Health Management Technology

News flash: Health Savings Accounts (HSA) are a boon to large corporations and consumers, reducing healthcare costs for businesses while empowering patients to take control of everything from where they seek treatment to how they pay for services. Not so new, right?

Indeed, we’ve been watching this trend escalate for a number of years now, and healthcare organizations continue to operate in catch-up mode, seeking solutions—from administrative to technological—that will help them deal with the inevitable growth of consumer-driven healthcare.

While many in the industry have yet to form a solidified opinion on HSAs, it’s time we face the music: These new billing standards also offer hospitals a golden opportunity to improve a patient’s entire experience with a healthcare organization, from the first point of inquiry to the final billing. In fact, in the very near future, “happy patients” will become the benchmark for success when it comes to the financial health of hospitals in America.

Service Solutions

Recent studies indicate healthcare administrators should jump at this opportunity: A 2006 national healthcare satisfaction report from Press Ganey Associates Inc. concluded the healthcare industry in general “is not successfully responding to the opportunities for improvement presented by its customers.” Moreover, with a growing number of consumers becoming proactive with researching and selecting their own healthcare options, a new era of “customer service” is now in play at hospitals and other healthcare facilities.

Just as a consumer today can pick and choose where to get a car repaired based on pricing, staff experience, convenience and customer service, so too can HSA patients pick and choose the medical facility where they receive care and treatment, based largely on the same criteria. The consumer-driven playing field can actually help healthcare organizations both alter existing negative consumer perception and ensure repeat business in the following five ways: 1) Urging the institution of a more comprehensive financial clearance process as a pre-service; 2) Pushing the adoption of online access to consolidated, consumer-focused billing; 3) Requiring customer service and pricing transparency in hospitals, as patients with HSAs are empowered to be the “first payer” following treatment; 4) Forcing hospitals to put in place procedures and technologies that facilitate information flow between the patient and the administrative staff; and, 5) Ensuring the correct patient information is collected only once, and is disseminated to all relevant administrative departments.

Priorities

We already know that non-emergency patients are happier when they can simply show up for prescheduled treatment and quickly be checked in without providing their contact and billing information over and over. They appreciate thinking that every person they encounter, from the front lobby to the nurses’ station, is thinking only of how to best care for them—not about how the hospital will be paid for services.

Of course, most patients aren’t naïve enough to believe hospitals exist purely for altruistic reasons. But how can their “patient experience” be improved, and how can hospitals, therefore, become the kind of service provider consumers seek out? First, it’s critical to separate the financial side of treating a patient with the actual clinical treatment of that patient. Patient satisfaction surveys at hospitals routinely indicate that patients often feel like the hospital cares more about their financial status than their health status.

And why wouldn’t they? Patients’ first encounters too often occur at check-in, where the primary focus of the hospital administrative staff is how well insured they are, and whether they understand their personal financial obligation should their insurance company not pay claims in full. So what do consumers really want? They want, and increasingly expect, to give hospitals relevant information only once and to have all of their records, from treatment to billing, be accurate and accessible by all departments on demand.

Policies and Systems

Accurate and accessible information is especially critical for HSA patients since they are increasingly becoming the hospital’s first payer. And while it may seem to be such a small piece of the healthcare picture, for consumers, it is at the top of the list when it comes to what they want when they enter a facility. Research indicates that HSA patients are savvy consumers, who want transparency in pricing and the opportunity to ask billing-related questions before turning their complete attention to their medical situation.

For the healthcare organization, this means not only developing new policies for communicating pricing information, but also creating new systems that facilitate the gambit of administrative protocols through which patients are funneled. Disseminating pricing information up front, reviewing the patient’s financial obligations and ability to pay are some issues that these process improvements should address. Completing the necessary follow-up with the patient, including approval for access to the HSA funds, and verifying that funds are available for payment are additional protocols that should be better facilitated.

A primary challenge for everyone is the ability to accurately maintain balances in the patient’s HSA, especially in an environment where several providers are clamoring for payment at one time. The patient must be able to track the total out-of-pocket expenses for all services, and hospitals require the capability to simply and accurately provide them with the information to do so.

Technology is Key

As more banks are stepping into the picture to process debits against HSA accounts, consumers and hospitals alike must be able to understand not only the cost of the services but also the availability of payment for those services. These new systems, then, must connect the front-end processes with the back end, procuring payment in a timely, accurate manner and with minimal impact to the hospital’s workflow—and minimal additional contact with the patient on billing matters.

But how? Hospitals must deploy end-to-end solutions that streamline cash flow and speed up the reimbursement process. They must use an electronic system that allows direct access to federal health insurance programs and must be able to link together all patient information to ensure a true and complete financial picture.

In other words, the right technology and systems will help hospitals embrace the HSA patient and improve lagging patient satisfaction by providing the tools and information that will allow them to better address the patient’s needs. Each day, consumers are gaining power. Hospitals must find new methods of satisfying patient demands in unprecedented ways, and technology holds the key to meeting those demands.

Sheila Schweitzer is chairperson and CEO
of CareMedic Systems Inc. in St. Petersburg, Florida.
Contact her at sschweitzer@caremedic.com.