Increased patient pay responsibility has had an undeniable impact on healthcare providers. In 2017, patient pay represented nearly 35% of all specialty practice revenue, and that same year, TransUnion reported an 11% increase in out-of-pocket expense for patients. This shift in payment responsibility, high deductible health plans, and the dismantling of the Affordable Care Act have left patients and providers struggling to navigate this changing landscape. Nowhere is this more evident than in rural hospitals. More specifically, rural hospitals in the South.
Many rural communities are disproportionately uninsured with a greater percentage of low-income and poverty-level households than their urban and suburban counterparts. This mix of circumstances has ultimately left smaller community hospitals in jeopardy.
The North Carolina Rural Hospital Research Program reported that between 2005 and 2017, more than 120 rural hospitals closed across the US with most closing in the last eight years. When the data is broken down geographically, 60% of rural hospital closures happened in southern states.
Perhaps most concerning, the majority of hospital closures in recent years have been Critical Access Hospitals, designated by the Center for Medicare and Medicaid Services as essential to their communities. Without these crucial facilities, patients are often forced to travel over forty miles for care, so when a hospital closes, it is both the result of and the catalyst for a vicious cycle of decline.
The closure of a rural hospital has a lasting impact on the community it serves. These hospitals and healthcare providers are often the largest employers in rural areas with doctors, nurses, staff, and support services all employed by the facility.
While there is no easy solution, and the problem is multi-faceted, most of the facilities that closed in recent years were unprofitable, unable to service their debt, and struggled to collect payments from patients with or without insurance.
Unlike insurance billing, collecting from patients is not easy and cannot be solved by simply improving a process or hiring more people. The processes and people required to bill patients and protect the patient experience are completely different than the resources needed to bill insurance companies, and most rural hospitals cannot dedicate the time or budget to rebuild their billing office. There is however, an answer: the outsourced, patient-pay billing office.
A rural hospital may serve an entire county or region but remains part of a tightknit community where patients and providers see patients at the store, church, or school functions. This sense of community is what makes living in rural America so appealing, so turning patients over to an outside vendor is a daunting and scary step.
Outsourced billing historically meant bad-debt collectors hounding patients until they paid, but that model no longer works in today’s environment. Vendors dedicated to serving both the hospital and the patients can provide the same level of care, consideration, and compassion for which the hospital is known.
Patient collections are most effective when handled by experts skilled and equipped with the appropriate processes, people, and technology. PatientFocus was founded to help rural hospitals and other providers reverse the downward trend of revenue by giving patients the options they need to pay their medical bills over time and on budget. We help providers succeed by focusing on patient experience, treating patients like customers, and creating a meaningful impact on the entire hospital, not just their A/R.
Macon County Community Hospital is a perfect example of a facility serving a small rural community facing these challenges. After Macon partnered with PatientFocus to handle patient billing, the hospital’s patient-pay collection rate increased 51% from Macon’s historical baseline. While those numbers are impressive, Scott Tongate, Macon County’s CFO, framed up the real impact of improving their patient collections.
“So when we look at the additional revenue, we’re basically talking a capital budget,” said Scott. “And that budget is a CT machine, or this year for example, we’re investing in an EKG machine, and a second ultrasound machine. We’re also starting a new cardiac rehab, pulmonary rehab, and sleep study program. These are all things we weren’t able to do in the past. These are programs that have a huge impact on the community we serve, the community we live in.”
Patient experience is often framed within the moments of a doctor or nurse caring for a patient, but Scott reminds us that experience is greater than these moments extending beyond the walls of the hospital. At PatientFocus we deliver that same level of care throughout every patient call, letter, and conversation. When so many comparable hospitals are talking about scaling back, Macon was able to expand their services.