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Healthcare industry suffers from late payments - is transparency the cure?

News   •   Jun 06, 2019 09:07 +08

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The health-care industry is seeing late payments from patients, because of the opaque nature of its billing practices.

At a time when the Internet is providing transparency and more complete information for people to make better decisions, the health care industry still cannot answer the simple question of, "how much will this doctor's visit cost?"

According to Payments Journal, the healthcare industry is currently behind other industries in terms of price transparency and payment options. "The lack of transparency can cause concern and confusion among patients about what they owe and how to pay, often leading to either delayed treatment to avoid paying high, unexpected costs or significantly late payment for medical bills", the Journal writes.

The lack of transparency in the industry is so bad that the Trump administration is going to release an executive order to mandate the disclosure of prices in the healthcare industry.

The order could direct federal agencies to pursue actions to force a host of players in the industry to divulge cost data. The administration will also take on regional monopolies of hospitals and health-insurance plans due to concerns they are driving up the cost of care.

Will doctors and hospitals ever decide to give patients their total care costs of up front?

If they do not, they might find payments harder to come by. In a 2017 study by West Corp titled "Optimizing Revenue: Solving Healthcare's Revenue Cycle Challenges," the findings about patients delaying their payments are stark:

The study had this to say: "30% of patients cited confusion about how much insurance will cover what patients owe; 30% cited "receiving bills for services patients don't think they should have to pay for'; 25% of patients cited "waiting to receive the final bill so they are sure of the amount owed"; and 11% of patients cited 'uncertainty about what payment method to use.'"

In the United States, a law passed in 2011 required urgent care clinics to display the prices of their most frequently provided services, and to encourage general practitioners to do the same. But things did not improve.

In April 2018, the Centers for Medicare and Medicaid Services (CMS - Medicare) issued a draft rule in which hospitals had to publish their prices online for consumers and update their price lists annually. Hospitals are already required under guidelines developed by CMS to do so. But CMS updated its guidelines to specifically require that hospitals post the crucial information to make their charges more transparent.

The changes took effect in January. We are not sure whether it will be successful.

The healthcare industry is unique in that it can tie prompt customer payments to service and care. It is literally a life-and-death situation. But the lesson from other industries is clear: if you want to be paid on time, you have to make it easy for customers to pay you. Being transparent about the price is an obvious first step.

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