4 Key payment trends impacting physician practices

For a modern medical practice, efficiency is everything. Labor costs continue to increase, putting a pinch on practices that are still recovering from pandemic shutdowns.

An August 2022 snapshot of practices shows that, although physician productivity is increasing, expenses are growing faster than reimbursements.

Every person in the practice must work at peak efficiency, from the physicians and nurse practitioners to assistants, front-office staff, medical billers and coders. Reducing manual processes can result in increased revenue while freeing up staff to perform more value-added functions to grow the practice or expand service offerings.

Receivables are the lifeblood of every practice. However, many practices still send paper statements and limit means of electronic payment that patients increasingly prefer.

Hendersonville Pediatrics, which serves Western North Carolina, faced this situation, with paper statements that confused and frustrated families and resulted in increased call volume. By adopting electronic statement and payment processes, the pediatrics practice increased total online payments by 123% and total patient payment volume by 82% while greatly reducing call volume that was sapping employee productivity.

Take notice of these four key payment trends that are impacting pediatric practices:

1. Patient Pay Amounts Are Increasing

Although the percentage of Americans using high-deductible health plans (HDHP) decreased between 2020 and 2021 to 28%, family deductibles for 2023 are $3,000, with a maximum out-of-pocket for in-network services of $15,000. Families could be financially liable for dozens of in-office visits and procedures before insurance pays for anything.

Even for those with more traditional insurance, deductibles and co-pays continue to increase, placing more payment burden on patients and their families. According to the InstaMed Trends in Healthcare Payments Twelfth Annual Report, nearly half of American households incurred healthcare expenses in the previous 12 months. Nearly one-fifth of respondents (17%) owed more than $1,500. It’s not surprising, then, to discover that nearly one-third of Americans declined to seek medical care due to the cost of that care.

Medical practices can learn from payment trends among hospitals, which show higher balances and increasing difficulty to pay. Collection rates for hospital self-pay accounts dropped to 55% in 2021, down from 76% the previous year. The percentage of balances in excess of $7,500 more than doubled between 2018 and 2021, growing to nearly 18% of all balances. Even more troubling, 60% of patient bad debt in 2021 could be attributed to self-pay after insurance accounts, a 450% increase from three years earlier.

2. Inefficient Manual Processes Harm Productivity and Collections

Like many practices, Hendersonville Pediatrics was relying on paper statements to collect balances from families. The InstaMed reports notes that 70% of consumers receive medical bills via mail, but that only 9% want to pay that bill with a paper check.

According to practice leaders, the statements were confusing for families and balances often did not reflect insurance adjustments or clearly detail the amount owed. Families sometimes received balance-due bills even though they didn’t owe the practice anything. Because statements were confusing and often misleading, a significant amount of call volume coming into the practice concerned billing questions and what families owed.

Manual billing processes can slow payments that are vital to the continued health of practices. However, 70% of providers say it takes more than 30 days after a patient visit to collect on that visit and 74% say that means more than one statement. As a result, nearly one-half of practice leaders say their A/R days increased during 2021.

The potential savings from electronic transactions are huge, with the Council for Affordable Quality Healthcare (CAQH) estimating that healthcare could save $20 billion annually by fully adopting electronic transaction methods.

3. Consumers Want Digital Payment Options

In terms of billing and collections, patients are far ahead of providers in the acceptance of electronic statement and payment options.

The InstaMed payments report shows that 75% of providers primarily use paper and manual processes for collections, while 74% of consumers prefer online payment options for medical bills. While four in 10 providers believe their billing and collection effort have no impact on the patient experience, five in 10 consumers overall say they would consider changing providers for a better healthcare payments experience, including 74% of Millennials — those ages 25 to 40. Millennials overwhelmingly want digital platforms for medical bills (80%) and mobile apps for medical bills (85%).

Overall, 87% of consumers want to make all their healthcare payments in one place, and 25% of consumers have ended a transaction for a medical bill because the provider didn’t offer credit/debit payment options. Although 73% of consumers indicate a willingness to receive electronic statements, just 3% are enrolled in them. One possible reason for the poor adoption could be a failure on the provider’s part to widely publicize the availability of electronic statements, which cost considerably less to compile and send than paper statements.

4. Electronic Practices Bring More Revenue

Hendersonville Pediatrics now uses an electronic payments platform that integrates with its practice management system so users can see the full clinical and financial picture in one place.

Intuitive and consumer-tested bill design makes it easy for families to see what they owe and understand how that amount was calculated. Statements have also improved the overall family experience, practice leaders say. As a result of online options, patient pay volume has increased by 82% and total online payments have increased by 123%.

The practice now offers electronic statements, which comprise 20% of all statements. Families can manage their statement and payment information in one place and also receive text payment reminders. And if families need more time to pay a large balance, the practice can set up an automated payment plan.

Conclusion

As healthcare costs continue to rise and the payment burden shifts more toward patients, providers must do a better job of collecting payments as soon as possible. Consumers have expressed an overwhelming interest in electronic statement and payment practices, but providers have been slow to offer such options.

Experience show that electronic statements and payments not only help to cement positive provider/patient relations, they can also improve practice finances.

Brendan Crotty is head of product Management at InstaMed a J.P. Morgan company.