2017 Patient Payment Check-Up

2017 Patient Payment Check-up

February 20, 2017

Phil Dolan

Chief Marketing Officer

Navicure®

Bryan Fiekers

Sr. Director, Research Services

HIMSS Analytics

What Are We Going to Cover

© 2016 Navicure, Inc. All Rights Reserved. 2

About Navicure

Importance of Research

Research Methodology

Attitudes around Cost Estimates

Attitudes around Bill Payment

Opportunities for Improvement

Key Takeaways

Who is Navicure®

© 2016 Navicure, Inc. All Rights Reserved.

Navicure is a provider of cloud-based revenue

cycle management solutions, each designed to:

Increase Revenue

Accelerate Cash Flow

Reduce the Cost and Effort of Staff

Integrated on a Single Platform

Who is Navicure®

© 2016 Navicure, Inc. All Rights Reserved.

Headquartered in Atlanta, GA

300+ Employees, all US-based

8,000+ Clients, 100,000+ Providers, 350+ Facilities

All Care Settings, including Hospitals, & Practices

Award-Winning Solutions and Service

Best in KLAS, Black Book, Stevie Awards

30+ Leading EMR, PMS, HIS Partners

Allscripts, eClinicalWorks, Epic, Greenway, Nextgen

Healthcare Management Partners

MGMA, HIMSS, AMGA, HFMA, RBMA, HBMA

Partnered with Leading Investment FirmBain Capital Private Equity

The Healthcare Landscape is Shifting


• The care delivery paradigm is starting to shift from Volume to Value

• EMRAM shows that organizations are becoming increasingly sophisticated related to technology• Access to data is driving a trend toward consumerism

• Patient financial obligations and patient choice are at the heart of consumerism

This research focused on what patients and providers are expecting from each other related to payments, and how the attitudes and expectations are changing

Data Collection and Analysis


To provide insights into behavioral

trends among providers and patients

Through a blinded, web-based, voice-

of-customer quantitative study with

personnel at provider facilities and

patients

In order to create content around

billing and payment challenges

uncovered

Demographics


Targeted: Executives, C-Suite, business

office, financial, revenue cycle and IT

leaders at hospitals and healthcare

systems; providers, office managers and

practice managers at outpatient facilities

– Contacts via:

Recruitment: Web survey link open

between January 6 and January 30, 2017

Targeted: Individuals that visited a provider setting (inpatient or outpatient) in the last 12 months

Qualifying criteria:– 18 year old or older

– Not covered by parent or guardian insurance policy

– Does not work for healthcare technology company

Recruitment: Web survey link open between January 16 and January 20, 2017

1,000 Respondents

Patient Provider

553 Respondents

Generally, Patients Feel the Same Responsibility to Pay Healthcare Expenses as Other Professional Services


86.1%

13.9%

Do you feel the same responsibility to pay for healthcare services as you do other professional services, e.g. lawyer, accountant,

child care, home contractor, dry cleaners, etc.?

Yes

No

Are patients starting

to expect the same

ability to compare

healthcare services

as they do when they

are shopping for a

vehicle?

Current State: Three Quarters of Organizations are Able to Provide a Cost Estimate, but Patients Do Not Ask

9

25.3%

74.7%

Is your organization able to provide patients a cost estimate upon request?

No

Yes

1.2%

3.7%

3.8%

5.3%

9.8%

76.2%

0% 10% 20% 30% 40% 50% 60% 70% 80%

After I left; before I wasbilled

After seeing the provider,but still in the office

When I checked in

After scheduling appt

Prior to scheduling appt

Never

N = 861

Did you request a cost estimate for your last visit or procedure, and if so, when?

N = 553

Future State: 56% of Patient Respondents Would Request a Cost Estimate in the Future


27.9%

16.1%

2.8%

4.6%

5.1%

13.3%

30.2%

0% 5% 10% 15% 20% 25% 30% 35%

No, an explanation of costs with my bill is fine

Sometimes but not always, depending on thepurpose of seeing my provider

Yes, after I leave the office but before I receive my bill

Yes, after seeing the provider, but in the office beforeI left

Yes, when I check in before seeing my provider

Yes, between scheduling my appointment and seeingmy provider

Yes, before scheduling my appointment

N = 1,000

Would you plan to request a cost estimate from your healthcare providers in the future, and if so, when would you find it most useful?

Two out of Three Participants Say an Estimate Within 10% of the Actual Cost is Adequate


1.7%

4.1%

11.5%

64.0%

18.9%

0% 10% 20% 30% 40% 50% 60% 70%

Other

Within 30%

Within 20%

Within 10%

Any estimate is helpful

N = 1,000

If you were to receive a patient cost estimate for a procedure or office visit, how close to your actual cost would the estimate need to be considered a good estimate?

Patients Tend to NOT Compare Prices; When They Do it is Impactful


No, 86.2%

Yes, 13.8%

Did you compare healthcare prices between potential providers related to your last healthcare experience?

75% Of those that compared prices are between 18 and 34

17.3%

10.8%

26.6%

18.7%

26.6%

0%

5%

10%

15%

20%

25%

30%

<6 7 8 9 10

N = 139

How much influence did your price comparison have?

Of the 25% of Providers Not Providing Cost Estimates, 44% Have No Plans to Provide

13

7.1%

7.1%

7.9%

34.3%

43.6%

0% 10% 20% 30% 40% 50%

Yes, within the next 6 months

Yes, within the next two years

Yes, within the next year

Unsure

No current plan

N = 140

Do you currently have plans to offer cost estimates to improve your organization’s patient experience?

Why not?

Providers Believe Patients are Less Comfortable Submitting Their eMail Address than Patients Report to Be

14

3.6%1.3% 1.6% 5.4%

9.5%

19.9%

58.7%

3.8% 2.9%4.9% 12.7%

19.2%

24.4%

32.2%

0%

10%

20%

30%

40%

50%

60%

70%

1 2 3 4 5 6 7

How comfortable are you with submitting your email address to your providers when requested?

Patients (N = 1,000) Providers (N = 553)

Very ComfortableUncomfortable

If we can accurately predict costs, how do patients want to pay for services?

15

Current State: 90% of Organizations Send Paper Bills Through the Mail; Half of Patients Would Prefer Some Form of eBilling

16

1.8%

0.9%

12.7%

89.2%

4.2%

12.7%

17.2%

17.5%

48.4%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Electronically via text with link to viewbill on a mobile device

Electronically via e-mail and text toview bill wherever I am

Electronically via e-mail linked topatient portal

Electronically via e-mail withattachment to view bill

Paper bills via the mail

How do you (would you) prefer to receive bills from your providers?How does your organization send bills to patients? (select all that apply)

Patient Preference (N = 1,000)

Provider Billing (N = 553)

40.8%

Patients Report Paying Their Full Balance Much Faster than Provider Organizations Report Receiving Full Payment

17

5.2%

51.4%

22.8%

15.9%

4.7%

1.0%

4.2%

14.6%

17.7%

20.8%

18.8%

22.9%

0% 10% 20% 30% 40% 50% 60%

Never paid any of what is owed

Never paid some of what is owed

I have not been billed yet

More than 3 months

Between 2-3 months

Between 1-2 months

Less than one month

How long did you take to pay the full balance of what you owed?On average how long do your patients take to pay the full balance of what they owe?

Patients (N = 96)

Provider (N = 553)

78% of Participants Would Authorize a Credit Card Payment of $200 or Less

18

22.3%

31.7%

46.0%

0% 10% 20% 30% 40% 50%

I would refuse to provide my healthcare provider with my debitor credit card to be charged one time for what I owe, up to

$200, even if it meant that I could not see my provider

I would provide my card to be charged one time for what I oweup to $200 if required to see my provider; however, I would not

feel comfortable doing it

I would feel comfortable submitting my debit or credit card to becharged one time for what I owe, up to $200, after my

insurance company pays its portion. The rest would be billed orpaid via an automated payment plan.

N = 1,000

In order to see the provider, if the office required you to securely store your debit/credit card in its system and charged your card for actual charges up to $200 one time only after insurance pays its responsibility, how

comfortable would you feel?

Providers: Online Bill Pay and Securely Storing Patient Card Information would Reductions in Cost of Collections

19

1.8%

20.2%

22.0%

14.6%

10.2%

12.2%

0% 5% 10% 15% 20% 25%

Other

Secure credit card on file, charging one time upto $200 once patient responsibility is known

Online bill pay

Electronic statements

Consumer credit line, e.g. CareCredit

Automated payment plans

What payment option do you think would be the most likely to create reductions in Cost of Collections?

N = 549

Key Takeaways

20

Patient Cost Estimates

• Provider organizations claim to be able to provide a cost estimate upon request, yet less than 25% of

patients requested one

• Over two-thirds of patients would find an estimate within 10% or more of their actual cost helpful.

Patient Billing

• Providers believe patients are less comfortable providing email addresses than patients report to be.

• Over half of all patients (52%) surveyed would prefer to be billed electronically vs. paper.

• Providers and patients disagree on how long it takes patients to pay.

Patient Payments

• Among payment methods that a provider organization can provide its patients, patients view credit card-on-

file (CCOF) as their preferred method for charges of $200 or less.

• Over three-quarters (78%) of patients say they would provide their debit or credit card number to be charged

one time up to $200 after claim adjudication if asked by their provider.

• Credit card-on-file (CCOF) is viewed by providers as the best way to improve patient collections.

Thank you!

Phil Dolan, Navicure: 770.342.0271/ [email protected]

Bryan Fiekers, HIMSS Analytics: 312-497.6617/ [email protected]

mailto:[email protected]

mailto:[email protected]