three strategies to achieving a consumer-centric …...• decreased ar days with upfront...

PROPRIETARY & CONFIDENTIALPROPRIETARY & CONFIDENTIAL

09.27.18

THREE STRATEGIES TO ACHIEVING A CONSUMER-CENTRIC FINANCIAL EXPERIENCE

PROPRIETARY & CONFIDENTIAL 2

Speaker

Matt Moore Executive Director, Consumer Payment Solutions, Change Healthcare Matt Moore is responsible for the strategy and product development for consumer healthcare payment solutions, focusing on solutions for providers.

Prior to joining Change Healthcare, Matt was responsible for the patient access business at McKesson. In that role, he launched a highly innovative and configurable patient communication platform that was tightly integrated with the consumer payment solution and several patient access market-leading solutions.

Over the past 20 years of his career, Matt has worked with large U.S. financial institutions, including ABN Amro, U.S. Bank, and First National Bank of Chicago (now Chase) –developing and launching online transactional solutions, invoice presentation and remittance processing solutions for retail and commercial companies. He also has expertise in designing EBPP and EIPP revenue management services for small businesses.

PROPRIETARY & CONFIDENTIAL 3

Agenda

• Trends in Healthcare Consumerism• Three Strategies to Achieving a Consumer-Centric Financial

Experience:• Optimize Touchpoints Along the Patient Journey• Enhance Consumer-Centric Collection Tools• Think Like a Consumer

• Integrated Payment Solutions• Summary• Q&A

© 2018 Change Healthcare LLC and/or its subsidiaries or affiliates. All Rights Reserved. PROPRIETARY & CONFIDENTIAL 4 4

HEALTHCARE CONSUMERISM TRENDS

Trends

© 2018 Change Healthcare LLC and/or its subsidiaries or affiliates. All Rights Reserved. PROPRIETARY & CONFIDENTIAL 5

Healthcare Consumerism puts the economic purchasing

power and decision-making in the hands of consumers.

Enable patients to become wholly involved in their healthcare decisions.

What is Healthcare Consumerism?

• Goal: Provide better healthcare and improve patient outcomes while reducing costs and driving efficiencies throughout the healthcare industry.

Source: “How Real is Healthcare Consumerism?” Health Leaders Media, April 4, 2016


Consumerism is Changing the Game

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§ Over 6x growth in HDHPs in past 10 years1

§ Estimated 12.2M marketplace enrollments leading up to 20182

§ Consumers demanding simple, retail experience3

§ Engagement and reimbursement models

§ Payment and collections strategies

§ Digitization of healthcare information

Market factors:

Impact:

Total consumer out of pocket spending in 20164

$352B

Sources: 1 “Health Policy Brief, High Deductible Health Plans” Health Affairs, February 4, 2016, 2 “Projected 2018 Marketplace Enrollment in the Absence of ACA Sabotage” Center for American Progress, October 30, 2017, 3 “Why value-based care challenges providers, payers to offer retail-like experience” Healthcare Finance, October 4, 2017, 4 “National Health Expenditures 2016 Highlights” Centers for Medicare & Medicaid Services, 2016


Patients are the “New Payers”...but Struggle to Make Timely Payments

• Nearly 3 in 5 Americans (56%) delay paying their medical bills:2� 67% of patients say their financial situation makes it difficult to pay their medical bills

on time� 42% patients cite high insurance deductibles as the top reason behind delayed

payments� 36% find it difficult to remember to pay their bills on time� 30% of patients contribute delayed payment to confusion over how much insurance

will cover versus patient responsibility

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Patients are now responsible for 30% of their healthcare expenses.1

Sources: 1 “Patients are the new payers in healthcare” Healthcare IT News, February 6, 2018, 2 “West Study: 56% of Americans delay paying medical bills” West Corporation, August 28, 2017


78.9

76.9

73.2

77.6

54.4

0 20 40 60 80 100

BUYING A TV

CHOOSING A CELL PHONE PROVIDER

BOOKING TRAVEL

BUYING A CAR

HEALTHCARE SPENDING

2016 Consumer Healthcare Spending Index1

29.8

41.5

41.6

21.9

0 20 40 60 80 100

COLLEGE SAVINGS

RETIREMENT SAVINGS

"EMERGENCY FUND" SAVINGS

HEALTHCARE SAVINGS

2016 Consumer Healthcare Saving Index1

Survey of over 1,000 US healthcare consumers affirms that there is still much room for improvement for consumers to optimize their financial health

63% of Americans are unable to handle a $500 surprise bill, or a $1,000 emergency room bill2

Consumerism: Spending and Saving At-A-Glance

Sources: 1 Alegeus Healthcare Consumerism Index, 2016, 2 “Most Americans can't handle a $500 surprise bill” CBS News/Bank Rate survey, January 16, 2016


90% or Better

73%

53%

29%

At Point of Service

3 Months Later

6 Months Later

7+ Months Later

Self-Pay Collection Rates2

Likelihood of Collecting Patient Payments

Sources: 1 “Patient out-of-pocket costs increased 11% in 2017” Fierce Healthcare, March 5, 2018, 2 “Improving Self-Pay at All Points of Service” Change Healthcare

Patients pay three times slower than insurance carriers and cost twice as much to collect revenue from1.


Pain Points: A Tale of Two Segments

PatientsHigher Out-of-Pocket Costs

Limited Financial Savings

Increased Stress & Anxiety

Unclear Cost Transparency

Struggle to Understand Financial Obligation

Non-Retail-Like Payment Options

Providers Increased Bad Debt

Decreased Revenue

Reduced Patient Satisfaction

Higher Cost-to-Collect

Cost of Switching to Patient-Centric Approach

Adapting to New Reimbursement Model


Provider Results

Source: “The Engagement Gap: Healthcare Consumer Engagement” ORC International, 2017

92% of providers using

patient experience metrics to measure

success

72% of providers have given priority to

strategies focused on consumer-centricity

28% of consumer-centric budgets are being funneled towards software solutions


Provider Results


Majority of Consumer-Centricity Investments

are Being Funneled Toward Software

Solutions

Departments of Focus for Consumer-Centric

Investments

1 Ambulatory/Out-PatientServices

2 Inpatient Services

3 (General) Patient Education

Consumer-Centric Initiatives in Past 18 Months

Launched consumer-centric task force 47%

Other consumer-centric staffing 44%

New consumer engagement function 39%

New chief strategy or marketing officer 22%

New C-suite exec w/CG/S background 19%

None 12%

Providers are focusing consumer engagement investments on departments that involve personal patient interactions


OPTIMIZE TOUCH POINTS ALONG THE PATIENT JOURNEY

Strategy #1


Consumer Perspective in Patient Collection

• Complaints:� No one told me….� Why do I owe this?� I’m going to owe how

much?� Why do I have to pay?

• Demands:� Price transparency and

comparison� Cost after insurance� No surprise billing

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Providers have a 70% chance of collecting patient responsibility either prior to or at the point of service, compared to a 30% chance after discharge1

The cost to collect is lowest at point of service3

is the recommended upfront amount that providers should collect if patient obligation is less than $2,000 to improve likelihood of collecting the entire obligation2

60%

Optimize Pre- and Point-of-Service Collections

Sources: 1 The Academy of Healthcare Revenue, 2 “Optimizing Front Office Performance Executive Briefing” The Advisory Board Company, 2016, 3 “Patient collections: MGMA polls practices on billing policies” Fierce Healthcare, April 17, 2017


Consider adding QA reviews regarding pre- and point of service collection to assess efficiency.

Avoid billing patients with the full amount of the bill during post-point of service collection.

Encourage staff to discuss estimates and train them to collect payment at pre- and points of service.

Prevent the “Flight Risk” Scenario


92%of consumers want to know payment responsibility prior to a provider visit2

Collect at Every Touchpoint

17

Immediate results of providing estimates:1

• Patients who are informed about their financial responsibility are more likely to pay.

• Patients begin to expect knowledge of what their insurance will cover and what their out-of-pocket will be.

• Decreased AR days with upfront pre-service collections.

Are you positioned to go from estimate to collection in the same breath?

Sources: 1 “Why You Should Offer Patient Payment Estimates in Advance of Care” MediRevv, April 13, 2017, 2 “Healthcare Statistics that Every Hospital Should Care About” MedData, March 9, 2018


Reduced Patient Anxiety

Increased Patient Satisfaction

Discuss payment options, plans and timing

Higher Collection Rates

Start with the Conversation…

Personalize touchpoints / build trust

Provide cost estimates at pre- and point of service

Review multiple, patient-centric channels

Incorporate “Compassionate Collections”

Source: “Provider Insight: How compassionate payment collection boosted Grinnell Regional” Healthcare Finance, February 11, 2015


Pre-Service Point-of-Service Post-Service

Help improve patient satisfaction by presenting a seamless, consistent experience at all patient touchpoints

Check-in: Provide estimate; review payment terms

and options

Communicate insurance financial

responsibility

Billing statements: Be concise regarding

financial expectations; clearly outline multiple

payment channels

First phone call: Check eligibility

and provide estimate

Collect up-front payment

Confirm appointment and collect at time of service

Collect payment via

multiple channels

Leverage the Patient Payment Journey


ENHANCE CONSUMER-CENTRIC COLLECTION TOOLS

Strategy #2


Improving the Patient Financial Experience

21

Patients want:1 Providers need:

Convenient access

Personalized interactions

Expediency of services

Secured Payment Transactions

Accelerated cash flow

Greater patient satisfaction

Maximizing collections requires multiple payment channels and drives patient satisfaction through the last step of the healthcare episode, patient billing2

Sources: 1“The Engagement Gap: Healthcare Consumer Engagement” ORC International, 2017, 2 “What We Can All Do About Rising Healthcare Costs” All Business, June 28, 2017


Consumer Healthcare Payment Patterns

22

of consumers said they would prefer to pay medical bills electronically, with either payment cards or digital wallets.1

of patients compare their provider’s bill to their health plan Explanation of Benefits (EOB)2

of consumers preferred to pay healthcare bills online2

of consumers said they are concerned about online security for healthcare payments.1

72%

71%

69%63%

Sources: 1 “5 Patient payment trends affecting payers, providers in 2016” Becker’s Hospital CFO Report, June 22, 2016, 2 MadPow Consumer Survey, commissioned by Aetna


Price Transparency

Effective Patient-Centric Payment Approach

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Components: Benefits:• Retail-like experience • Omni-channel payments, including print

and electronic • Integrated solutions• Conveniently available at every point of

service• Includes digital alerts and

communication preferences • Secure and PCI compliant

• Helps reduce AR days • Helps to improve cash flow and speed up

patient payments• Helps to reduce bad debt• Lowers your third-party collection costs • Improves patient experience, thus

increasing patient satisfaction

Personalized Touchpoints

Tailored Billing Statements

Omni-Channel Payment Options


Obtain Patient Preferences

Design Thinking

Statement Templates & A/B Testing

• Statements are the first billing communication to patients.• Incorporate intuitive design into statements that capture the attention

of patients, and that help drive prompt payments.

Develop an array of statement templates that resonate with patients based upon their preferences. Determine which type of statement best resonates with patients by assessing their payment timing and channel.

Encourage patients to select a preference for digital communications, and opt-in for electronic billing notifications. Leverage their preferences in communications, where they can easily pay their bill in an expedited manner.

Personalize the Billing Experience

Source: “Provider Insight: How compassionate payment collection boosted Grinnell Regional” Healthcare Finance, February 11, 2015


Omni-Channel Payments

• Today’s consumers are seeking a retail-like experience in healthcare, and that includes the way they make payments

• They want multiple options using multiple:� Types of payments� Types of channels

• Enhanced data and payment security

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THINK LIKE A CONSUMER

Strategy #3


Consumer Results

Despite significant investment in consumer engagement, consumer experience with providers has not improved

There were no specific areas where consumers saw drastic improvements

Only 1 out of 5 consumers felt their experience with the providers improved and about the same think things actually got worse.

Less than

25%...

…of consumers saw No drastic improvements across all key measures of engagement with providers:

22% Ease of getting appointment18% Getting info from website14% Understanding billing statements9% Comparing health costs



Patients who are satisfied with the medical billing process are five times more likely to recommend a hospital than those who aren’t satisfied.1

74%Satisfied patients paid their

bill in full2

95%Satisfied patients would return for future service2

As opposed to unsatisfied patients…

33%Paid their bill

in full2

58%Would return for future service2

Improving Patient Satisfaction Pays Off

Sources: 1 “CFOs: The New ‘Executive Champions’ of Patient Satisfaction” Becker’s Hospital CFO Report, August 3, 2017, 2 “Study: Satisfied patients more likely to pay medical bills in full” Becker’s Hospital CFO Report, March 16, 2016


What providers think is successful(% very / extremely successful)

Channels consumers prefer(% prefer most / second-most preferred)

43%

40%

WEBSITE

53%

67%

EMAIL

32%

18%

MOBILEAPP

33%

40%

TEXT MESS.

29%

16%

TELEMEDICINE

23%

12%

IVR

14%

7%

WEARABLES

Providers/Consumer Perspectives: Most Successful Channels



Improve Communication Channels and Benchmark Success Rates

• Providers reported the greatest success through strategies designed to increase consumer engagement, with 42% of providers rating patient access first.

• Among solutions, 27% of providers said improvements and upgrades to their websites and online portals was the second most effective strategy.

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Consumers prefer to interact with provider via email, website, and texts


INTEGRATED PAYMENT OFFERINGS

Offerings

PROPRIETARY & CONFIDENTIAL© 2018 Change Healthcare LLC and/or one of its subsidiaries. All Rights Reserved. 32

Collecting Consumer Payments Requires an Integrated, Multi-Channel Approach

Customer

Consumer & Statement Data

Patient Response tracked across Web and Server Interactions

Feedback

Targeted Engagement: Billing content at the right time,

in the right way

Multiple Payment Tools:

• Online

• Lockbox

• Call Center

• IVR

Communications and Payment Solutions


Patient Payment Process

Mail Payment

Communication to Patient Patient Payment Payment Processing

Provider CustomerSatisfaction

Point of Service Collections

Print Statements

Email Statement Alerts

Patient Payment Online

Collections Support Call Center Payment

Phone Payment

Merchant Services

Lockbox


Integrated Solutions

eCashieringPoint-of-service

Consumer Pay Online

Phone Pay (IVR)

SmartPay™ Merchant Services

Pre-negotiatedagreement

Simplified fees

Consolidatedbilling

1

2

3

+

Patient Billing & Statements

Return Mail Manager

Inserts Invoices

+

Tax Forms (1099/W2)

Design Thinking Methodology

Letters

Personalized Communications

Patient Statements

Consumer Lockbox


SUMMARY

Summary


Shift from volume to value

Shift to becoming a low-cost, high-value provider

Shift from providing episodic care to engaging

with patients in their care

Shift from traditional models of care delivery

to multiple alternative models

What Shifts Do Providers Have to Make?


What Successful Consumer-Centric Collection Looks Like…

• Win for Consumers: Simple, easy-to-understand bills and ways to pay, less frustration, reduced transactional friction; enhanced patient experience

• Win for Providers: Reduce bad debt, lower costs to collect, and increase overall collections and cash flow; increased patient satisfaction

• Win for Industry: Increase the strength of partner relationships and trust between patients and providers

37

Win

WinWin

PROPRIETARY & CONFIDENTIAL© 2018 Change Healthcare LLC and/or one of its subsidiaries. All Rights Reserved. 38

Contact

Matt MooreExecutive Director, Consumer Payment SolutionsM 630-551-8689E [email protected]

mailto:[email protected]


Q&A

Q&A

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