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Why Hospitals Should Seek to Continually Improve Self-Pay Management Processes

UPDATED:
October 19, 2023
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In the span of three short years, our industry has been knocked off course, adapted to huge changes and finally, we’ve come full circle. When the COVID-19 pandemic and subsequent public health emergency (PHE) hit the U.S., hospital finance teams did everything they could to get people insured so patients could receive necessary care. Now, we’re resetting that process and disenrolling many of these same patients via Medicaid redetermination. 

While no one is entirely sure where the healthcare industry will end up after redetermination is complete, it’s wise to consider what you can already learn from the past three years. Then, take the opportunity to proactively apply your findings to improve revenue processes and self-pay patient management for future success.

Redetermination and self-pay management

At Office Ally, we were proponents of continual process evaluation long before the PHE. While we didn’t foresee a global pandemic, an industry shakeup is never off the table. The past three years changed the healthcare world (especially how we engage with self-pay patients and vulnerable populations) and showed that “business as usual” can no longer be the industry standard.

In light of everything that’s happened since 2020, we’re continuing to push our main message. Redetermination is a key driver for reevaluating self-pay management processes, but it’s not the only driver. There’s value in proactivity and continual improvement - especially now that we understand to a greater degree the importance of assisting the self-pay population prior to any big industry disruptions. 

Why put time and effort into process improvement?

  • It’s better for patients
    • Stronger relationships: Tools that make engagement and communication easier for the patient increase trust, strengthening their relationship with the financial team. 
    • Reduce the stress of medical bills: No matter the size, no one likes a medical bill. The fewer the bills, the better the patient experience. 
    • Improved health: Removing the stress of medical bills makes it easier for the patient to focus on getting better and taking care of themselves - the ultimate goal. 
  • It’s better for the hospital or health system
    • Less pressure on human capital: You never know when you will face a labor or staffing shortage. An efficient self-pay management process makes use of automation and workflows to minimize pressure on your team.
    • Improved finances: Finding coverage for self-pay patients sooner rather than later boosts the hospital’s bottom line.
    • Improved patient outcomes: Less financial stress improves patient satisfaction leading to higher quality rating for the hospital.

How to evaluate self-pay management

Redetermination may hardly be underway, but it’s time to start thinking beyond. Moving forward, basic analysis and implementation of the most effective technologies and best practices can go a long way in preparing for any unanticipated increase in self-pay patients and quickly finding coverage.

Below are three key factors to review when evaluating your self-pay management processes.

Team resource constraints

Problem: When experiencing a shortage of labor, money, space or time, hospitals looking to be more efficient need to invest in technology solutions. Gaps that aren’t filled with some sort of solution (technological or otherwise) will only continue to grow.

Solution: Use tools that facilitate data analysis in order to automatically screen and prioritize accounts before entering them into the appropriate workflow. With automation, financial counselors are no longer required to spend time on manual tasks, but can instead automate pieces that follow defined workflows and rules. Strategic automation can trigger predefined communications with a patient confirming the submission of an application or document upload. It can also place certain patient accounts as high priority so your team can allocate their attention appropriately. 

Patient satisfaction 

Problem: When self-pay patients are saddled with heavy medical bills or have difficulty navigating the financial counseling process, health outcomes and patient satisfaction decrease. If patient satisfaction surveys continuously come back negative, it’s time to make some changes.

Solution: A patient portal can completely overhaul your patient experience. These electronic portals grew in popularity during the PHE, but digital communication has now become an expectation. Moving forward, electronic tools are key to successful patient outreach and engagement for faster screening, easier communication and secure exchange of information.  Reporting tools can also be used internally to determine team performance and identify areas for improvement. Addressing these areas will ultimately translate to increased self-pay patient satisfaction.

Enrollment efficiency

Problem: Medicaid redetermination is expected to prompt an increase in self-pay patients, but we never know what or when the next disruption will be. Taking extra unnecessary time to enroll a patient in a financial assistance program results in an irritated patient and a smaller bottom line for the hospital.

Solution: There are so many moving parts in patient screening due to redetermination (identifying who lost Medicaid, who converted to commercial insurance, who remains eligible, etc.) that insurance discovery and validation are more important than ever. Harnessing existing insurance-related data is the easiest way to get a better handle on who has coverage, who still requires assistance and what information may have been missed at registration. 

Similar tools, like credit scoring and secure document exchange, make it fast and easy to analyze data to determine what patients qualify for assistance. When it comes to self-pay patients, the faster you can find coverage, the better. 

The importance of continual evaluation

The last three years have shown that these tools are a key part of the revenue cycle. Everything you held back on implementing or conducted manually runs the risk of disrupting the revenue stream. The name of the game moving forward? Continual evaluation and improvement. 

By combining data analysis with the proper technology, you can increase patient satisfaction, the hospital’s bottom line and your team’s productivity all at once. Let’s start optimizing!

The Office Ally team would love to spend time understanding your current processes, unique challenges and experiences over the past three years so we can bring these solutions to life in a way that works for you.

Contact Office Ally today to learn more about our suite of available tools designed to improve your self-pay management systems.