Hospitals prepare for a cash-based future

MDsave also works with patients who want the amount they paid through the platform applied to their deductible, Wojtalewicz said. MDsave keeps a percentage of each procedure sold, although it did not provide details.

Baptist Health South Florida, where Miri serves as senior vice president and chief digital and information officer, began in July allowing patients to use Apple Pay and Google Pay to pay for health care procedures for their co-pay. or their procedure. The health system previously collected most of its payments over the phone or in person, he said. Patients could pay by personal check, credit card or cash.

Switching to additional payment options presented a workflow challenge, rather than a technical hurdle, Miri said.

“What’s hard is getting a zebra to change its stripes,” Miri said. “If you’re a health system that’s been around for over 65 years, like Baptist, you’ve always collected payments in a certain way, right? And if I’m going to change that on you and go very modern and digital, a lot of people said ‘Whoa, man, what are you talking about?’ It’s the heavyweight.

Listening and directly addressing employee concerns about implementing new payment processing systems has helped ease staff skepticism, Miri said. Baptist Health held several meetings where groups of employees from front desk, revenue cycle management, clinics and other employees discussed what the workflow should look like to serve self-serve patients. -paid. The health system has also developed staff initiatives to answer patient questions about using Apple Pay and other types of payment. Baptist Health staff have been trained to help patients recover their Apple Pay passwords, for example, he said.

In the first 45 days after launch, Baptist Health experienced some issues with the accounting staff transferring payment to the incorrect general ledger account, Miri said. He plans to monitor the books daily during the first trimester to ensure minor errors are caught early and resolved. The patient experience was not affected, he said.

With only 5% of Baptist Health customers paying directly for health services, it was important to implement Google Pay, Apple Pay, and other cash-flow capabilities because that’s where the industry is heading. Miri said.

“When you look at the directionality of demand, it’s only going to increase,” Miri said. “Patients are going to start seeing their estimated total bill and say, ‘I want to spend my $500 on a healthcare system that’s been really transparent with me and made me feel comfortable, relative to the healthcare system. down the road I’ve always gone, but that just can’t tell me what my actual amount is owed.

In response to requests from providers, Smith at the Oklahoma Surgical Center began licensing its Claims Settlement Center to help hospitals accept cash-paying patients and determine the appropriate rate to pay. to invoice. For hospitals looking to develop cash rates, Smith recommended health systems start by pricing their services as a percentage of Medicare.

But thinking about his own rates, Smith avoids the government program. Instead, it asks clinicians how much they expected to be compensated for each procedure, factors in expenses such as surgical equipment, medical implants and office space, then calculates a 10-15% profit margin. . If the surgery ends up costing the center more than the patient has agreed to pay, the center picks up the cost, he said. If the procedure was too high, Smith often said he would reimburse the patient.

“It’s kind of on a bell curve,” Smith said. “I make mistakes on both sides, and it balances out. I have a marginal profit which is integrated and which protects me.

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