate patient identification, which costs the average hospital $1.5 million and the U.S. healthcare system more than $6 billion annually. (2)
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Author:Considine, Jason
Publication:Health Management Technology
Geographic Code:1USA
Date:Jul 1, 2018
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