While physicians and medical staff certainly consider patient care their priority, those same priorities don’t always apply for patients when it
comes time to pay their medical bills.
The growing popularity of high-deductible
health plans (HDHPs), coupled with health savings accounts (HSAs), has shifted the payment
responsibility away from payers and toward
patients. Over the past decade, HDHPs with
HSAs have grown nearly 400% to 21. 8 million in
2017, including an 8% increase between 2016
According to Internal Revenue Service (IRS)
rules, a HDHP has a minimum deductible of
$1,350 for an individual and double that for a
family. In-network, out-of-pocket expenses can’t
exceed $6,650 for an individual and $13,300 for
a family, a limit that doesn’t include any out-of-network care. 2
These costs represent a significant financial
burden for most families. Practices, however,
have been slow to catch on to this trend.
Front-office staff at many practices are adept
at collecting copays, but aren’t trained to prop-
erly educate patients about the ultimate cost
of their care or how to proactively engage with
them on payment options.
While cost estimator tools can help, patients
continue to bristle at pre-paying for care.
There is a fear of overpayment and potential
struggle to recoup their money from providers.
However, focusing on calculating payments
using accurate cost estimator tools, and
producing accurate claims at the outset, can
go a long way to help reassure patients and
increase upfront payments.
Medicare and Medicaid still dominate how health
By Timothy Mills
systems and providers get paid, but patients
recently surpassed private payers as the third
highest source of reimbursement. Patients now
account for 35% of provider revenue, up from
just 5% at the turn of the millennium. 3
High-deductible plans were initially viewed
as an insurance alternative for low-risk con-
sumers. But ever-escalating healthcare costs
Improve workflows, technology
to increase patient pay
Over 72% of
said they were
willing and able
to pay for medical