Wednesday, January 19, 2010
Are You Ready to Write Off 14% of the Market?
data from the U.S. Substance Abuse and Mental Health Services Administration, approximately 14% of all mental health
expenditures are from consumer out-of-pocket spending. Yet, few provider organizations have the ability to estimate a patient’s out-of-pocket expenses, present a bill at the point of service, and collect immediately. Instead, the typical process is to send a bill, often weeks later, and hope that the patient antes up – with little plan to pursue "payment deadbeats" aggressively. Is your organization one of the many that is willing to write off this portion of the market?
Looking ahead, we can expect the proportion of consumer-paid health care to increase: Out-of-pocket health care costs for individuals with employer-sponsored health care insurance
increased by 30% between 2001 and 2006; Medicare has long required significant consumer contributions to service costs; Medicaid plans are now appearing that have consumer payment provisions similar to employer-sponsored plans; And, the health insurance options that will be offered by the state health insurance exchanges under health care reform will allow for a wide-range of consumer participation in payment.
The good news in all of this is that while conventional
wisdom says that many U.S. consumers can’t—or won’t—pay for
health care costs,
recent research from McKinsey and Company suggests that consumers are, in fact, willing to pay for services. Still, many of the respondents also said that confusion about payments and the lack of financing options for expenses are major problems when it comes to making payments.
Expect to see a greater proportion of the total health care dollars in "self pay" with more copayments and deductibles in the years ahead – and a mandate by payers to collect these funds. What all of this means is that simply sending a bill and then calling a collection agency can no longer be considered good business practice—for your organization, or for the consumers that you serve. You can read more about the issues of consumer payment in my article,
Consumers Can & Will & Must Pay for Services: Mastering the Self-Pay Process is a Necessity for Your Organization
Monica E. Oss
Chief Executive Officer, OPEN MINDS
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read more, see:
Out-of-Pocket Health Care Costs Up 30% From 2001-2006 for People With Private Insurance
This is free for the next sixty days to all registered
OPEN MINDS Circle members.
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