Developing a Patient Collection Strategy for a Growing Health System

July 09, 2019 - Hospital mergers and acquisitions have the potential to improve affordability, care access, and innovation. But rapid growth has not necessarily helped patients pay their growing financial responsibility.

That was the case at OhioHealth. Like many health systems across the nation, the health system has undergone significant growth over the last couple of years. The non-profit health system now boasts 12 hospitals and over 200 ambulatory care sites across Ohio.

Expanding its footprint to 47 counties has allowed OhioHealth to reach more patients and providers to improve care across the state. However, the merging of different provider organizations left many patients confused about how to pay their medical bills, OhioHealth’s Jason Glenn recently explained.

“At OhioHealth, our main challenge was identifying how we can make it easier for patients to pay. That was one of the biggest challenges with some of our current processes and systems that we had in place. Combine that with rapid growth over the last five to ten years, and we had a lot of opportunities to make it easier for patients to pay,” the director of revenue cycle recently told RevCycleIntelligence.com.

High deductible health plans and greater out-of-pocket costs continue to drive patient financial responsibility up. On average, patients owed 12 percent more in out-of-pocket costs from 2017 to 2018, and in the period before that, patients saw their financial responsibility increase by 11 percent.

READ MORE: Key Ways to Boost Collection of Patient Financial Responsibility

But just because patients owe more to their providers does not mean it has become easier to pay. In fact, an April 2019 report found that 90 percent of providers rely on paper and other manual processes to collect from patients.

Furthermore, only about one-third of hospitals and health systems recently analyzed by consulting firm Kaufman Hall have at least a “thoughtful” approach to becoming more consumer-centric, which includes more convenient, electronic patient collection capabilities.

Part of OhioHealth’s problem with developing the necessary capabilities to ease patient collection problems was the patchwork of IT systems and EHRs its new providers used.

“We had different processes in place depending on where patients were seen within the system. A lot of that was due to growth and acquisitions over the years, which resulted in the inheritance of different software and patient portals,” Glenn said. “The majority of our hospitals are also on Epic, but we had a few outliers who had some other patient accounting systems in place.”

Different processes and IT systems impacted OhioHealth’s online patient collection process, which allowed patients to pay their financial responsibility through the health system’s website. Without uniform systems, the website could not easily pull up accounts for patients receiving services at certain facilities.

READ MORE: 3 Patient Collections Best Practices to Boost the Bottom Line

“We wanted to make it easier for patients to pay regardless of what hospital, physician practice, or urgent care center they went to and what EMR that facility used,” Glenn stated. “We had to combine all of the systems and consolidate them into one platform to make it quick and simple for the patient to pay.”

The health system partnered with RevSpring to combine patient records from across systems and hospitals so the website could find patient financial responsibility in just two clicks.

“The patient can now use quick pay. They enter an account number and their date of birth and the website pulls up any balance they have open at any of our hospitals. In two clicks, they can get to the bill pay page to see and pay their bill,” Glenn highlighted.

The system also enabled OhioHealth to simultaneously improve and consolidate patient statements to improve the collection process. RevSpring’s propensity to pay scoring feature allowed the health system to personalize patient statements while creating a uniform process across the organization.

“Our entire statement design focused on what the patient’s next steps were whether it be financial assistance or setting up a payment plan. The propensity to pay score determines what the next step is or what that patient is going to see first on the statement,” Glenn explained.

READ MORE: Patient Financial Experience the New Focus for Revenue Cycle Tech

For example, if a patient has a history of using financial assistance or going into bad debt, the statement will first draw the patient’s attention to OhioHealth’s financial assistance application, whereas a patient with no history of outstanding debt would be directed to pay the bill online. It would not be until the third or fourth statement that such a patient would see a payment plan or financial assistance option at the top of their statement.

“It's more of a smart patient billing cycle versus doing everything the same for thousands of patients. We are trying to use data to drive the results that we want, as well as the results that are going to be the most impactful to patients and their families,” Glenn stated.

Making online patient collections more accessible and optimizing patient statements across the growing organization has led to a significant increase in self-pay and self-pay cash, the revenue cycle leader reported.

“When we compare year-over-year, we've seen more self-pay patients paying their bills and less going to bad debt,” he said. “We have also noticed a reduction in self-pay A/R days purely because patients are paying faster than they were previously, and we think that's a testament to making online bill pay more accessible.”

The revenue cycle leader has also noticed a dramatic uptick in online patient collection. After about a year, about 40 percent of OhioHealth patients have used the website to pay their financial responsibility.

The current online adoption rate is a noticeable difference from the previous 15 to 20 percent rate.

“Patients were calling into the call center to pay their bill or they maling a check. Now, we're seeing patients paying online, which is what we want. We want patients to be able to self-serve,” Glenn said.

Most importantly, Glenn also anticipates OhioHealth’s new patient collection strategy to grow with the organization.

“When we were designing the online bill pay feature, we also wanted to think about future acquisitions and the potentially different EMR systems that we might inherit,” he said. “We selected a tool and a company that's able to help pull those systems and their data into the same platform. They can work across any system out there and have the technology to do so rapidly because we do change very rapidly.”

Hospital mergers and acquisitions do not appear to be slowing down in the near future, but having a patient collection strategy and system in place that can expand with providers is helping organizations like OhioHealth navigate the changing healthcare landscape.