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St. Luke's Blogs

A Better Way to Bill: iVinci and St. Luke's

By Dr. David C. Pate, News and Community
June 25, 2013

You don’t hear too many stories about hospitals and health systems working to improve their billing, but here is one! 

St. Luke’s Health System Chief Financial Officer Jeff Taylor has brought on iVinci, an innovative revenue cycle company that, in the short time we have been working together, has made significant improvements. 

Jeff and Kent Ivanoff, co-founder and CEO of iVinci, have worked with our TEAMwork process improvement group, nationally recognized patient empowerment advocate e-Patient Dave deBronkart, patients, and our billing leaders to figure out how to streamline and simplify our billing process for our patients. 

We still have much work to be done, but at a time when few hospitals and health systems are really listening to their patients, we are transforming the patient experience based largely on their suggestions and recommendations. I have asked Roya Camp, my blog editor, to tell the story. Here it is below.

St. Luke’s is transforming health care for our region and our communities on many different fronts. Changes we are working on range from how we view our role in health and wellness, and what we do in those areas, to improvements in many of our clinical and business processes.

High on our list are fixes to billing. Our work to make billing processes easier is as important as anything else we’re doing to advance our Triple Aim of better health, better care, and lower cost.

We’ve started to put into place new tools that help us all: our patients, our hospitals and clinics, and the communities that own St. Luke’s.

We’ve done so with the help of iVinci Health, a Boise-based company founded in 2010 by CEO Kent Ivanoff and COO Vince Martino. IVinci Health is working with St. Luke’s so that we can better understand patients’ needs when it comes to tailored billing, payment plans, and eligibility for assistance.

It’s important information; research shows that nationwide, patient populations, from the more affluent to those with much lower incomes, worry about how they will pay back the costs of medical treatments – particularly when care is needed unexpectedly.

Patients and family members helping us redesign our billing processes. We know that a great care experience isn't always a great billing experience. Patients want flexibility, easy statements, and no surprises, all of which our new approaches address.

Patients are more worried about access to reliable financing than they are about their statements, follow-up to questions, access to online payment mechanisms, and other factors of the payment process.

We know health care costs too much, which is why St. Luke’s is working with payers and internally to bend the cost curve.

What many people don’t know is that providers’ costs of care aren’t covered entirely, or that the trend among traditional payers, including the largest federal programs, is to shift costs increasingly to patients.

Hospitals and hospital systems, including St. Luke’s, routinely are owed 13 cents of every dollar by a patient, but only receive about 6 cents on average in payment.

The other 87 cents is owed and paid by Medicare, Medicaid, and insurers.

The rest of the patient’s portion, that missing 7 cents, is written off as charity for low-income patients or as bad debt. 

iVinci is helping St. Luke’s to close that 7-cent gap by building ways to help patients manage their charges and by helping us understand which patients need help and when that help is needed most.

We know that billing is hard to understand, and that bills, accounts, and explanations of benefits are complicated, more complicated than they should be. And because of that, patients don’t understand their bills, they don’t understand that they may have multiple accounts, they don’t understand explanation of benefit forms, and they don’t understand why it’s all so difficult.

Enter iVinci. Ivanoff and Martino, who come from careers in consumer finance, have envisioned a very different patient billing experience. The iVinci team has built an information base that allows us to understand who is best served by financial support and simple tools for everyone to be able to manage and control their payments for care.

With iVinci’s help, we have been building better repayment plans for our patients for the past two years. This summer, iVinci and St. Luke’s will test an electronic payment management system that lets St. Luke’s patients easily see what’s owed and make payments, as individuals or as families.

VisitPay Express, which we will also start testing in July, will serve the needs of St. Luke’s patients wanting to make a single online payment, rather than separate payments for each separate bill that is created. VisitPay Premium, to be launched in August, will begin with St. Luke’s employees and expand from there.

Here’s how it will work:

Every family member will have one account within the complete electronic record. Patients will be able to set up their own payment plans, receive e-mail or text confirmation of the terms they’ve chosen, review charges before automatic payments are made, and receive regular reports of account activity.

Patients can choose to link their family’s bills together in one consolidated account or generate individual account views and financing structures.

Our patients, including employees who have been patients, helped us to design an account system that would best serve them. They helped us refine payment cycles, determine how accounts could be linked, and ensure that the system is as patient-centered as possible.

Their input made all the difference. Due to insurer and other activity within accounts and the fluctuating balances that result, we are building in the opportunity for review, along with a process to channel disputes so that they get resolved promptly.

We also built in choice around due dates and terms of payment plans, among other features.

We will assess our new payment processes in late fall and expect to have early results in December.

St. Luke’s sends out 60,000 to 80,000 statements every month, and for the most part, our processes run smoothly.

But we want to make sure our patient experience is exceptional, and we know that all it takes is one bad experience, or lack of resolution to an unsatisfactory experience, to leave a patient dissatisfied, no matter how good the medical care may be.

Our work with iVinci is helping us with our Triple Aim and with some of the far less visible, but no less gratifying, work that we do to support our patients of limited means; for the past two years, iVinci has helped us to identify patients St. Luke’s can support through debt forgiveness and other financial assistance.

About The Author

David C. Pate, M.D., J.D., is president and CEO of St. Luke's Health System, based in Boise, Idaho. Dr. Pate joined the System in 2009. He received his medical degree from Baylor College of Medicine in Houston and his law degree from the University of Houston Law Center.