Hospitals have faced issues with managing patient balances after insurance usage for years. However, a recent study by TransUnion Healthcare found the challenge continues to grow. Not only is this issue impacting hospitals across the country, but it's also making it more difficult for patients, posing a serious financial burden on those who can't afford care costs.
PBAI increasing by the numbers
According to the analysis, total bill responsibility of patient balance after insurance (PBAI) rose from 8 percent in 2012 to 12.2 percent in 2017. Commercially insured patients saw bills rise from an average of $467 to $781, a substantial increase of 67 percent.
"The continued trend in costs is correlating to an increase in uncompensated care."
Unfortunately, this continued trend in costs is correlating to an increase in uncompensated care, something that impacts both the patient and the provider, according to Jonathan Wiik, author of "Healthcare Revolution: The Patient is the New Payer" and principal for healthcare strategy at TransUnion Healthcare.
"It is becoming clear that patient balances after insurance is a major factor in increases in uncompensated care at the macro level," said Wiik. "Higher out-of-pocket-costs from cost sharing has made patients responsible for an increasing percentage of the bill. Most patients simply cannot afford that, and hospitals need to make sure they're actively engaging their patients to ensure they have funding mechanisms for the care needed. Tools like propensity to pay, charity scoring and others can help differentiate a patient's willingness or ability to pay."
Medicare patients see costs jump
Medicare patients are also struggling to pay deductibles and coinsurance. Hospitals and facilities are struggling to find a balance between reimbursement and patient responsibility due to this issue, according to John Yount, vice president of TransUnion Healthcare.
"Unpaid medical debt continues to pose challenges and the rise in uncompensated care further reflects the importance of implementing new solutions to prevent revenue leakage, which ultimately provides a better patient financial experience," said Yount. "A solution to address Medicare Bad Debt reimbursement is another critical component in a hospital's toolkit to ensure they're managing to the increased PBAI."
With the right plan in place, facilities can make better and smarter decisions toward decreasing the financial burden on patients.
RCM companies can provide a solution
Making sure the correct payer is identified to maximize reimbursement can solve such issues faced by both the patient and healthcare facility — a good example being an injury from a motor vehicle accident or at work. This is one way to reduce the problem of bad debt exposure, allowing providers to decrease cases of uncompensated care.
Hospitals can benefit from outsourcing to a third-party revenue cycle management company like PROMEDICAL. With a technology-driven revenue cycle partner, you may reduce patient balances after insurance. This minimizes the bad debt and ensures your patients receive the quality care they need without worrying about the financial burden that follows.
Some of the core benefits of working with an RCM provider include a streamlined process, increased efficiency, reduced operating costs and an improved patient experience. There's no need to rely on just the hospital's revenue cycle professionals to take care of all revenue cycle management — hire a team of RCM professionals to reduce these tasks.
By partnering with PROMEDICAL, you can improve reimbursement, timely resolutions, and increased cash and, in turn, have more satisfied patients. Reach out to PROMEDICAL today to learn about the benefits of partnering with our team.