Paper-Based Billing is Ancient History in Healthcare

"Today's realities are that managing a practice is more complicated than ever…"

That's how an assessment begins on what it takes to successfully run a medical group in 2017 by Triple Tree, a merchant bank focused on healthcare. In a recent report, the bank also looked at the forces driving mergers of specialty groups. Chief among them is the realization by administrators and their physicians that the healthcare business isn't what they hoped it would be.

The mounting pressures are affecting medical groups' top and bottom lines. The bank's report suggests that while opting to be part of a larger group might sound attractive to an independent practice, the non-clinical demands are the same, just more complex.

And that is why all medical group administrators must realize the way to manage their group should sync with the business environments in which they operate. According to TripleTree, a critical success factor is administrative and operational efficiency, due to the significant burden created by government regulation. It also noted that groups need to support and keep pace with changing consumer preference.

Those two aspects have combined to force medical groups to work "more for less." Between the CMS and commercial payers, one might think that is plenty to focus on. However, there is a third payer with which to contend, the patient. The rise of high-deductible health plans (HDHP) has created a third payer group, your patients.

The patients who you see in your office every day could also be its undoing. Because patient financial responsibility has gone from about 10 percent of your bill to 50 percent or more, bringing greater efficiency to the billing and collection of patient bills is a necessity. It demands that administrators take a less lackadaisical attitude across their groups, from how the front desk greets the patients, to the people in the back office who often call about the past due balances. It also requires understanding how patients handle their bill-paying activities.

Among the observations made by TripleTree is that efficiency starts before the patient comes to the office. It suggests that "it is critical to driving highly efficient scheduling and reminders to ensure repeat volume is consistent and reliable."

Related to that is the need to realize a growing number of patients, or the parents of pediatric patients, manage much of their lives from their smartphones. The calling, texting or emailing of appointment and care reminders are reaching the level of ubiquity.

Interestingly, the Pew Charitable Trust reports nearly a quarter of smartphone users have paid a bill from their mobile devices. It's interesting because nearly 9 out of 10 healthcare bills sent to American consumers arrive in paper form via the U.S. Postal Service.

To make your medical practice more efficient, today's new approach to management demands that financial management and operations —including billing and collections, accounting, analytics, and budgets —get done differently.

Most medical groups run their business offices the same way as the day they opened their doors. No matter how many years ago your medical group opened, maintaining the status quo can be harmful to its financial health.

Let me repeat a harsh fact of life for a medical group, half of your revenue will soon come from patients. Unlike insurers who, even if challenging at times, pay like clockwork every couple of weeks on approved claims, it takes longer and costs more to collect from patients. The paper-based billing process results in a dangerous 90 to 120-day payment cycle, according to the MGMA, who suggests consumers don't pay anything until at least three paper statements have been issued.

If your group is still paper-centric, grasp the findings of a survey conducted by Aite Group, a global research and advisory firm, which looked into how consumers pay their healthcare bills. The researchers learned that use of the USPS to pay bills declines with each younger generation. The study found that 40 percent of bills paid by seniors went through the mail. By contrast, 44 percent of payments by millennials were made electronically.

There's much attention paid to finding ways to enhance the patient experience. In virtually all instances of such initiatives, this experience focuses solely on the time spent by a patient in the office, and largely while in an exam room.

If you send a bill in a way your patient doesn't prefer and, to add insult to injury, the statement is utterly confusing, whatever goodwill you built up through the efforts of your healthcare professionals vanishes in the moment the bill is opened.

In my dealings with medical group executives, I hear all sorts of excuses not to take simple, easy steps to improve their collection rates. It's as if they've turned a deaf ear to the challenging environment in which their practices exist and the shifts in the preferences of their patients.

Those who choose not to hear the signal for change will likely falter and fail. It's your practice. Manage it the way it needs to be so you can have a future.