Health Care Finance: Tools and Techniques

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Recent healthcare reform (The Patient Protection and Affordable Care Act) has affected not only patients but also healthcare organizations. Healthcare organizations are now relying on payments from patients to maintain their facilities and pay their workers. The creation of new insurance plans has increased the number of patients who pay for their health care costs out of their own pockets.

This situation has been aggravated by high rates of unemployment and the introduction of self-directed health care plans in the American health care system. The result of such reform has been the active involvement of patients in the daily decisions of their care. On the other hand, it has compelled health practitioners to improve their strategies to collect payments from patients through the development and adoption of strategic plans.

When patients fail to pay accounts receivable, the cash flow dwindles, bad debt accumulates, and the long-term growth of the organization is compromised. The enhancement of patient pay accounts receivable is the most effective way of improving the operations of health care facilities. My plan to enhance out-of-pocket accounts receivable would include the implementation of policies to encourage prompt payments and the utilization of technology to improve payment processes.

Literature Review

Poor payment processes are major causes of the mismanagement of patient receivables (Newby & Carr, 2013). Patients inability and reluctance to pay their out-of-pocket health care expenses is affecting many health care facilities that are already stretched financially (Fordney, 2017). Effective plans to enhance patient pay accounts receivable involve patient engagement and accounts management. Educating patients on organizational financial policies could reduce the incidence of missed payments. An increasing patient accounts receivable could signify ineffective front-desk processes and poor communication regarding the organizations financial policy (Paterson, 2014).

My plan to enhance patient-pay accounts receivable would comprise two main components: implementation of policies to encourage prompt and full payment and the use technology to streamline payment processes and remind patients of their financial obligations. Policies that offer cash discounts, time-of-service discount, and impose fines if payments are made late would be implemented (Baker, Baker, & Dworkin, 2017). Discounts would also be offered for cash payments. Many patients make promises to pay their bills but fail to keep them. In that regard, a fine would be imposed for late payments (Baker et al., 2017). A policy that imposes fines would encourage patients to pay on time and avoid extra charges.

The second component would involve using technology to improve payment processes, remind patients of their obligations, and increase the number of payment options available. According to Fordney (2017), technology enhances the process of educating patients and verifying their insurance eligibility. Using technology for check-in enhances upfront payment collection (Paterson, 2014). Technology would also facilitate credit card billing, hence maximize payments and shorten the time taken to collect debt (Marcinko & Hertico, 2013).

Facilitating automated credit card payment would eliminate the possibility of late payments (Paterson, 2014). Patients would be informed about their upcoming payments and insurance eligibility through automated reminder calls.

Summary

Health care reforms have resulted in high health care costs that have increased out-of-pocket payments. As a result, patients are incurring higher premiums, co-payments, and deductibles. Healthcare providers are getting more of their revenues from out-of-pocket payments. Therefore, it is imperative for them to develop plans to enhance patients out-of-pocket accounts receivable. Studies have shown that ineffective and limited payment processes are among the major causes of low out-of-pocket patient payments. My plan to enhance patient payments can be summarized as processes and technology.

Processes can be improved using technology, and technology can be used to educate patients. The plan would not employ aggressive methods such as the involvement of a debt collector because they would damage personal relationships with patients. Technology is used to remind patients of their obligations and improve payment processes. Moreover, it would be used to verify the insurance eligibility of patients. Many patients fail to make payments because of limited availability of payment methods. Part of the plan is the use of technology to allow patients make payments any time from whichever location. Reminding them of their financial obligations ensures that they do not incur extra charges for late payments.

The plans main objective is to make it easy and comfortable for patients to make payments and clear outstanding balances without any coercion. Moreover, the plan is also aimed at avoiding rocking relationships between patients and the staff. The implementation of the aforementioned plan would increase revenues and improve the provision of health care services.

References

Baker, J. J., Baker, R. W., & Dworkin, N. R. (2017). Health care finance: Basic tools for nonfinancial managers (5th ed.). New York, NY: Jones & Bartlett Learning.

Fordney, M. (2017). Insurance handbook for the medical office (14th ed.). New York, NY: Elsevier Health Sciences.

Marcinko, D. E., & Hertico, H. R. (2013). Financial management strategies for hospitals and healthcare organizations: Tools, techniques, checklists and case studies. New York, NY: CRC Press.

Newby, C., & Carr, N. (2013). Insurance in the medical office: From payment to Payment (7th ed.). New York, NY: McGraw-Hill Higher Education.

Paterson, M. A. (2014). Healthcare finance and financial management: Essentials for advanced practice nurses and interdisciplinary care teams. Lancaster, PA: DEStech Publications.

Penner, S. J. (2013). Economics and financial management for nurses and nurse leaders (2nd ed). New York, NY: Springer Publishing Company.

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