Healthcare payments pose challenges to all affected parties

More than 90% of healthcare consumers were surprised by a medical bill in 2018, while nearly three-quarters were confused by a bill’s content and more than half could not pay a bill in full if it totaled more than $1,000.

That’s according to an annual survey commissioned by the payment network InstaMed, which queried consumers, providers and payers whose payments were processed in the company’s payment platform.

Commenting on the above findings, the report’s authors said payers and providers “must rethink the payment experience for consumers as payment responsibility continues to increase for both health plan premiums and medical bills.”

The pressure to do so is escalated by industries outside of healthcare raising the bar on consumer expectations, InstaMed added.

It’s not only consumers who are driving change in the payments arena. The survey showed that 90% of providers still use paper and manual processes for collections. Meanwhile 77% of providers said it takes more than a month to collect any payment, and 69% reported more out-of-pocket patient payments in 2018 than in the previous year.

“Providers are seeing the impact of the sharp rise in deductibles and patient responsibility,” the report authors wrote. “Yet there has not been a major overhaul in how providers are tackling the challenges of collecting from patients.”

Payers are feeling the heat of change too. The survey showed 82% of providers prefer electronic fund transfers, yet 91% still receive paper checks from one or more payers.

Payers are further confounded by 72% of consumers wishing to receive their bills for premiums electronically while some 42% are unable to receive bills this way.

And, not surprisingly, a strong majority of consumers, 71%, are confused by the explanations of benefits on their statements.

“Payers face pressure from shifts in federal mandates and new competition from leaders in retail,” the authors wrote. “Payers need to drive better member experiences, while looking for ways to optimize costs through the elimination of paper and manual processes.”

InstaMed is offering the full report as a free PDF download to those who provide name and contact info.