As healthcare providers continue along the paradigm shift towards a pay-for-performance model of healthcare, specific factors continue to affect the hospital revenue cycle management (RCM). In a hospital revenue cycle overview, the effects of rising healthcare costs make it apparent that patients have difficulties submitting payments. Therefore, hospitals and health systems are faced with millions in unpaid hospital debt. Not. Good.

hospital revenue cycle technology

Patient payment solutions are truly some of the heaviest revenue cycle technology artillery to have in your hospital’s arsenal.

What is the answer? Will blockchain technology increase the likelihood of receiving payment? Can robust hospital revenue cycle technology make it easier, and therefore more likely for patients to pay? These questions are covered in detail via analysis of current news and reports about the hospital revenue cycle industry.

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Hospital Revenue Cycle Overview: How Rising Costs Affect Patients and Providers

Lasting effects of rising healthcare costs include those felt by the patients and hospitals alike. In this new era, the patient, in effect, has in many cases become the payer, as identified in a TransUnion Healthcare analysis. In just 2017 alone, patients experienced an 11 percent increase in the average out-of-pocket costs for healthcare services. In fact, the average cost per patient out-of-pocket in the fourth quarter of 2016 was $1,630. In the fourth quarter of 2017, that figure swelled to $1,813. Further identified in the report was that on average:

  • Forty-nine percent of these out-of-pocket costs per healthcare visit was less than $500
  • Thirty-nine percent were between $501-$1,000
  • Twelve percent were more than $1,000

Jonathon Wiik, TransUnion’s principal of healthcare strategy, recently reported on these findings and more along with the release of his new book, “Healthcare Revolution: The Patient Is The New Payer” at the 2018 HIMSS Conference. According to Wiik:

“Increasing healthcare costs and patient responsibility is a continuing trend that does not seem to be slowing anytime in the near future. Given the increased payment responsibility, being able to determine a patients’ ability to pay is increasingly important for hospitals. In order to allow patients to focus on getting the care they need, healthcare providers need processes and tools in place to help patients meet their financial obligations and to establish funding mechanisms that will benefit both the patient and provider.”

Patients are feeling these effects of rising healthcare costs with:

  • Thirty-five percent of adults stating they would not be able to pay all of their other bill payments entirely if they were faced with an unexpected $400 emergency expense according to a 2016 Federal Reserve Economic Report that was also cited by the TransUnion study.
  • Furthermore, the 51 percent with costs greater than $5—cited their household finances were thrown into chaos on account of the high healthcare expenses.
  • Forty-nine percent whose bills were less than $500 also cited that financial complications likely resulted from the high out-of-pocket healthcare costs per visit.

As a result, hospital revenue cycle management professionals are left with millions of dollars in unpaid medical expenses that need to be sorted out. The entire revenue cycle management industry as a whole is now shifting toward a more consultative and upfront approach when it comes to dealing with those patients looking at high medical bills. Revenue cycle technology plays a crucial role along with a deal of patience as organizations improve their processes to promote patient payment follow-through.

Can Blockchain Technology in Healthcare Improve Hospital Revenue Cycle Management?

When you take a hospital revenue cycle overview and consider the possibilities — maybe blockchain will be a positive factor!

Data is everywhere. People are gaining more access to and control over their personal and financial data. One concept of data consolidation is the implementation of blockchain technology in healthcare.

Discussion around the concept of using blockchain technology for financial purposes has been ongoing for many years. Why would the use of blockchain in healthcare be any different? Proponents of the adoption of blockchain technology in the healthcare setting claim it can improve hospital revenue cycle management.

What is blockchain technology?

Blockchain technology is the permanent record that is shared of online exchanges or transactions. Within the healthcare revenue cycle industry, this includes all financial activity between a patient and providers of healthcare services.

[Read Also: Blockchain Healthcare Disruption in 2018?]

Essentially, hospitals and health systems rely on revenue cycle technology to help boost patient collections and reduce claims denials to improve RCM. A recent article in Becker’s Hospital Review listed the following four ways that healthcare RCM can be improved using blockchain. Suggestions included were according to an industry expert, Lynn Carroll, chief of healthcare strategy and operations at HSBlox, a provider of healthcare finance and IT solutions:

  1. “Value-based contracting initiatives. Healthcare organizations using value-based contracting initiatives can benefit from automation using smart contracts to administer bundled payments and episodic reimbursement models on blockchain.”
  2. “Real-time claims settlement and adjudication. Smart contracts on blockchain also allow for real-time claims administration and settlement processes, as well as EOB statements, at the point of service.”
  3. “Point-of-service transparency for patients. For patients, real-time EOBs — generated at the point of service using smart contracts — provide transparency with respect to their financial responsibility.”
  4. “Point-of-service transparency for patients. For patients, real-time EOBs — generated at the point of service using smart contracts — provide transparency with respect to their financial responsibility.”

Two Revenue Cycle Management Industry Leaders Partner to Deliver Better Experiences

The SSI Group is proud to offer more seamless and streamlined approaches to RCM and end-to-end payments made possible by the recent partnership with PatientPay.

Providers are able to increase collections with the combination of expertise and payment technologies. Patients benefit from greater flexibility and visibility that contributes to reduced cost. Jimmy Lyons, CEO, and President at SSI released this statement regarding the partnership:

“With the increased financial responsibility associated with high deductible health plans, the ability to communicate this responsibility and effectively collect payments is critical to effectively managing the provider revenue cycle. The integration of PatientPay’s solution into SSI’s revenue cycle offerings will provide our clients with a single platform where they can manage both claims and patient payments.”

The CEO of PatientPay, Tom Furr, expresses his thoughts on how this partnership affects the revenue cycle management industry as a whole:

“SSI understands what’s important to their clients and the industry as a whole. I am impressed with their plan of offering one comprehensive platform enabling the full spectrum of RCM services. We are fortunate to be working with SSI and look forward to our partnership to address the growing patient payment challenges.”

The SSI Group editors will continue our hospital revenue cycle overview looking for trends, tactics, and best practices for our growing clients in hospitals across the nation. We will also continue to bring you reviews about blockchain technology in hospital RCM.