Patients Now More Cost Conscious

Estimates of out-of-pocket costs before treatment would likely increase patient payments and improve the billing process, according to a survey from TransUnion Healthcare.

A survey of more than 700 insured consumers found that 75% of patients believe their ability to pay for healthcare would improve with pre-treatment estimates of out-of-pocket costs. More than half (56%) either rarely or never receive this sort of price estimate, though. Furthermore, 59% of respondents said they have been surprised by their costs when they received a final bill.

"These survey results tell us that consumers are less likely to have payment problems when they obtain more information about the cost of their healthcare services up front," said John Woody, vice president of product development for TransUnion Healthcare.

Of the patients who either paid a bill late, left a bill unpaid, or let a bill go to collections, three-quarters said they were surprised by the costs for which they were responsible.

According to TransUnion and Medicare industry estimates, hospitals without a program to identify ahead of time which procedures may not be covered by third-party payors face an average of $960,000 a year in denials.

"Now, more than ever, it is critical that providers capture all reimbursements owed to them, given the impending changes to reimbursement structures under the Affordable Care Act and the introduction of healthcare exchanges," said Woody. "A failure to quickly and accurately verify patients' eligibility and benefits on the front-end can lead to costly billing errors and claim denials on the back-end and, ultimately, significant profit loss for healthcare providers and hospital systems."

Another TransUnion survey found that 55% of patients have been paying more attention to the details of their medical bills. This increase in cost consciousness is impacting decisions about care received, choice of providers, and selection of insurance plans, according to Becker’s Hospital Review.

There is a clear connection between the billing process and satisfaction with quality of care: those who gave high ratings for their billing experiences—clear and transparent billing with pre-treatment estimates of costs—were more likely to give high ratings for the overall quality of care, Milton Silva-Craig, president of TransUnion Healthcare, wrote in Becker’s.

“The new healthcare consumer is shaping up to be a lot like the consumer we know in other industries,” he concluded in his editorial. “Cost is certainly a major factor in their decision-making process, but it is just part of their determination of value. The entire customer experience is what counts.”