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The changing payment landscape for ASCs: 3 Qs with an expert

Tyler Crawford is CEO of BHG Patient Lending, a patient-financing partner for hospitals and ASCs. Here, he shares his thoughts on the changing payment landscape for surgery centers.

Note: Responses have been lightly edited for style and clarity.

Question: Why do you think self-pay plans will become more popular for patients? What effect do you think this will have on ASCs?

Tyler Crawford: The increase in patients with employer-based high-deductible healthcare plans, coupled with providers and consumers frustrated with the black hole that is the traditional commercial insurance model, has created a rise in self-pay plans. Because of the move toward cash pay options, consumers want more transparency when it comes to understanding what they’re paying for and are looking at the possibility of cutting out the middleman when finding more cost-effective ways to pay. This is forcing ASCs to explore better payment options to offer patients.

Another resulting effect of this trend on ASCs is lost revenue. With nearly half of all patients unable to cover an unexpected healthcare expense, one of two things may happen: Patients abandon treatment, or they don’t pay their bill. Procedure abandonment is already high, with one in three adults having skipped a medical test, treatment, or follow-up appointment in the past 12 months. And those who do follow through with procedures may not be able to afford the cost, so staff spend valuable time collecting outstanding payments when they should be focused on patients.

Q: What payment trends do you think ASCs should be paying the closest attention to?

TC: Continued increase in patient costs. We’re seeing patient out-of-pocket expenses continue to rise as insurance companies cover less, and more consumers carry high-deductible plans. I expect that we will see patient responsibility increase to over 40 percent of the bill over the next five to 10 years. As a result, ASCs need to consider what kind of payment options they’ll offer to patients.

  • Transparency. One in every two patients wants to discuss payment and financing options when faced with a steep medical bill. Overall, there’s little communication from ASCs and a lack of understanding from patients about the costs and payment options. ASCs have the opportunity to empower patients so they can make informed decisions about what they can afford and how to pay for it.
  • Changing payment structures. I predict we’re going to see healthcare transform to a monthly expense for consumers, similar to the way they already pay retail subscriptions, car payments or utility bills.
  • Evolving payment solutions. Patients deserve better financing options than what many facilities offer today. Facilities should explore partnering with an organization that can help both patients and the ASC by providing a more innovative payment option that can also help create efficiencies.
  • In-house collections are becoming outdated. Staff already have their hands full with patient management. They shouldn’t have to spend their valuable time collecting on outstanding bills.

Q: What advice would you give ASCs looking to improve their patient financial experience?

TC: ASCs need to have the financial discussion with patients early in the process. Financing can be an uncomfortable conversation, but one in every two patients wants to have it. Cost can be a significant stress factor for patients, and transparency about what they can expect to be billed, and then offering them a flexible way to pay, can go a long way in creating a positive patient financial experience.

Also, ASCs need to recognize that the bill-and-collect approach isn’t feasible anymore. Facilities are only collecting 45 percent to 50 percent on average because patients can’t afford the cost. Offering patients an affordable payment option can reduce cancellations and missed payments. This is an area where an ASC can truly differentiate itself.

Consumers today want control, right down to the way they find a healthcare provider and pay their bills. BHG Patient Lending addresses that by offering a solution in which patients select their monthly payments and terms — while facilities get paid in full up front.

More articles on coding, billing and collections:
Moving cardiovascular services to ASCs — 5 insights in light of CMS' proposed rule
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3 areas ASCs experience revenue leaks & how to prevent them

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