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4 Insights into revving up rural patient financial engagement—digitally


Digital financial engagement offers significant opportunities to reach patients early in the financial stage of their encounter while lowering administrative costs.

digital healthcare graphic | © greenbutterfly - stock.adobe.com

© greenbutterfly - stock.adobe.com

As inflation reaches its fastest pace in 40 years, rural populations are feeling the pinch of higher prices for essentials like food, rent and gasoline acutely. Consequently, there is greater competition for limited dollars, which results in payment delays or defaults on monies owed.

Growing economic challenges are putting pressure on rural healthcare revenue cycle departments to engage patients early and give them confidence that they can manage the cost of their care. In addition, tighter operational margins are driving the need for systems and infrastructures that drive efficiency in self-pay collections while reducing the cost of financial engagement.

Digital financial engagement offers significant opportunities to reach patients early in the financial stage of their encounter, when fears about the “sticker shock” of care are highest, while lowering administrative costs like paper statements and postage.

For MainStreet Family Care, a leading provider of urgent care to rural residents in Alabama, Florida, Georgia and North Carolina, the move to digital-first notification of payment in 2019 resulted in an 11% decrease in paper statements—eliminating $6 per statement cycle to send. It also improved revenue capture, growing digital payment collections to 7% of all patient payments.

Notably, most digital payments are now sent within seven days of a text notification that payment is due, with 62% of these payments made the day of text notification and 84% sent within three days.

But there is more to engaging rural patients in digital payment than simply sending an electronic notification via patients’ smartphones. MainStreet Family Care’s experience points to nuances in digitally activating patient financial behavior in rural populations.

These four lessons learned stand out:

  1. Take time to craft the right text messaging for your population. The immediate response to digital payment notification by MainStreet Family Care was strong, but when the organization reached out to patients for feedback, leaders discovered that some felt the language used in the texts was a little too aggressive. In other instances, patients thought the messages were spam. With this feedback in hand, MainStreet took a second look at the messaging—which was limited by character count, much like a Twitter post—to soften the communications. Today, the initial message reads, “Thank you for your recent visit to MainStreet Family Care. You’ll now receive statements via text.” Refining the message enabled MainStreet to deliver a better digital experience. It’s a process the organization will undertake again to ensure the messaging still resonates with consumers in a high-inflation environment.
  2. Make patient financial services staff “digital ambassadors.” At MainStreet Family Care, staff in scheduling, registration, and financial services play an important role in preparing patients for text notifications, letting them know that a text will be sent to their phone when their statement is ready. This removes the element of surprise from digital communications around payment. It also helps increase the likelihood that individuals will open the text and engage with this payment vehicle. One tip: Create scripting for staff that helps introduce the concept of the organization’s text-to-payment feature. This helps staff feel more comfortable initiating these conversations and keeps messaging crisp and clear. This also provides an opportunity for front desk staff to double-check that smartphone notifications are sent to the patient’s preferred number.
  3. Give digital communications time to breathe. Allow a week for consumers to engage with the digital communications that are sent before mailing a print statement. At MainStreet Family Care, this approach has led to substantial cost savings since launching text-to-payment notifications in 2019. It also saves office staff time processing these manual statements and payments, enabling staff to spend time on more value-added work.
  4. Make the digital payment process as smooth as possible for consumers. It’s easy to assume that rural patients—who are not always a tech-forward population—will not be receptive to digital healthcare payment. At MainStreet Family Care, leaders sought a solution that would remove friction from the digital payment process by ensuring texts would link directly to the person’s bill and payment options, rather than requiring consumers to log onto a patient portal or set up an account. This creates a seamless experience that increases receptiveness to digital payment and paves the way for continued adoption—speeding up cash collections and protecting the rural organization’s bottom line. MainStreet also worked with its digital payment vendor to create a branded look for the payment site, providing consumers with a feeling of reassurance that the site is a trusted resource.

Key to relieving consumers’ anxiety around the cost of their care: Make sure payment options—including the ability to self-enroll in a payment plan or apply for charity care—are clearly visible and easy to navigate. This helps boost consumers’ confidence that they can manage the cost of their care on their own terms from the comfort of home. In addition, use vendor solutions that accommodate a five-digit short code as opposed to a full phone number. This differentiator is critical to signaling that the text is coming from reputable source and is not spam.

A more modern approach to rural healthcare payment

Early this year, there were signs that consumers were tapping into savings to pay for basic necessities. It’s a scenario that is likely to hit rural consumers harder than those in urban settings—and it could increase apprehension regarding whether to seek care and how to pay for it. The right digital approach to payment can help ease financial concerns by providing the information people need as soon as it is available and giving them the tools to manage the cost of their care. By taking a careful approach to messaging and providing seamless avenues for bill management and payment, rural healthcare organizations can more quickly activate patient financial engagement, providing positive experiences that strengthen cash flow.

Drew Smith is director of revenue cycle for MainStreet Family Care.

Jeb Burrows is senior vice president, business development for AccessOne.

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