Health Data Analytics Improves Self-Pay Collections

By Katie Wike, contributing writer

An upcoming webinar presented by MedeAnalytics shows how predictive analytics and data insight help providers tackle the issues surrounding self-pay situations

Becker’s Hospital Review notes that while spending in healthcare is dropping, patient’s out-of-pocket expenses are soaring. Citing a Health Care Cost Institute report, Becker’s writes, “Out-of-pocket expenses have jumped 4.8 percent to $768 per person per year. When considering older adults 55 to 64, out-of-pocket costs hit $1,265 per year. High-deductible health insurance plans and co-payments have triggered the shift to greater self-pay (the amount owed by a patient), and consequently, these collections have become a larger percentage of a hospital's accounts receivable. According to research by the Healthcare Financial Management Association, more than one-third of hospitals surveyed saw their self-pay receivables increase by 10 percent or more year-over-year.”

Becker’s suggests “hospitals need a more intelligent and cost-effective way to drive self-pay collections” rather than rely on third parties for credit data and account follow up. “Technology innovation, like predictive analytics, can help hospitals leverage their own data to gather the right information for a more effective and efficient process for self-pay collections. By leveraging hospital's patient claims data, predictive analytic models can accurately estimate a patient's propensity-to-pay with accuracies of 90 percent or higher. These probability scores provide the analytic horsepower to increase yield, allowing hospitals to strategically align resources, focus on the right accounts at the right time, and ultimately improve the patient experience by proactively identifying alternative payment options for those in need.”

Four steps to utilize patient data to accurately and efficiently are offered by Becker’s, including applying predictive analytics and leveraging actionable insight. Additionally, healthcare blogger Phil Solomon offers “25 Ways To Unthink Patient Self-pay Collections,” his reaction to the “rising challenge of collecting cash from patients who are responsible for paying their own hospital bills. “ A sampling of Solomon’s strategies that can immediately improve patient self-pay collections include:

• Use a registration quality technology to accurately classify self-pay patients at point of service and improve payer claims outcomes.
• Partner with a vendor who offers a fixed fee, unlimited-use, real-time insurance eligibility verifying program to check eligibility of patient accounts throughout the entire revenue cycle collection process.
• Insource or outsource self-pay account processing. Utilize a predictive-blended dialer for inbound and outbound calls, closely monitor right time calling analytics, send out-patient friendly statements/invoices and most importantly, ensure that all self-pay patients are treated with respect, dignity and professionalism.

MedeAnalytics, in an upcoming webinar hosted by Health IT Outcomes editor-in-chief Ken Congdon, will present ways providers can better manage the self-pay revenue cycle. This is of particular importance in light of the effects the implementation of the Affordable Care Act has had on healthcare. One of the consequences of the ACA has been more patients opting for higher deductible health plans forcing providers to find ways to cope with an increase in self-pay revenue and new collection costs.

The presentation, Boost Self-Pay Collections with Health Data Analytics, explains how patient data such as payment history, federal poverty level, Medicaid eligibility, and credit score can be analyzed to improve collections while reducing collection costs. Accelerating cash collections, reducing bad debt, and most importantly evaluating the performance of the health plans currently in place are some of the key elements to managing receivables in a self-pay world.

According to a MedeAnalytics data sheet, organizations using self-pay analytics improved productivity and collections at every phase of the revenue cycle. “With real-time reporting, we can analyze accounts receivable in ways we never could before,” said Michelle Jones Wheaton of Franciscan Healthcare.

According to the release announcing the webinar, “MedeAnalytics will show how data insight and predictive modeling can determine the propensity to pay, help you prioritize collections efforts, and more – giving you the power to improve revenue and cash flow.”

To register for the webinar, click HERE