The changing face of self payment in hospitals slide deck

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Zafar Hasan is posting the attached slide deck on self-payment in hospitals. Its a great deck.

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  • Welcome Introduce self Thanks The mission of healthcare providers is as critical as it is challenging Virtually all of those challenges involve business , from controlling costs to getting adequate payment to having the resources to provide high-quality care
  • Will share key trends that influence the ability of healthcare organizations to provide excellent care for their communities Will discuss actions we believe that leaders can take, the critical role of making various kinds of connections to foster change, and what HFMA is doing to improve the business of health care
  • Making Connections among stakeholder groups… HFMA has brought together representatives of hospitals, physicians, payers, employers and consumers We have gained consensus on principles of a new payment system, such as quality, aligning incentives, simplicity, and fairness We are identifying how specific changes in payment will be viewed by different stakeholders McKesson has sponsored this effort
  • Making Connections among stakeholder groups… HFMA has brought together representatives of hospitals, physicians, payers, employers and consumers We have gained consensus on principles of a new payment system, such as quality, aligning incentives, simplicity, and fairness We are identifying how specific changes in payment will be viewed by different stakeholders McKesson has sponsored this effort
  • Making Connections among stakeholder groups… HFMA has brought together representatives of hospitals, physicians, payers, employers and consumers We have gained consensus on principles of a new payment system, such as quality, aligning incentives, simplicity, and fairness We are identifying how specific changes in payment will be viewed by different stakeholders McKesson has sponsored this effort
  • The changing face of self payment in hospitals slide deck

    1. 1. HFMA’s Healthcare Financial PulseThe Changing Face ofSelf-Payment in HospitalsNovember 2009HFMA’s Healthcare Financial Pulse is sponsored by:
    2. 2. Impact on Self-Pay Receivables• Part I. What hospitals are experiencing• Part II. What hospitals are doing• Part III. Keys to success• Appendix A. Additional resources• Appendix B. Survey methodology 2
    3. 3. Part I. What Hospitals Are Experiencing Overview of Findings • 97% of hospitals surveyed have experienced an increase in self-pay accounts receivable compared with prior fiscal year • Small hospitals were most likely to experience a self-pay increase of greater than 10% • Receivables are growing faster than patient revenue at almost one-third of respondent hospitals • Emergency departments and unscheduled outpatient services are experiencing the most self-pay growth • Difficulty estimating the cost of charges is a significant barrier to point-of-service collection 3
    4. 4. Self-Pay Trends: Accounts Receivable97% of respondents experienced an increase in self-pay accountsreceivable compared with the prior fiscal year. Of these hospitals: • More than one-third have experienced an overall increase of 10% or greater • 39% have experienced a growth in self-pay balance after insurance of 10% or greater • One in five have had a 10% or greater increase in bad debt write-offs 4
    5. 5. Self-Pay Trends: Hospital SizeSmall hospitals (1-100 beds) were most likely to experience a self-pay increase of greater than 10%. Of these small hospitals: • 45% experienced a greater than 10% self-pay increase, compared with 36% overall. • 64% saw self-pay balance after insurance rise by more than 10%, compared with 39% overall. 5
    6. 6. Self-Pay Trends: Receivables Growth asCompared with Patient RevenueReceivables are growing faster than patient revenue at almostone-third of hospitals. Only 10% indicate that patient revenue isoutpacing receivables. 6
    7. 7. Self-Pay Trends: Service Area Emergency departments and unscheduled outpatient services are experiencing the most self-pay growth. 7
    8. 8. Part II. What Hospitals Are Doing • 72% of respondents report that they are devoting moderate or substantial efforts toward point-of- service collections in their facilities – Only 50% of hospitals that are shifting resources toward point-of-service collections are seeing decreases in their cost-to-collect performance indicator • Respondents are indicating that difficulty in estimating the cost of services to be received remains the most significant barrier to more extensive point-of-service collections 8
    9. 9. Self-Pay Trends: Barriers to Point-of-Service Collection More than half of respondents say difficulty estimating cost of charges is a significant barrier to collecting at time of service. 9
    10. 10. Revenue Cycle Response to MarketTrends Respondents have increased accessibility of financial counselors and have increased collection activity 10
    11. 11. Part III. Keys to Success• People – High standards for hires – Compensation structures aligned to business goals and employee satisfaction – Devote resources to education• Process – Use formal structures to obtain stakeholder input – Target improvement around areas most affecting customer experience 11
    12. 12. Part III. Keys to Success• Technology – Selectively use technology for high volume transactions – Maximize value of technology investments by improving processes before automation – Consider dedicating IT staff to revenue cycles systems and support• Metrics – Seek the customers’ perspectives through surveys and customer advisory panels – Develop and regularly report measures that span the entire revenue cycles operation – Consider non-traditional metrics such as customer satisfaction and employee turnover 12
    13. 13. Part III. Keys to Success• Communication – Support a positive scheduling/registration experience – Provide estimates of financial obligations early in the patient interaction – Publicize financial assistance – Provide clear and simple billing and collections materials• Culture – Organizational leadership support for the revenue cycle at the highest level – Demand high performance from staff across the revenue cycle – Make innovation a priority – Celebrate success 13
    14. 14. Appendix A. Additional Resources HFMA’s Healthcare Financial Pulse • Research, how-to guidelines, industry analysis, and case examples • New resources added regularly Visit www.hfma.org/pulse 14
    15. 15. A sample of the resources availableLeadership and planning• Key Legal Issues … as a Result of the Financial Meltdown (how-to guidelines)• The Next Wave of Mergers and Acquisitions: What’s Your Organization’s Position? (how-to guidelines)Cost and quality• Benchmarking Tools for Reducing Cost of Care (how-to guidelines)• Case Study: Seamless Service Line Management (case study)Preserving cash• Leveraging Business Intelligence for Revenue Improvement (case studies)Capital• Financing … A Guide for Small Hospitals (how-to guidelines)• Navigating Today’s Opportunities for Capital (how-to guidelines) Visit www.hfma.org/pulse 15
    16. 16. Appendix B. Survey Methodology • E-mail survey sent October 2009 to revenue cycle leaders and executives in hospitals and health systems • 92 responses received. Summary of hospital respondents: 16
    17. 17. HFMA is the nation’s leading membership organization for more than 35,000 healthcare financial management professionals employed by hospitals, integrated delivery systems, and other organizations. HFMA’s purpose is to define, realize, and advance the financial management of health care by helping members and others improve the business performance of organizations operating in or serving the healthcare field. For more information about HFMA’s Healthcare Financial Pulse, visit www.hfma.org/pulse.HFMA’s Healthcare Financial Pulse project is sponsored by:McKesson Corporation is the world’s leading provider RelayHealth connects providers, payers, pharmacies,of healthcare supply, information, automation, financial institutions, and patients to support quality careconnectivity and care management solutions designed improvements and reduce administrative costs.to reduce costs and improve care quality. McKesson RelayHealth’s proven financial clearance and settlementsolutions empower healthcare professionals with the services enable you to effectively manage your payertools they need to improve patient safety, reduce reimbursement and self-pay patients from inceptionvariability, and better manage their revenue stream and through resolution. RelayHealth securely processes overresources. 12 billion financial and clinical transactions each year. 17

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