Write 4- 5 paragraphs about your reaction to the finance article below and how you might integrate this into your current and future work as a healthcare administrator. Consider the balance between earning money to pay the bills, patient satisfaction, and the mission (not-for-profit?) or goals of the organization you work for. Also consider the current COVID context. How would you strive to achieve the right balance? [Answer must be 4 to 5 Paragraph Response]

Article: REVENUE CYCLE NEWS

By: Nick Hut

Hospitals and health systems can use best practices in

medical account resolution to avoid creating a negative

financial experience for patients.

Intermountain Healthcare Executive Vice

President and CFO Bert Zimmerli recalls a

conversation 15 years ago with a patient advocate

about the challenges facing many patients with

healthcare-related debt.

Most of them are overwhelmed, the advocate

told Zimmerli. Some are clinically depressed.

You would see a stack of bills on the table that they

havent even opened because they know they cant

pay them.

If you really cared, she said, you would put a

statement on the outside of envelopes containing

your bills that says something to the effect that,

If you need help paying your bills, please call the

following number.

Soon thereafter, Intermountain began including

that statement in both English and Spanish on the

back of every such envelope.

More broadly, that exchange has helped

inform Intermountains approach to patient

billing and collections under Zimmerlis

stewardship of the finance department.

The goal, as the organizations website states,

is to allow patients to focus on getting well

rather than worrying about how they will pay

for care.

Scrutiny of collection policies

The issue of patient collections has landed

squarely in the spotlight in recent months

following media coverage of the approaches at

various health systems. Its not a stretch to think

other providers could find themselves the subject

of unwanted headlines as media outlets search for

patients to profile in the current healthcare

environment.

Patients bear more financial responsibility for

healthcare services in this era of high-deductible

health plans, while the prevalence of narrow

networks can mean a greater chance of receiving

costly and unexpected out-of-network bills for a

portion of care.

Healthcare these days absolutely rivals buying a

house or car in terms of the consumer payment

burden, said Jonathan Wiik, principal of healthcare strategy at TransUnion Healthcare. The

difference, he said: Healthcare generally is far

less voluntary than those purchases.

Yet hospitals require some form of payment from

most patients to be able to sustain operations and

fulfill their missions. The question, then, is how

to implement a collections policy that is effective

yet fair.

Making sure best practices are followed

Although debt collection agencies operate

independently of the hospitals that contract

with them, hospitals can take steps to ensure

extraordinary collection activities are conducted

only when appropriate circumstances dictate.

In the wake of recent news, providers should

examine their patient collection practices

Bert Zimmerli, executive

vice president and CFO of

Intermountain Healthcare,

strives to ensure that revenue

cycle metrics track how we

serve people who cant afford

to pay.

16 November 2019 healthcare financial management

10 medical account

resolution goals to follow

In 2013, HFMA partnered with ACA

International (Association of Credit and

Collection Professionals) and gathered a

task force of stakeholders to develop

common-sense best practices for the

medical account resolution process.

The best practices offer guidance on

resolving financial obligations before, during

and after a patient visits a hospital or other

healthcare setting.

Healthcare providers and their business

partners using the best practices will be able to:

1 Lay the groundwork for successful

account resolution by educating

patients and following best practices

for communication prior to the time

of service.

2 Make bills and all communications clear,

concise, correct and patient-friendly.

3 Establish policies for account resolution

and ensure they are followed internally

and by business affiliates.

4 Be consistent in key aspects of account

resolution, from billing disputes to

payment application.

5 Coordinate account resolution activities

with business affiliates to avoid

duplicative patient contacts.

6 Exercise good judgment about the

best ways to communicate with

patients about bills.

7 Start the account resolution clock when

the first statement is sent to the patient.

8 Report back to credit bureaus when an

account is resolved (in the event that an

account is reported to a credit bureau).

9 Track all consumer complaints.

10Use best practices, principles and

guidelines to inform their organizational

approach to medical account resolution.

Much more on medical account resolution

and other aspects of the patient financial

experience is available as part of HFMAs

Dollars & Sense initiative (hfma.org/

industry-initiatives/healthcare-dollarsand-sense.html).

You definitely can work with collection

agencies around principles, Zimmerli

said. If they wont agree, they probably

arent the right collection agency for you

to use.

For example, Intermountain states on its

website that it goes to court to collect on

an unpaid medical bill only if there is

evidence of fraud or an indication that the

patient has the means to pay.

Intermountain, said Zimmerli, also

requires collection agencies to agree

they will:

n Interact with patients in a

respectful, compliant way (allowing

Intermountain to monitor and

review recorded calls)

n Proactively support and offer

financial assistance based on

Intermountains policy

n Maintain Intermountains values and

commitments, including adherence

to all compliance regulations

n Facilitate the recall of any placed

account for any reason

n Provide recurring performance

metrics to measure success

(e.g., collections, complaints,

response time)

Seeking an upfront solution

Just as prevention is more effective than

any cure, hospitals can enhance their

patient payment processes to cut down

on the need to engage in collection

activities.

The goal, Wiik said, should be to clear all

patients financially either ensuring they

can pay or deeming them eligible for

financial assistance before arrival, or at

the very least before discharge.

As Wiik sees it, hospitals generally have

opportunities to transfer more patients

from bad debt portfolios to payment or

charity care.

For example, when Wiik was chief revenue

officer at Boulder Community Hospital in

Colorado, the organization would pay an

uninsured patients COBRA premium if

the patient was eligible for that coverage.

As he noted, footing the bill for a $1,600

premium is more than worthwhile for the

hospital if it ensures the patient is covered

for a $160,000 care episode.

Other patients may qualify for charity

care, steep discounts on care or perhaps

an interest-bearing loan to cover their

financial obligations.

It is critical for providers to engage

patients early to optimize collections,

Wiik said. Reliance on the traditional

billing cycle will result in poor patient

collections and a poor patient

experience.

Ensuring financial

assistance is accessible

Intermountain tracks its ability to inform

patients about the availability of financial

assistance. We want people to know

about it and use it if it applies to them,

Zimmerli said. For processing assistance

applications, the organization uses

48 hours as a benchmark and usually

beats it.

Im pretty proud of that, Zimmerli said.

We dont want anyone to ever feel like a

charity patient at Intermountain.

In general, he said, revenue cycle metrics

should be in place for how we serve

people who cant afford to pay as well as

for how effective we are in collecting from

those who can.