In an era where healthcare is undergoing unprecedented transformation, the focus often lands squarely on technological innovation, clinical efficacy, and operational efficiency. However, one facet that often gets overlooked, and at times remains disconnected from overall patient experience surveys and results, is the financial experience of the patient. It’s a crucial dimension that profoundly impacts not only patient satisfaction and trust, but also the bottom line for healthcare providers.
As financial responsibilities shift increasingly onto the shoulders of patients, healthcare organizations find themselves at a critical juncture. The challenge is no longer just about providing exceptional clinical care; it’s about creating a holistic, patient-centered experience that seamlessly integrates care excellence and administrative ease with transparent, more predictable, and efficient financial interactions.
And while technology, data, and processes are important to improving all facets of revenue cycle, the ability to create positive and memorable experiences for patients—especially in the financial environment—can serve as a powerful asset. In this time of greater consumerism and competition, providers can benefit by investing in their financial team’s adoption of stronger customer experience practices and extending the actionability around brand promise.
Surge in Patients-as-a-Payer
Patient collections have become an increasingly difficult challenge for hospitals due primarily to a shift in payer mix. The percentage of healthcare provider revenue collected directly from patients has increased signficantly over the past decade. Increase in deductibles, inclusion of co-pay percentage, and the growth of high-deductible health plans equates to greater financial responsibility has fallen directly on patients. As a result, patient out-of-pocket spending has grown a whopping 124% since 2020—from $193B to $433B each year. And it is projected to increase by 10% each year through 2026.
According to the most recent Employer Health Benefits Survey from the Kaiser Family Foundation, the average premium for a family has increased 20% in the last 5 years and 43% in the last ten. Faced with soaring premiums, deductibles, and copays, many patients have no choice but to resort to borrowing money, paying with a credit card, or utilizing a GoFundMe-type moneyraising site. The JAMA Network reveals that nearly one in five individuals in the U.S. holds medical debt, amounting to a staggering $140 billion.
The implications are signficant, as a recent Gallup poll found that nearly 4 of 10 Americans postponed medical care due to financial constraints, a rise of 12 percentage points from the previous year. This delay in necessary medical attention exacerbates health conditions, leading to preventable hospitalizations and additional costs. We can also look at financial impact when it comes to fueling the estimated $300B in medication nonadherence.
The State of Patient Financial Experience Today
Healthcare media cited a 2021 consumer experience study by a billing technology company, where nearly 40% of participants expressed dissatisfaction with provider billing, and 53% found understanding their coverage and bills stressful. In addition, 63% of patients indicated a willingness to switch providers for a better payment experience.
Think about asking for your favorite meal at a fine restaurant—such as a perfectly-cooked Porterhouse steak with crispy pototoes and savory mushrooms. However, instead being brought out a fine white china plate, the chef goes out into the back alley, retrieves a dirty trashcan lid, deposits the cooked meal on it, and then brings it out your way.
Not so appetizing now, right?
That’s the way too many healthcare organizations make the financial experience. You can have the best clinical care, but the financial interaction leaves a sour taste in the mouth. Think about the ramifications that has on trust, retention, referrals, and patient engagement. Given this backdrop, the onus is on healthcare providers to take concrete steps to transform the patient financial experience.
The Importance of a Superlative Customer Experience
The entire patient financial experience is not just a by-product of efficient software, omnichannel digital interaction, or automated processes; it is often supported by human interactions that accompany these transactions. Whether that’s double checking on a bill, getting an upfront care estimate, or getting further details about payment plan options. This makes employee training, especially on optimizing engagement and outcomes, a necessary investment for staff members in revenue cycle operations. They are not just performing administrative tasks; they are each powerful points of brand and experience, contributing to the overall brand promise of delivering compassionate, comprehensive care.
Healthcare can take best practices of customer experience (CX), used in other industries—such as retail, travel, and hospitality—to improve financial experience, and overall patient experience. Think about training every single team member of a provider organization, who is involved in engaging with a patient within revenue cycle management, on these tenants of CX:
• Understanding customer needs
• Personalization
• Consistency
• Speed and Efficiency
• Transparency and trust
• Employee empowerment and accountability
• Follow-up, feedback from patients, and improving from that feedback
• Proper use of empathy, active listening, compassion, and emotional support
Extension of Brand Promise
Brand promise is the commitment a company makes to its customers about what they can expect during every interaction with the products or services the brand offers. It sets the expectations for the customer experience, serving as the cornerstone for all the brand’s messaging, design, and corporate decisions. A compelling brand promise should encapsulate the essence of the company and its core values— extended through and into interactions with, and creating memorable experiences for customers.
Many provider organizations focus primarily on the clinical environment in terms of patient experience. Today’s surge in consumerism, greater competition, and power of the “digital word” requires and greater level of competition requires a more holistic and true patient experience encompasses interactions and quality of engagement through clinical, digital, administrative, as well as financial environments. Here are some examples of how proper CX, coupled with the actionability of brand promise looks in creating better financial experiences for patients:
Emotional Support for Case of Confusing Charges:
Mrs. Johnson, an elderly widow who just lost her husband, is struggling to make sense of a long, complicated bill for her own emergency room visit. Calling into the billing center, frustration fills the patient’s voice as she struggles to understand the description of services. Emily, a call center billing representative, utilizes active listening and strategic empathy to help the patient “feel heard” in this stressful period. Once the frustration is reduced, and a greater trust is established, the patient makes her payment.
Financial Flexibility in an Unemployment Scenario:
Mark, a father of two, has just lost his job and is still grappling with the reality of how to provide for his family. When he needs emergency surgery, his anxiety peaks. Sara, from the billing department, proactively calls him to offer multiple payment options, even deferring the initial payment. Mark breaks down, relieved that his healthcare provider sees him as a human being first, not just a dollar sign.
Charity Care Example:
The Ramirez family, already burdened by the weight of both parents working multiple jobs, face crushing medical bills for their daughter’s unexpected illness. John, in the billing department, takes the initiative to flag their account for a charity care review. When they receive a letter stating that 80% of their bills have been covered, Mr. and Mrs. Ramirez break down in tears of relief and gratitude.
Communication on Estimate Before Surgery:
Sarah is a young woman grappling with the decision to undergo a life-changing surgery. She’s scared—not just of the medical procedure but also of the financial burden it could impose. Yolanda from billing sits down with her to provide a comprehensive, easy-to-understand estimate. Answering all of her questions and concerns in full. This act of transparency and care makes Sarah feel more in control and eases her emotional burden significantly.
Billing Dispute:
Kevin, a veteran facing PTSD, is already struggling emotionally when he notices a charge he didn’t expect on his hospital bill. He sends in an angry email to the billing contact center. Instead of receiving a cold, automated response, he gets a phone call from DeAndre in billing, who sincerely listens to his concerns. Discovering the mistake, DeAndre corrects it and thanks Kevin for his patience and sharing. This simple act makes Kevin feel seen and respected, easing a small but significant part of his emotional load.
Personalized Follow-Up After Final Payment:
Mei, a single mom who has been juggling multiple jobs, just made her final installment on a payment plan for her son’s hospital stay. Amy from billing sends her a handwritten thank-you note, making Mei feel appreciated and valued. In a world where she constantly feels overlooked, this simple note makes her day and she keeps it on her fridge as a small beacon of kindness.
Loyalty and Reputation Within an Online Review:
After experiencing a memorable moment from the local hospital billing team, Ahmed takes to social media. He shares a heartfelt video about how the compassionate act from a billing representative named Tammy eased his family’s emotional turmoil during his father’s cancer treatment. The video goes viral, attracting thousands of views and leading many new patients to choose that healthcare provider.
Conclusion
In a rapidly evolving healthcare landscape, patient financial experience is often the overlooked dimension that is ripe for transformation. Shifting payer mixes, soaring deductibles, and the rise of high-deductible health plans have made financial interactions between patients and providers increasingly complex. As a result, hospitals now grapple with the mounting challenge of patient collections, all while the financial burden on patients is reaching critical levels. This combination has spawned a vicious cycle of deferred medical care, ballooning medical debt, and growing dissatisfaction with the healthcare experience.
Yet, amidst the technological advancements and digital interactions that dominate healthcare reform discussions, it is vital to remember the human element. The revenue cycle and financial teams within healthcare organizations have the power, and the responsibility, to fundamentally reshape the patient financial experience. Their roles transcend mere administrative tasks; they can serve as the linchpin in delivering on the brand promise of compassionate, comprehensive care.
The days of delivering top-notch clinical care but failing miserably on the financial aspect are long gone. Patients demand—and deserve—a seamless, integrated experience that combines excellent medical treatment with transparent, empathetic, and effective financial interactions.