The unprecedented challenges health systems face today are well publicized — from rising costs to scarce labor to shrinking margins — each of which is compounded by the ever-increasing portion of revenue that falls under patient responsibility. Patients simply can’t keep up. Even insured patients now represent 60% of bad debt accounts, leaving 18-35% of Americans with medical debt in collections. Moreover, persistent labor shortages — 90% of revenue cycle leaders report they are experiencing a labor shortage — only make account servicing harder and more costly. Hence, capturing patient revenue becomes more and more difficult and expensive.
For the last decade, many health systems have used a mix of approaches to manage patient payments, including unsophisticated patient portal solutions, in-house collection teams and third-party early out services. Each of these options presents challenges. While the hope is that patients will embrace managing payments digitally, adoption rates can be low and patients must decipher complex information, such as insurance benefits and payments, on their own. With current labor shortages, in-house service teams are harder than ever to recruit and retain. Early out providers vary widely in cost structure, are more inclined to focus on easy-to-collect accounts and have little incentive to drive patient adoption of digital self-pay tools. Given this, the standard approach lacks strategic alignment, resulting in higher costs and lower returns while also missing the mark on patient experience.
Patient experience is critical to revenue capture
Falling short on patient experience can have significant consequences. For instance, 63% of patients are reportedly ready to switch providers over a difficult payment experience. Healthcare providers need to address their entire patient obligation pool while driving more digital engagement and higher patient satisfaction. These challenges are the reason we introduced R1 Patient Resolution, a fundamentally different model for revenue performance and patient experience.
R1 Patient Resolution seamlessly integrates our market-leading digital financial engagement platform with its operational excellence and scale in servicing patient accounts. The result enables healthcare providers to use a new model for patient payments:
- Employ digital-first technology proven at enterprise scale: With decades of consumer finance expertise built in, patients readily adopt self-service tools to manage everything in one place for themselves and their families. The intuitive experience drives unmatched patient engagement and up to 40% more net-new cash. What’s more, the greatest improvement in payment rates tends to be among patients with moderate or low propensity to pay and those managing higher balances.
- Create personalized interactions across digital and agent encounters: Patients want to feel known by their healthcare provider. With best practices and supporting technology honed over years working with leading health systems, highly skilled service teams are equipped to provide personal, compassionate assistance that resolves more than 85% of issues on the first call, while continuously encouraging digital engagement.
- Realize higher performance with one perfectly aligned strategic partner: Central to this model is R1’s focus on aligning with partners that share the goal of improving patient experience while driving specifically identified performance metrics to increase operational efficiency, improve revenue performance and build patient loyalty.
A bold new approach is needed
With a fresh approach to revenue capture, healthcare providers can build stronger patient relationships while addressing the entire pool of revenue that falls under patient responsibility. Leading with intuitive, digital self-service tools and supporting patients with personalized customer service when needed drives more digital engagement. Ultimately, R1 helps health systems leverage the Patient Resolution solution to simplify their vendor footprint and reduce operating costs, while powerfully aligning incentives in a way that encourages digital self-service, drives net-new cash and increases patient satisfaction.
Learn more about overcoming patient payment challenges with R1 Patient Resolution.
Author bio: Nikolaus Trotta is the General Manager of the Patient Experience Business for R1 RCM.