The new year is the opportune time not only to reflect, but also to engage in meaningful conversations about rede- signing your whole approach to revenue cycle management (RCM). Those of us with time spent in the world of billing
and payments are accustomed to revenue-cycle challenges, like
spikes in denials or declining reimbursement rates. What we’re less
accustomed to is asking patients to pay a significant portion of
their medical costs, especially when they least expect a bill.
For most practices, that’s about to change dramatically—if
it hasn’t already.
Patients are now the third largest payer, per a 2017
TransUnion analysis, which pointed out that as many as 68%
of patients with bills of $500 or less did not pay their balance.
In addition, patients saw an increase in average out-of-pocket
costs by 11% in 2017 to $1,813, from $1,630 in the fourth quar-
ter of the previous year. 1
These data points coincide with the growth of high-deductible health plans (HDHPs), with average annual
deductibles as high as $6,550 for individuals and $13,100 for
families. 2 According to a recent Kaiser/HRET Survey, 51% of
covered workers in 2017 reported an annual deductible of
$1,000 or more for single coverage, up 34% from 2012.3
As a result, the once-rogue patient who defaulted on a
medical bill is no longer an anomaly. What’s possibly worse is
many physicians don’t even realize the extent of this problem
because it hasn’t caught up with them. We must understand
how our outdated technologies, habits, and workflows are
inconsistent with patient payment and billing trends.
2006 2007 2008 2009 2010 2011
Average deductible for
single coverage among
Source: Kaiser Family Foundation, 2017 Employer Health Benefits Survey
Buy Now, Pay
By Matt Seefeld