Almost all hospitals and doctors today affirm that patient-pay revenue is a larger part of their billable accounts receivable. According to Visa, it represents 25% of every revenue dollar booked. However, for every eleven (11) patients billed, only one (1) patient will pay the provider within the first billing cycle. This performance (or lack thereof) applies to patient accounts of all shapes and sizes. In fact, whether uninsured, Medicare or balances after private insurance, more than ½ of balances less than $100 are headed to bad debt status and more than 90% of patient accounts greater than $500 are still unpaid after 90 days. And once an account is sent to collections, pennies on the dollar are the best result providers can expect. All in all, 50% or more of all patient-pay revenue goes uncollected.
So, what should healthcare providers do? Hospitals and doctors provide exceptional healthcare, save lives, cure disease, fix injuries, and yet, when they send a bill to patient for their services, many patients won’t pay it, and they may actually hate them for it.
We’ve talked to hundreds of hospitals and doctors, and researched the issue of patient medical bill payments in-depth, and here’s how we see it. To begin, the problem is getting worse, and will continue to worsen. Patient bad debt is growing on practically all healthcare provider balance sheets. And at the same time, we will continue to see a greater percentage of healthcare costs being shifted to the patient even with the launch of healthcare reform. So let’s start to dig a little deeper and try to uncover what works and what doesn’t when it comes to patient medical bills, and how and when they pay.
It is important to first recognize that the use of the Internet to remit payment for household bills is a widely-accepted practice. According to Checkfree, 75% of consumers pay their bills online, and the average household pays 11 out of 16 bills online on a monthly basis. But there seems to be an obvious disconnect within healthcare, as only about 25% of doctors, and about 40% of hospitals, accept online payments from patients. Quite simply, when hospitals and doctors bill patients and do not take online payments, they are already handicapping performance, because from a consumer’s perspective, online patient-payment options are virtually mandatory.
We also know that Americans LOVE a good money-saving deal, and that the majority of us are influenced by sales and discounts. An interesting growth trend to follow closely is the broader practice of patients successfully negotiating the price of a medical bill. This practice is rapidly becoming more mainstream. Popular websites with millions of users like Angie’s List now rate medical providers and their willingness to negotiate with their patients. It’s even being used to advance political ambitions, and patient bill negotiations were actually a point of focus in the senatorial race in Nevada.
And what other consumer industries have shown is that increasing the volume of revenues and payments can impact the bottom-line the most. Priceline’s Jay Walker taught the hotel industry that it’s not about selling rooms at a lower price, but rather filling up all the empty ones. In a consumer-driven marketplace, the cost of a product or service has to be correlated to what the market will bear and what consumers can and will pay. Technology and the Internet have armed the consumer with more information, transparency and the ability to be empowered. And as more costs have been shifted directly to the patient, many hospitals and doctors are now looking at a lot of empty hotel rooms in the form of unpaid medical bills.
Many healthcare providers look at this challenge and see their patients as debtors, not consumers, and are tempted to step-up more aggressive collection practices. But healthcare providers can’t afford that risk in today’s consumer-driven environment. Traditional debt collection practices may be necessary in some cases, but these are not strategies to increase patient satisfaction and loyalty. It is very expensive to recover a dissatisfied patient, and it costs lots of money to attract new patients, versus just keeping existing patients happy. More importantly, should a healthcare provider find themselves battling a negative perception of their hospital or practice locally or in social media, it can take a LONG time to change that image. In today’s age of social media and instant information, you may find yourself fighting a losing battle.
Let’s face it, patients are consumers. They are smart, savvy, informed and there are certain rules that need to be followed. Hospitals and doctors must find a way to apply these consumer-driven rules or face worsening financial performance. Consumers want to be rewarded for their loyalty and payment – it’s that simple. It’s not enough to just provide your service and get paid. You have to provide your service, then offer as much value as you can on the price, and then more will pay. Providers must take online payments. And above all, consumers want control of their price. They now know that insurance companies and government reimbursement programs have a seat at the negotiation table, and they want one too and will not pay you if they don’t get that seat. The price of healthcare charged to consumers cannot just be a cost plus margin formula. The price is only what the market will bear determined by what patients will pay. That’s the new financial reality for hospitals and doctors when working with patients today.








