Online Billing Solution Boosts Intermountain's Out-Of-Pocket Payment Yields

The health system has digitally streamlined its patient financial experience, allowing patients to consolidate, view, and pay all of their Intermountain bills from a single electronic location.

This article appears in the November/December 2018 edition of HealthLeaders magazine.

Billing patients from separate entities within a health system often leads to confusion and delayed or lost revenue.

For instance, a patient might get bills for both a hospital visit and the medical group, set up a payment plan for one bill, and ignore the other, thinking that they've already paid or been accidentally double billed.

That's why Intermountain Healthcare has been working to digitally streamline its patient financial experience, allowing patients to consolidate, view, and pay all of their Intermountain bills from a single electronic location.

"One of the big issues that we've faced is, how can we create a more consistent, cohesive billing experience for the consumer, regardless of how we've segmented our business?" says Todd Craghead, vice president of revenue cycle at the Salt Lake City­–based health system.

Bills in One Location
 

Intermountain has been working with the company VisitPay to give patients access to an electronic system that provides a cohesive view of everything a patient owes across the system, channeling all their bills into one place and in a single monthly statement.

The opt-in system presents what patients owe in a single dollar amount, breaking it down by charge, payment, and insurance coverage for each visit.

The bills could be coming from a variety of places and multiple billing systems—different medical group visits, or a hospital stay, perhaps—but they're all drawn into one place and the view is the same.

"Every time a patient enters the system, they get a new account for billing purposes," Craghead says. "Once they opt in to use VisitPay, all of the accounts channel through that medium."

Patients are given the option to pay their balances in full or set up payment plans. There's flexibility in how and when they pay, too. For instance, they can use their credit card or Health Savings Account credit card to pay.

They can also set parameters for automatically paying bills that fall within a certain dollar amount.

"It helps leverage some of the techniques that many of us have been using in other industry settings to pay bills," Craghead says.

A single user can also channel multiple family members' bills together, such as spouses, minor children, and even aging parents, with the appropriate authorizations. That's why although the system has roughly 38,000 users (up from about 5,000 a year ago), Craghead says it actually represents many more patients.

Plans and Results
 

When it comes to setting up payment plans, Craghead says the system provides flexibility for the consumer, while also making sense for the health system. If a patient suggests a dollar amount that's too low, the system will alert them that it doesn't meet the criteria for a payment plan.

Instead, it will recommend a minimum amount based on the balance and the payment plan length, recognizing patients' limited resources, especially when it comes to high-deductible health plans.

"We try to encourage folks to set something that's meaningful, that will help them satisfy the debt in a reasonably quick way, so they're not burdened with that," he says.

Craghead says the average patient payment plan is 17 months long.

"But they're resolving," he says. "So that's helpful for us. That means that as long as we are in a position, which we are, to allow those accounts to reside in our accounts receivable, they're going to resolve, and that's been the case."

Since implementing VisitPay, yields from out-of-pocket payments improved by 15% to 20% at Intermountain. Intermountain is also tracking to a 25% increase in overall yield, while experiencing cost reductions.

In addition, the number of Intermountain patients who rate their billing experience as good or excellent is up more than 40%.

Don't Delay Digital
 

Hospitals and health systems may want to take their time in developing a complete digital strategy, but "in the meantime, I think that the consumer continues to be dissatisfied with their billing experience, and then they tend to characterize everything about their experience with the system as bad," Craghead says.

That's why he suggests that leaders not delay in making digital progress around patient finance and bill pay, especially since most digital efforts are related to things such as patient engagement and how patient care is delivered and managed.

Often, the patient financial experience is an afterthought.

"There are some great tools that are in the marketplace today that can help show meaningful improvements in the consumers' [financial] experience while you're working on your digital strategy," Craghead says. "You need to move forward on that particular element. Don't pause on that to wait for the broader strategy to emerge."