Today’s guest blogger is Michael Rawdan, senior director of revenue cycle, to tell you more.

- David C. Pate, M.D., J.D.

As we mark the first year of St. Luke’s Bill Pay, I wanted to take a moment to reflect on the experience and performance to date of this new product for SLHS.

Health care is moving at light-speed, and we have an ever-improving understanding of how to treat patients and their conditions. This clinical experience has been the focus of SLHS for many years, resulting in lots of recognition and many awards. Transformation of the financial experience is now under way, reducing patient frustration and clinician time spent on billing concerns.

In 2013, our patients told us that they were not satisfied with the financial experience that St. Luke’s was providing. The feedback was very specific; they wanted clearer information and the ability to repay obligations over longer periods of time. We started working with iVinci Health and St. Luke’s Bill Pay began to take form. The new product was tested in mid-2013, launched in early 2014 with employees, and rolled out with the public in August 2014.

Since the public launch, St. Luke’s Bill Pay has added 17,758 unique patient users and more than 58,000 individual account interactions. Through the new platform, these patients have made more than $9.2 million in payments and established another $10.5 million in payment plans. 

By empowering our patients to manage their own accounts, we have been able to strengthen the organization on behalf of the communities that own St. Luke’s. For example, by improving our processes via the new platform, we can invest more quickly in the buildings, equipment, and employees needed to provide the best possible care for communities across Idaho. 

And it’s critical that we get financial experience right, because the financial pressures of health care are everyone’s concern.

The Affordable Care Act (ACA) was intended to help patients acquire insurance benefits and manage their care in a more informed and comprehensive manner. While ACA does provide some very nice benefits to previously uninsured, mainly allowing patients with preexisting conditions to purchase insurance benefits, there are also a few unintended consequences.

According to the Patient Responsibility Analysis by the Center on Budget and Policy Priorities (June 2013), 71 percent of patients acquiring new insurance selected a Bronze or Silver plan. The average deductibles for these plans are $6,000 and $5,000, respectively.

After almost 1.5 years with the ACA, we are finding that many patients who purchase these plans either (a) do not understand they have a large out-of-pocket expense before benefits pay for their healthcare services or (b) they have not planned for an event that requires healthcare services and cannot afford their deductibles. This leaves patients owing much more out of pocket than they ever anticipated, placing the obligation with St. Luke's until they are able to pay.

Similarly, employer-sponsored benefit plans are increasingly moving towards high-deductible designs. By 2020, it is estimated that 40 percent of employer-offered insurance plans will fall into a high-deductible range, defined at $3,000 out of pocket before benefit coverage begins. This will create a situation very similar to patients enrolled in ACA; higher out-of-pocket expenses before healthcare services are paid by benefit plans.

This trend clearly places more pressure on patient financial services to develop patient-centered repayment options.

With this focus on an increasing obligation, patients are demanding more transparency and more flexible payment options. At St. Luke’s Health System, we are placing a priority on treating patients well throughout their experience with us, including their financial care.

In partnership with iVinci Health, SLHS has developed a unique online bill pay system that allows patients to see a very detailed accounting of their St. Luke’s interactions over time. Patients are provided longer terms for repayment of up to 36 months, with nominal interest, so they are able to manage larger or unplanned account balances.

This product is much different than other bill pay products, given the ability to “invite” someone else to help manage the account; a really nice option for children of older patients receiving treatment, and  very similar to the “add a friend” feature of Facebook allowing one person to manage all family accounts in one digital location.

The platform offers automatic payment processing, so a payment can be scheduled in the future on any date the patient wishes to pay, and provides a historical view of all detailed transactions that can be downloaded at any point in time. And patients can manage their monthly payment amounts, which is wonderful if they find themselves receiving multiple services or treatments.

This combination of clear information and longer repayment options has helped us improve our patient financial experience scores by 105 percent since 2013. This improved experience and transparency has also lifted payment performance by more than 30 percent over traditional billing alternatives.

Based on feedback from our patients, we are looking at additional improvements, including a mobile application to assist with real-time point-of-service questions or payments, functions that allow people to manage all aspects of care with a single sign-on, and integration of benefits into the Bill Pay product.

The bottom line? Improved information, access to account-level data, and longer repayment timeframes has led to a better financial experience. We absolutely believe this approach, in turn, leads to lower stress and better overall health at lower costs.