Creating a new era of healthcare pricing and payments


While a third of US consumers say they have forgone necessary medical tests or treatments due to cost fears that stem from opacity and escalate from there, change is dangerously overdue.

Depending on who you ask, health systems have been expanding payment options for years — if not by design, at least by default — but even some who agree think that’s faulty reasoning at best.

“Health systems will tell you that they’ve been funding patients for a long time,” Shannon Burke, senior vice president and general manager of health systems at CareCredit, told PYMNTS. “What we haven’t been successful at is educating patients about funding and giving them broader options as they see it in other aspects of their lives. »

Burke joked, “You don’t just throw a bunch of groceries in a cart and have no idea. [of the costs]until you get to the register. You want to know the costs. You want options to pay these costs if you can’t afford to do so right away.

“Wellness and Affordability: How Payment Practices Create Positive Patient Experiences,” a PYMNTS report with research sponsored by CareCredit, found that 33% of consumers chose not to participate in medical interventions. Twenty-one percent cited cost as the most important reason, and not being able to afford treatment was the most important reason for 22% of those who said they chose to not receiving the necessary medical treatment.

Get the study: Wellness and Affordability: How Payment Practices Create Positive Patient Experiences

Meet the patient as a consumer

Slowly but surely, medical costs have shifted from employers and health plans to resting on the shoulders of consumers, which is not working out so well for anyone, starting with the patient.

Burke said that at one point, “We just consumed care. Over time, we became payers due to the nature of how health care was funded and paid for. The last thing that stands out is that we have become customers.

Integrating payment options throughout the healthcare journey, from planning to post-treatment care, is how forward-thinking operators are handling fundamental changes in healthcare payments.

“The new wrinkle is that healthcare systems are recognizing that one size won’t fit all,” she said. “You and I probably have different expectations when we receive an invoice. That’s really what it’s all about, meeting customer demand, flexibility and choice.

Burke said having a healthcare line of credit is not only comforting and valuable to patients, but also allows doctors to pay and maintain healthy credit scores.

“Costs increase when we delay care. Things don’t tend to resolve themselves in most cases,” she said. “What we do in funding is make sure we empower patients, comfort and trust [of]know what the costs are.

See also: New Financing Options Help Patients and Practices Manage Rising Healthcare Costs

A triumph for transparency

The post-pandemic patient has transformed into a paying customer and, as such, must feel comfortable asking their doctor questions about pricing normally reserved for a retail transaction. It’s not how we were trained to interact with healthcare, but we secretly wanted it to be.

As the Wellness and Affordability Study revealed, difficulty obtaining costs before a visit or treatment is a significant reason why 38% of respondents would switch healthcare providers. Additionally, 36% said they would switch providers because their practitioner’s billing process was difficult to follow or understand.

“There was a time when we had a doctor – we started with this doctor probably with our family, he was the only doctor we knew and he was the doctor we went to, and we never thought differently “, Burke said. “The study certainly shows that when we don’t get the experience we want and when we don’t get the customer service we want, we will walk.”

Health systems and practices can avoid the relentless search for second opinions by emphasizing price transparency and including payment options in their conversations about care.

“A lot of unfortunate things have come out of COVID, but definitely one of the by-products of it, at least in healthcare, is the fact that I think it’s really brought more transparency [and]the need for funding at the forefront,” she said. “I believe we will continue to see this trend.”

The new mindset starts with the patient as the consumer, and all stakeholders need to understand this.

As Burke said, “Just as we think about patient-centered, patient-centered clinical care, we need to think about patient-centered payments. It’s no longer in the back office. It’s being taken out more and more because we as patients pay more for that care and therefore want that transparency — and, frankly, we don’t want to be surprised.

Read more: 89% of consumers say health care estimates help them feel better, combined with financing



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