HIMSS Revenue Cycle Improvement Task Force Readies Presentations for HIMSS16

Microsite, road map and case studies to demonstrate patient-centered financial experience

Imagine a healthcare system where a patient finds care options and estimated costs virtually instantaneously via smart phone, from the moment of illness or injury onset all the way through discharge and post-acute care. At the end of the care episode, the patient receives one consolidated electronic bill including the cost for all of the care received during that episode, along with options for paying the bill in full or through periodic payments.

To demonstrate this future, the HIMSS Revenue Cycle Improvement (RCI) Task Force is putting the finishing touches on a richly illustrated microsite describing a scenario involving a 60-year-old woman who falls and injures her knee at home. The microsite will demonstrate how future health information technology can support decision making for the patient, her husband and their medical team while simplifying their financial experience.

The microsite is one of the initiatives the task force is undertaking to increase healthcare financial transparency and patient satisfaction with the billing experience. The task force will present the completed microsite – along with a related roap map to the future and relevant case studies – at the HIMSS Annual Conference & Exhibition, Feb. 29 to March 4 in Las Vegas.

Task force aims to speed collection of payments while increasing patient satisfaction

While improving the patient experience, the task force's efforts will help healthcare providers to increase collection of patient payments at the time of care and to decrease bad debt and the use of collection agencies – especially important as the percentage of healthcare expenses paid directly by patients increases. Participating on the task force are nearly 100 professionals representing healthcare providers, payers, technology, finance and other disciplines and professional organizations.

According to the Connance Consumer Impact Study, only 35 percent of patients are fully satisfied with their hospital billing experience. The study also found that this satisfaction correlates closely with patients paying their bills in full and in recommending hospitals to others. Because of the link between the billing experience and overall patient satisfaction with the hospital, revenue cycle management plays a key role in strategic planning.

"Our task force has agreed that the revenue cycle needs to be patient-centric," said Stuart Hanson, the task force's chair and senior vice president and general manager of consumer payment solutions at Change Healthcare (formerly Emdeon). "Providers and plans have recognized the need to collaborate to provide a more consumer-friendly revenue cycle experience."

Microsite to walk viewer step-by-step through patient decision making and financial transactions

The microsite illustrates how the woman's husband logs onto their health plan's website via smart phone after she injures herself to search for the closest and most timely treatment locations within the plan's network. After the husband chooses a location, the infographic shows a pre-visit registration form on the screen, populated with information from his wife's electronic medical record. The husband adds information about his wife's injury, indicates the form is being completed by the patient's representative, and gives permission for his wife's medical records to be shared with clinicians involved with her care. After submitting the information, he receives a cost estimate outlining how much the patient will be responsible for.

Later in the care process, the woman and her husband review a list of orthopedic surgeons to compare on cost, quality and patient satisfaction. After choosing a surgeon and before the procedure, they receive further financial information and make a partial payment. After discharge planning and her last post-acute care appointment, the woman receives a final easy-to-understand and consolidated bill for care related to her knee injury.

Microsite to be complemented by road map and case studies

In addition to the microsite, the task force will be introducing a road map outlining the health information technology gaps that will need to be addressed to achieve the task force's vision and several case studies demonstrating solutions aimed at closing those gaps. "The road map explains where we would like to see revenue cycle innovations in the future," says Zubair Ansari, a task force member and director of patient financial services, Johns Hopkins Medicine International. The case studies will provide examples from organizations that have begun taking steps toward fulfilling the goals described by the road map. The case studies will provide glimpses into point of care patient payment solutions, consolidated billing statements, and ways to comparison shop for healthcare services.

"This is an opportunity to bring all the parties together and make financial transactions more transparent," states Mike Olson, senior vice president, healthcare solutions, Fifth Third Bank, "so that everyone understands what their financial responsibilities are – from the patient all the way to the payer and provider. The task force is in a unique position to be able to influence the streamlining of that."

The infographic, road map and case studies will build upon the task force's vision for the patient financial experience of the future expressed through its "Rethinking Revenue Cycle Management" white paper and accompanying infographic presented last April at HIMSS15.