How well are you aligned with patients on financial experience? Study surfaces major disconnects

By Alan Nalle, Patientco Chief Strategy Officer, and Olivia Currin-Britt, nThrive Senior Director, Revenue Cycle Solutions | Posted: 07/19/2019

nThrive & Patientco patient satisfaction survey

Much has been written about patient financial experience, however, knowing what patients and providers really care about is the proverbial million-dollar question. A January 2019 survey by nThrive partner Patientco set out to explore the key concerns of both stakeholders, focusing on nine aspects of the health care financial experience. Fifty providers at large health systems with more than 350 beds responded, as well as 200 patients.

The goal of the survey was to help providers and the health care industry at large understand what patients seek from providers, identifying areas of alignment while also surfacing disconnects.

Here are the top insights gleaned from the study:

  • 79% of patients indicated that medical billing and payment experiences matter when choosing a provider, however, more than 50% of providers say they are NOT investing in consumer-friendly health information technology in 2019
  • 99% of patients want pre-service communications about costs and payment options, however, less than 10% of providers are focused on providing this level of patient satisfaction support
  • Patients want flexible, quality payment program options with two-thirds preferring to sign up online rather than by phone; online enrollment is virtually impossible to do today at most health care organizations
  • Patients cited affordability as a concern 4 times more than providers, while providers indicated that upfront patient collections were their chief concern

Deciphering the disconnects

For health systems participating in the survey, the focus was clearly on achieving an outcome, with most telling us “I want to collect more patient payments upfront,” or “I’d like to improve my point-of-service (POS) collections.” In contrast, patients were emphatic that they want to understand medical billing and payment options prior to care and before any money changes hands. If providers want to improve POS collections, they simply can’t bypass this important step that will drastically improve patient satisfaction while boosting revenue cycle management efficiency and effectiveness.

It is also clear that health systems aren’t focusing on affordability in the same way patients are. There is a preponderance of research pointing to patients deferring or delaying health solutions and preventative care because they are concerned about out-of-pocket expenses. Indeed, 60% of Americans say they cannot afford an unplanned bill of $1000, while the average employer plan deductible is $2000 or more, with high deductible plans averaging $7000+.

This impacts the health of communities – and health systems, which are at risk of not getting paid if they don’t offer affordable, quality payment programs. While many health care organizations do provide payment plans and alternative payment solutions, they are designed to force patients to admit that they can’t afford to pay and need help. In reality, patients don’t just want affordable options, they want digital, self-service enrollment.

Patients want to know, “Why do I have to ask permission from a call center person just to enroll?” They want to do it online.

Health Care Provider reactions

Reactions to the findings varied, with some health care providers patting themselves on the back and others viewing it as evidence that they need to continue working to address their patient financial experience.

For instance, we heard things like, “We understand that statements cause confusion, so we had a statement redesign,” implying they were in the “good” category. Others said the information was helpful, acknowledging that “this is making me think about how I address the digital front door for my organization.”

From a timing standpoint, most health care providers saw no immediacy to address patient satisfaction issues this year, which is ironic because nearly 80% of patients said they consider the medical billing and payment experience integral when choosing their health care provider. This is one of the areas where a health system could offer a differentiated patient solution experience in order to get more health care consumers through their door.

For instance, if one health system says, “You have to pay in full,” versus another that says, “Here are affordable quality payment programs and we’ll make it easy to enroll – you don’t have to ask for permission, just put a stored credit card on file and we’ll bill you every month,” I think we know which one is going to get the incremental visits.

Meeting customers where they are

Ultimately, patient experience is really about meeting the patient where they are. Health care organizations can do this by improving overall patient access and price transparency through effective charge description master solutions. Additionally, clear financial information and more flexible payment options are revenue cycle management solutions that span both the front and back of today’s health care revenue cycle and are dependent on a range of scenarios.

For instance, on scheduled procedures, medical organizations can work well in advance, reaching out to patients with accurate estimates produced by estimators such as nThrive’s CarePricerSM to discuss out-of-pocket costs and arrange upfront payment. Many organizations outsource these capabilities through services such as nThrive’s Financial Clearance Center, which leverages the latest in health information technology solutions.

For patients coming through the Emergency Department (ED), prior financial clearance may be virtually impossible, with billing happening following care. Patientco technology pairs with nThrive’s self-pay services, providing clear statements and a range of payment options.

As consumerism and price transparency fully take hold, health care providers can also differentiate themselves with online self-service estimating and payment capabilities. For instance, nThrive’s Carepricer Payment Estimator can be integrated into a provider’s website, enabling patients to create their own estimate to compare pricing. Similarly, Patientco technology can be integrated to make it easy for patients to make an online payment and/or enroll for a payment plan, bypassing cumbersome, password-protected EHR systems or having to speak to a representative.

Regardless of the scenario, this research reinforces why health care providers should be investing in health information technology and revenue cycle management services to streamline their processes and better serve patients. With patients as one of the largest payors now next to Medicare and Medicaid, providers need to give them every available option to pay their medical bill with ease.

Ready to take you patient experience to the next level and stand out among you competitors? Email us at or call us at (678) 323-2500 to talk with an nThrive health information technology expert.

About the authors

As Chief Strategy Officer, Alan Nalle brings more than 15 years of financial and corporate strategy business experience to his role at Patientco. In prior roles he has led innovation and growth strategy projects for leading payors and health systems.

Olivia Currin-Britt, nThrive senior director, Revenue Cycle Solutions, brings more than 15 years of health care delivery experience, developing and improving processes, procedures and operational goals for nThrive clients and directing overall workflow through managers, supervisors and front-line staff.