presented by: marla k. (smith) moszer globe university august 31, 2011
TRANSCRIPT
The Value of Electronic Payments in Health Care
Presented by:Marla K. (Smith) Moszer
Globe UniversityAugust 31, 2011
Key Points to be Covered• The Government’s influence to use
electronic payments in Health Care
• Private payers’ convenience with electronic payments & increased collectability
• The use of electronic payments in a large facility vs. a small facility
• The future of electronic payments in Health Care
Major ConcernsRising Cost of Health
CareIncreasing Political
Control
History of Electronic PaymentsWestern Union 187 1
(2009)
Electronic Data Interchange (EDI) & Electronic Funds Transfers (EFT) 1970’s
Credit Card Payments in the 1980’s
The 1990’s – a time for advancement
Can Electronic Payments Help?
?
The GovernmentHealth Insurance
Portability & Accountability Act (HIPAA) 1996
Administrative Simplification Compliance Act of 2001
Government payments exclusively electronic
Health Care Reform (“ObamaCare”) by 2014
The Private Payer & Electronic Payments
Common Methods of Electronic
Payments
Credit Cards
Automatic recurring debit
Payers in 2016 = $4 trillion
Public Insurance
Private Insurance
Patient Payer
$1,650 How MuchWill
BeWritten
Off?$1,940
$435
Amounts in billions
“77% of providers say patient responsibility is on the rise” (InstaMed, 2011)
(Downey & Hanson, 2011)
Electronic PaymentsLarge vs. Small Facility
Allergy & Asthma Specialty Clinic
Rice Memorial Hospital
The Large Facility
Rice Memorial HospitalWillmar, MN
Jackie Hinderks, Director of Revenue & Reimbursement
“Eliminate paper!”
Jackie Hinderks
Electronic Payments atThe Large Facility
ReceivablesCredit Card Payments
In PersonOnline Payments
Credit CardE-checkDay or Night without
making an extra tripAutomatic Payments
Finance charge less than credit card
Reduces time & paperwork
Electronic Payments at The Large Facility
ReimbursementsElectronic billingPaper Statement Currently
350-page reportAll day to post (Blind et. al., 2007)
Inefficiencies without bundling
“…it always makes sense to do more with less.” – Hinderks
One day, all facilities can be joined electronically.
$35 billion & 2.5 billion
pieces of paper(Blind et. al.,
2007)
Electronic Payments at The Large Facility
PayablesDirect payments to
vendorsDirect deposit of payroll
Prepaid debit card option
No printing or postage with online paystubs
Paycheck gets to the right person
Not lost in the mailMore dependable
The Small FacilityAsthma & Allergy
Specialty Clinic, Willmar, MN
Jim Ellingson, Co-owner/Office Manager
Positive attitude toward electronic payments
Electronic Payments atThe Small Facility
PayablesVendor payments onlineSaves around
$2.00/payment
ReceivablesCredit Card PaymentsRecurring Automatic
PaymentsConvenienceMore Manageable for
PatientSaves Time & Money
Electronic Payments at The Small Facility
ReimbursementsInsurance coding
electronicallySame service applies
payments to accounts automaticallyTakes 3 days to 2 weeks More speedy than self-
payMonthly Fee + 6-month
membership
Electronic Payments atThe Small Facility
Complaints
Reimbursements not instantaneous
Recurring payments can be returnedNSF or Closed AccountLittle extra effort to
collectGovernment involvement
Can’t handle their own debt
Putting the little guys out of business
2008 2009 2010 2011 (1st qtr)
2.70%2.43%
2.26%2.06%
PPD-type Return Rate**
(EPCOR, n.d.)
Electronic PaymentsLarge vs. Small Facility
Small FacilitySpecialty Clinic
Positive review of Electronic Payments
Costs = Expenses Saves Time & Money Little negative to say Pushing for
technological advances to improve efficiencies
Positive review of Electronic Payments
Costs = Expenses Saves Time & Money Less cost efficient for
smaller clinic than large facility
Difficult to keep up with legislation & upgrades
Convenience is worth cost
Large FacilityHospital
Expenditures of theHealth Care Industry
$750 billion
$7.5 billion30¢ on the dollar
1% of administration costs
$2.5 Trillion in Health Care Expenditures
2009(Toutman et. al., 2010)
ConclusionRelationship
Electronic payments Health Care
BenefitsFinancial Compliance
Effectiveness of Collections Health Care Reform
Increasing Efficiency Administrative Simplification
=
Questions
?
Thank youfor your time!
ReferencesBlind, J., Hatch, T., Lauer, E., Lazenby, G., & Slater, J. (2007, June). Provider Tips for Moving to Electronic Payment Receipt and Reconciliation. HFMA Executive Roundtable, (June 2007),
Downey, D. E., & Hanson, S. (2011, April 4). Building a Bridge to Healthcare Payments.NACHA. Retrieved from http://healthcare.nacha.org/financial-institution-resources/presentations/building-a-bridge-to-healthcare-payments-how-banks-providers-work-together/
Ellingson, J. (2011, August 13). Electronic Payments at Asthma & Allergy Specialty Clinic. Interview by M. K. Moszer. Capstone Paper by Marla Moszer. Globe University, Richfield, MN.
ACH Statistics. (n.d.). Retrieved August 27, 2011, from EPCOR website: http://www.epcor.org/imis15/EPCOR/ContentAreas/Resources/NACHA_Rules/ACH_Statistics.aspx
Administrative Simplification Compliance Act Enforcement Reviews. (2005, December 14). Retrieved August 8, 2011, from U.S. Department of Health & Human Services website: https://www.cms.gov/ElectronicBillingEDITrans/04_Administrative%20Simplification%20Compliance%20Act%20Enforcement%20Reviews.asp
Hinderks, J. (2011, August 3). Electronic Payments at Rice Memorial Hospital. Interview by M. K. Moszer. Capstone Paper by Marla Moszer. Globe University, Richfield, MN.
Trends in Healthcare Payments (Annual Report: 2010). (2011, March). Retrieved from InstaMed website: http://www.instamed.com/news-and-events/trends-in-healthcare-payments-annual-report-2010
Troutman, J. W., Lisi, D., & Mayerick, B. C. (2010, April 26). E-Payment Cures for Healthcare.NACHA, Herndon, VA.
History. (2009). Retrieved August 13, 2011, from The Western Union Company website: http://corporate.westernunion.com/history.html
Author Note…This research was conducted as a Capstone project of Marla Moszer being part of her coursework to achieve a Bachelor’s degree in Health Care Management from Globe University. Ms. Moszer is also an Accredited ACH Professional having earned her certification through NACHA in 2007.
Correspondence concerning this article should be addressed to Marla Moszer, 207 Stearns Avenue, Paynesville, MN 56362.
Contact: [email protected]