Understanding healthcare costs and determining payment responsibility can be challenging for many Americans. 

The problem? Patients don’t want to pay for something they can’t understand. Consumers struggle to navigate the complex world of medical billing, figuring out what they owe, when the payment is due, and their options for making payment. 

A lack of understanding is a primary barrier to healthcare access for many consumers. Patient financial education is essential to running a successful healthcare system; that is, one that is profitable and serves the best interests of patients. 

The Financial Confusion in Healthcare

What makes the cost of healthcare so confusing? Factors include the complexity of tiered networks, what services are covered, high deductibles and whether that has been met, the location of care, pre-authorizations, and more. The thousands of nuances add up to a confusing mess for who is responsible (i.e., insurance companies vs. patients) for each portion of a bill. 

With patient-centric resources and communication lacking, patients are left to their own devices to figure out where to get the answers they need. A big part of the problem stems from health insurance confusion. In fact, one recent survey shows that nearly 50% of Americans are confused about what procedures are covered under their insurance plans, and 52% do not understand what healthcare services count towards their deductible. 

And yet, health insurance literacy is only half of the battle. Providers must also focus on the broader topic of financial health literacy.

Financial health literacy refers to an individual’s capacity to procure, comprehend, and apply information related to their financial health, which can lead to better health and financial outcomes. To put it in simpler terms, it’s the ability of a person to decipher and understand the costs tied to their healthcare, like their medical bills or the expense of prescription drugs.

Without a focus on financial health literacy, providers run the risk of frustrated and confused patients, but also more serious consequences. 

Patients may delay care, ration medications, or forgo treatment entirely all while experiencing financial distress. In 2022, a record number of Americans put off medical care due to costs/confusion. Providers are left with late or unpaid bills, strained patient relationships, and inefficient revenue cycle management. 

The Role of Providers in Financial Education

Providers can bridge the gap that currently exists between insurance companies/providers and patients. A recent AccessOne survey found that 39% of patients are only somewhat satisfied or not at all satisfied with the quality of communications around how to pay for healthcare costs. 

Providers have a responsibility to educate patients about the financial aspects of their care with transparent conversations about out-of-pocket costs. 

This includes sharing up-to-date information on insurance policies, government aid programs, and patient financing options to accurately inform and empower patients. 

By delivering the financial experience that patients demand, providers are taking a crucial first step towards building trust and fostering stronger patient-provider relationships. Providers have the power to create a culture of financial empathy within their organizations. It’s important to remember that a crucial element of providing excellent care is helping patients manage their healthcare payments in a way that makes them feel supported and heard.

The numerous benefits of providing robust financial education to patients can be summed up as follows: 

Patients who understand their financial responsibilities are more likely to feel confident in their healthcare decisions, leading to better outcomes and reduced stress. Concurrently, providers enjoy stronger relationships, bolstered by trust and confidence, increased patient loyalty, and improved payment rates.

Implementing Financial Education: Practical Steps for Providers

Creating a safe, empathetic, and non-judgmental environment to discuss healthcare costs openly is one way providers can help break down barriers to care. Aim to understand each patient’s needs and concerns by implementing these practical steps. 

1. Utilize Clear Language

Patients may not be familiar with medical billing terminology. Ensure that your staff utilizes clear and simple language as they communicate about finances with patients. Asking, “Does this make sense?” gives patients an opportunity to ask clarifying questions about anything they do not understand. 

2. Provide Resources for Further Learning

Equip patients with resources where they can engage in additional research to better understand their options for managing their healthcare financial responsibilities. For example, offer printed materials, online resources, or referrals to patient advocates or financial counselors for patients who might be interested in healthcare financing options after insurance and financial assistance have been applied. . 

3. Proactively Discuss Cost 

The time to discuss healthcare costs is before the bill arrives. Most consumers want to discuss payment plans or financing options prior to a procedure so they can adequately prepare or budget for expenses. 

According to a recent research piece featured in the Annals of Internal Medicine, a surprising number of medical practitioners are not engaging in cost-related discussions with their patients. In fact, as reported by PatientEngagementHIT, “only 28 percent of patients said a hospital representative had discussed their total out-of-pocket costs before a procedure, meaning most patients went into their procedures blind to the costs.”

Given that many patients are concerned about their ability to pay a medical bill of $1,000 or less, it is financially prudent for providers to be proactive in cost discussions. Share as much information as possible about potential out-of-pocket costs, financial assistance programs, and then payment options after all other avenues are exhausted.   

4. Consider User-Friendly Payment Solutions

User-friendly payment solutions like text-to-pay are crucial for healthcare providers as they dramatically enhance the patient experience by offering unprecedented convenience and simplicity. 

With today’s patients expecting digital, seamless transactions, such solutions meet this demand. As an added benefit for providers, these types of solutions significantly reduce administrative burden, enabling staff to focus on critical tasks, thereby boosting overall efficiency and potentially reducing costs. 

While “how” to pay is ultimately the patient’s choice, again, it’s crucial to keep in mind that patient preferences have evolved with the times.    

5. Train Staff Regularly

Insurance plans and financial assistance programs constantly change. It’s important to invest in regular training for staff to ensure they have the tools and resources they need to comprehensively cover financial matters with patients. Patient satisfaction improves when patients can rely on staff to provide the same level of care from the exam room through the payment process. 

Partner with AccessOne to Empower Your Patients 

The data tells us that patients want transparency, communication, and control. 

Not knowing what to expect when it comes to what they will pay or how they will pay for medical care leaves patients feeling unprepared and confused. Implementing an agile payments solution like AccessOne MobilePay or offering extended repayment options can be a big step forward in giving your patients the tools they need to successfully manage their financial responsibilities. 

Book a demo today or reach out to speak to a sales team representative. To learn more about how our solutions are changing the game for RCM teams and patients all across the country, check out our client success stories.