4 Key Trends in ASC Patient Financial Responsibility

If you’re in healthcare, one trend that has been impossible to miss is the shift of financial responsibility from payers to patients. With high deductible health plans, patients have been turning to surgery centers to get a lower cost instead of going to hospitals.

According to REJournals, the number of ASC’s in the United States has grown 82 percent since 2000 and the number of outpatient surgeries performed has grown 30 percent since 1990. Two-thirds of surgeries are now performed on an outpatient basis. The main reason for this growth is that surgery centers provide patients high-quality personalized care at a lower cost and the ability to recover at home.

In a report, Kaiser Permanente said patients can see an average cost savings of 30 percent at ASC’s compared to hospitals.

With growing patient volume coming to ASC’s, the challenge of collecting from patients also increases. Here are key trends that will affect your ASC’s bottom line:

1. Patient financial responsibility is on the rise

A study by TransUnion Healthcare showed that patient responsibility after insurance increased 88 percent between 2012 and 2017. A recent TransUnion Healthcare analysis also revealed that patients experienced an 11% increase in average out-of-pocket costs during 2017 alone, increasing from $1,630 in Q4 2016 to $1,813 in Q4 2017. In addition, patients have experienced a nearly 30% increase in deductible and out-of-pocket maximum costs since 2015 according to a Black Book survey.

Furthermore, the average annual premium for employer-based family health coverage rose 5 percent to $19,616 in 2018 compared to $18,764 in 2017. Among covered workers, the average annual deductible for single coverage also rose to $1,573 in 2018 compared to over $1,200 in 2017.

2. Patients demand price transparency

According to Instamed, 9 out of 10 consumers want to know their payment responsibility prior to a procedure.

However, price estimate accuracy is a real concern. In a 2017 Black Book survey, 83% of ambulatory providers including surgical centers, diagnostic facilities and rehabilitation facilities indicated that estimates are wrong.

3. Patients want financing options

A study by the PwC HRI points out that 85 percent of consumers surveyed said that they want a service that would allow them to finance the costs of large medical expenses.

As consumers, patients are used to installment plans and financing options from the retail industry. ASC’s can leverage this trend by offering loans that are customizable to better fit patients' budgets and financial profiles.

4. Patients want online and mobile payment methods

In 2017, Black Book polled 2,698 healthcare providers and 850 consumers under high deductible health plans. The survey revealed that nearly 62 percent of medical bills are currently paid online.

But patients expected more: 95 percent would pay online if the provider's website offered the option. In addition, 71 percent of surveyed patients reveal that mobile pay and billing alerts have improved their satisfaction.

A majority of financial administrators expected healthcare payments to be made on phones/mobile devices but only 20 percent of healthcare providers surveyed are currently ready for electronic payments beyond checks, cash or credit/debit cards.

David Hamilton is the CEO of Mnet Health Services, a Business Process as a Service (BPAAS) and Financial Technology (FinTech) firm with a specialized focus on End-to-End Revenue Cycle Management, Care Coordination, and Quality Assurance in the healthcare industry.