Question
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
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.
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