5 Ways Healthcare Payers Can Change the Game for Members

By Gretchen Hayden

Gretchen Hayden is a writer creating insightful content across the healthcare revenue cycle. She produces content for Zelis and previously for Sapphire Digital, a leading member navigation and shopping platform. With a deep interest in healthcare finance, Gretchen helps Zelis clients stay current on trends in the healthcare payments market, with an engaging and provocative perspective.

The quest for a perfect member experience is a difficult one. Health plans understand the value of member engagement and satisfaction but technological, regulatory and operational challenges often slow the process of achieving this goal. Not surprising, one of the largest areas of member frustration is the post-care financial experience. The process of paying a bill post-care is often confusing, especially for those with large out-of-pocket costs. And while members’ participation in high-deductible health plans has grown, their ability to pay rising costs has not.

Members oftentimes have expectations their payer should help resolve these issues.

According to the Member Engagement & Satisfaction Survey (published by Aite Novarica in association with Zelis), only 48% of healthcare payers offer financing to ease member stress at the post-care stage today. Aite Novarica found that “the implication for health plans is that post-care member engagement must address the task of navigating medical bills and paying them. Patient payments are ultimately part of member satisfaction, even if it is a payment from member to provider.”

While the matter of improving member satisfaction overall might seem daunting, health plans that take steps to provide financing options, billing guidance and advocacy stand to gain distinct headway on the path to provider and member satisfaction.

Advantages of Providing Post-Care Financial Support for Members

1. Faster payments for providers

One of the most significant advantages when healthcare payers provide member financing options, billing guidance and advocacy is that it can boost satisfaction among healthcare providers. When their patients have support, providers can get paid for their services in a timely manner.

2. Improved member satisfaction

Members who struggle to pay for healthcare services or who are experiencing billing issues can become frustrated and dissatisfied with their healthcare experience. However, when payers provide financing options and billing guidance, members can feel more confidence in affording the care they need. This can lead to higher member satisfaction and loyalty for both the provider and the health plan.

3. Better communication between healthcare providers and payers

By offering billing guidance to patients, payers can establish a more collaborative relationship with providers. This can lead to better communication and understanding of each other’s needs and requirements. Providers can also receive help from payers on their billing process and make changes to improve their revenue cycle. The more that payers and providers can work together, the smoother the care experience will be for members.

4. Reduced administrative burden for healthcare providers

Healthcare providers can also benefit from the reduced administrative burden that comes with having a healthcare payer provide billing support to patients. When payers offer these services, providers can focus more on giving quality care to their patients and less on administrative tasks like billing and collections.

5. Improved healthcare outcomes

When patients can access the care they need and understand what the cost and process will be, they are more likely to experience positive health outcomes. Additionally, when providers are able to focus on providing quality care without worrying about the administrative side of claims, they can improve the quality of their care and affect better patient outcomes.

Healthcare payers who offer financing options, billing guidance and advocacy can provide several advantages to healthcare providers and members. These services can help improve business, increase patient satisfaction, better the communication between providers and payers, reduce administrative burden and positively change healthcare outcomes.