Introduction

Imagine if America’s government had an extra $1.3 trillion each year? Imagine how many poor and homeless people you could help, how much infrastructure could be improved, and how much money could be poured into educational and social care programs. According to government spending reports, the country could reach this type of saving it was to just bring down healthcare spending to that of comparable countries.

If we want healthcare spending and quality in America to be on par with the rest of the industrialized world, we need a fundamental shift in our approach to healthcare.

Below, we outline four distinct approaches exist for kickstarting this endeavor.

  1. Payment Plans
  2. Mail Order Pharmacy
  3. Technology to drive Continuum Care
  4. Helping patients understand Health Insurance Jargon

Patient Payment Plans

When patients have difficulty finding the means to pay for their health care, physicians are left to shoulder the financial burden. Their response is usually to send the outstanding monies to a collections agency without first trying Payment Plans.  If Providers became more familiar with employing payment plans to assist patients they would bring improved patient satisfaction and improved revenue and payment metrics! As out of pocket costs continue to rise for patients, payment plans will become an essential method of assisting them in paying for their treatment, over time, and in smaller quantities.  

Mail Order Pharmacy

The primary function of a “mail-order pharmacy” is to mail prescription medications to patients. Patients who fill their prescriptions through mail-order pharmacies, which are usually owned, or managed through their health or prescription benefit plan reduces the patient’s out of pocket costs, as the insurance plan offers to cover some of the copay costs as an incentive. Patients who use mail-order pharmacies are also more likely to be compliant, as their medications are delivered to their homes and usually in 90-day supplies.  So in addition to being cheaper, it is also more convenient and they have multiple months before they need to refill.

Technology to drive Continuum Care

Technology can provide patients with more options, such as receiving care in a less stressful environment. Since the Covid pandemic, patients are becoming increasingly comfortable with the use of telehealth and mobile apps to access care. These technology options meant that they  can avoid visiting out-of-network medical facilities, which place an increased cost burden on the patient.. Further, using technology can also promote patient compliance and make scheduling more efficient, reduce no-shows and more efficiently manage their providers scheduling. All of these factors allow health systems to save money over time.

Helping Patients Understand Health Insurance Jargon

It is crucial that patients understand key aspects of their health insurance. Words like “Deductible”, “Max out of Pocket”, “Copay”, “In-Network”, “Out-of-Network” are a jungle of insurance that much of the country doesn’t understand.  Healthcare advocates can help patients with this terminology so that they can learn that timing of their expenses can make a big difference to their overall costs (for example, if they have hit their deductible, then make sure any expensive procedures occur before the end of the year).

Conclusion

The cost of health care is out of control for most Americans, and when patients can’t afford their care, they either don’t receive it – causing major impacts in the care continuum and hurting hospital’s value-based care metrics, or become unable to pay their bills, impacting a provider’s revenue and their credit scores when they are sent to collectsion.

Implementing technology that helps patients adhere to their treatment plans is one option to save patient costs and improve efficiency. Payment plans are also vital for assisting patients in paying for therapy. It is also essential to communicate health coverage and health insurance jargon with patients to help them manage healthcare costs. To learn more about helping patients manage healthcare costs, get in touch with Qualify Health, we are dedicated to improving healthcare finances.

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