Healthcare is a constantly shifting landscape. As healthcare providers work to deliver excellent patient care while staying on top of their revenue, they need help improving the patent’s financial journey. Patients have become increasingly responsible for their healthcare costs, which has led to confusion around billing, payment schedules and financial accessibility. Let’s look at the evolution of patient financial responsibility and how your operation can use the right tools to make the patient’s financial journey more clear and simple to navigate. 

How Patient Financial Responsibility Has Changed

Healthcare costs before the 20th century were relatively low because people typically received care in their homes rather than in a hospital. Medical and social advances in the early 1900s led to the development of healthcare payment plans and insurance, beginning with Baylor Hospital’s introduction of the first prepaid hospital insurance plan in 1929.

Patients generally had minimal financial responsibility for medical care until healthcare payment plans took off in the middle of the century. Retirees and unemployed people struggled to get healthcare coverage as a result of rising premiums, which led to stronger government programs that limited patient payment responsibility.

The Affordable Care Act and Medicaid are two prominent examples of programs and initiatives that limited direct financial burdens on individuals and families, shifting most of the responsibility for payment to the government and insurance providers.

A Focus on Reimbursement From Payers

This system led to an emphasis on payer reimbursement. Healthcare providers worked to get reimbursement from entities like insurance companies and the government since they covered most healthcare expenses. Provider resources were focused on submitting claims, navigating insurance billing and getting timely payments from payers, not patients.

A system that emphasized payer reimbursement impacted the revenue cycle for healthcare operations. Providers’ billing, registration, claims processing and payment collection were all directed to payers. Providers tried to maximize reimbursement from payers. Since patients had limited involvement with payment processes, revenue cycle operations were less complex compared to modern systems.

Healthcare Consumer Financial Responsibility Today

Advances in surgery and medical care might have kicked off the need for insurance and healthcare coverage, but the financial responsibility for medical care has changed.

Today, 60% of U.S. adults have a chronic disease. In 2020, 86% of healthcare spending was spent on patients with at least one chronic condition. With so many patients needing chronic care, costs have increased for healthcare providers and payers. Additionally, the 1980s brought a shift away from government social programs and towards corporate healthcare structures. Decreasing government support and increasing medical needs and costs have changed how the healthcare consumer handles medical payments.

Increased Patient Responsibility

These shifts in political action, rising healthcare costs and increases in high-deductible insurance plans have increased patient financial responsibility. As a result, patients are now expected to take on a larger portion of their healthcare expenses, including deductibles, copayments and coinsurance. Patients are more involved in the payment process than ever, creating a complex system between the government, patients, insurance companies and healthcare providers.

The Impacts on Revenue Cycle Operations

While revenue in the past mainly came from insurance companies and third-party payers, the landscape has changed. Providers must now navigate a complex landscape that includes more patient payments. This has meant changing revenue cycle strategies and supporting better patient payment processes.

Your team has to spend more time managing patient accounts, verifying coverage and communicating with patients about their financial responsibility for care than ever before. Healthcare organizations need more sophisticated financial management practices as patient responsibilities increase. This includes using solutions like patient payment portals and revenue cycle management software. Additionally, you need a simple way to communicate with patients to help them navigate the system and understand their responsibilities.

How to Adapt to Increased Patient Responsibility

Increasing responsibility and costs have left healthcare consumers behind. In 2021, 87% of consumers received a medical bill that surprised them. Complex billing language, poor reminders and confusing systems can leave patients struggling to pay bills and cause healthcare facilities to be short on cash flow. Healthcare providers can turn to patient payment platforms to streamline the payment process and improve the patient experience. These platforms take the administrative burden off your operation and help patients feel more comfortable navigating healthcare financial processes and payments.

Here’s how point-of-service collections and payment platforms can make the payment process easier and more convenient for patients and providers:

Greater transparency: Patient payment platforms give patients better visibility and transparency. These platforms let patients view detailed billing statements and benefits explanations, allowing them to understand exactly what they’re being charged for and why. Greater transparency means less confusion, helping patients make more informed decisions about their healthcare spending.

Improved convenience: These platforms give patients convenient payment options. They can pay online using credit, debit, or digital wallets, as well as easily accessing their balances via statement QR codes or text to pay. Flexible payment plans and financing options help patients manage their bills over time. These solutions let patients easily pay their bills online with minimal stress.

Easier to understand: A quality payment platform will also feature user-friendly interfaces and an intuitive design. This design lets patients seamlessly access their accounts and make payments anytime, from anywhere. Improved accessibility and understanding means patients can stay on top of their healthcare finances without getting lost.

More streamlined revenue cycle: Patient payment platforms also help streamline your revenue cycle operations. These platforms automate billing and collections processes, such as invoice generation, payment processing and reminder sending. Your revenue cycle staff can focus their time and resources on more time-intensive activities like complex billing issues or helping patients with financial assistance programs.

Let Millennia Take Care of Your Patients

Getting patients to understand their financial responsibilities, submit payments on time and monitor important information is challenging. Using the right tools can make the process more convenient for patients. With better patient engagement, you’ll see increased revenue and on-time payments, helping your revenue cycle.

A cutting-edge, all-in-one patient processing software can help you simplify payments and enhance patient engagement with features like secure self-payment options, mobile payment convenience and real-time chat support.

If you want to transform your patient revenue recovery process, contact us to learn more about Millennia’s Patient Payment Solution today!

About The Author

Kevin Hidenfelter

Kevin Hidenfelter is Millennia’s Executive Vice President of Sales and Marketing. He joined the team in 2022 with 25 years of experience in healthcare services and technology. With 14 years of experience in healthcare revenue cycle management, Kevin is very passionate about improving the patient experience.

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