[Event Debrief] Improving Healthcare Billing UX

Improving User Experience in Healthcare Billing

For health consumers navigating the financial side of care, the only thing more confusing than ‘the bill’ is accurately predicting the expense in the first place. Jeff Harrison, Senior User Experience Consultant for Fathom Consulting, presented the problems with the current billing system and possible solutions at the March Healthcare.mn meet-up.

Designing a Workflow Innovation

The March 6th talk “A Bill You Can Understand” detailed the process Fathom Consulting used and findings found after participating in the Obama administration’s contest to design a better healthcare bill, sponsored by AARP.

Participating teams had two options: 1) Focus on reimagining the UX of the bill itself to promote clear understanding for all parties involved or 2) improve interactions for health consumers end-to-end.

The Fathom team began with the first objective and quickly pivoted to conceive a workflow that allows consumers to better forecast, predict and pay for health expenses. Because, while the contest was framed as a bill redesign, the problem wasn’t solely the physical bill — it included factors leading up to it.

Gathering Background Through Discovery

To start the research process, and his talk, Jeff deconstructed some of the more convoluted components of current bills consumers receive. In some instances, the price is even listed twice. Explanations of Benefits issued by insurance companies further complicate things. In addition to understanding the bill, customers must learn to recognize whether the document detailing prices and totals is actually a bill.

The team talked at length with clients, in-house experts and patients to further explore the nuances and players. They learned consumer empowerment and control has a tremendous impact on perceived experience. Currently, healthcare bills have the advantage of surprise over consumers, because so many siloed parties are involved.

The Fathom team sought to accomplish multiple objectives:

  • Make the paper-based bill more workable
  • Make the bottom line less surprising
  • Change healthcare billing to align with modern consumer expectations
  • Reduce unpredictability

Truths to Govern Billing Health Consumers

Through the process and in their final submission, the Fathom team featured the following healthcare consumer truths they identified.

1. Help consumers better understand their options at enrollment.

Enrolling in a healthcare plan can feel like a high-stakes decision, in part because the differences between plans are not often clear. Consumers are asked to make predictive decisions, and many don’t have the patience, time or background to understand the intricacies and implications for their decisions.

Despite the systemic reluctance to sway consumers during plan selection, Fathom proposed an individualized and data-driven addition to the enrollment process. What if users could visualize a comparison of plans that included their estimated savings based on past health and billing data?

2. Tell me what this is going to cost me.

Most consumers don’t have an accurate understanding of price until each bill is received. According to Jeff and team, estimation is the cornerstone of meeting modern consumer expectations. The inability to predict care costs robs the marker of consumer price input. Fathom recommended a procedural change where at each stage in the billing process, the consumer would be given a bill with a cost estimation based on their particular insurance, including progress toward the deductible.

3. Tell me when I could be saving money.

While some states have more robust disclosure laws, elements of billing like facility fees often surprise consumers. To counterbalance, increase visibility for consumers, and help them save where possible.

4. Don’t punish me for other people’s decisions.

During his talk, Jeff shared the all-too-common issue where an in-network provider engages an out-of-network specialist, like an anesthesiologist. As this wasn’t the consumer’s decision, she shouldn’t bear the burden of additional cost.

5. Figure everything out, then bill me.

Care consumers who have weathered an extended billing cycle for surgery or other costly and phased treatments have likely experienced a stream of bills extending several months after the given procedure. As a part of the process Fathom proposed, care consumers would receive a bill only after the back office administration has been organized to present one bill — not 50.

6. Let me pay over time.

Consumers expect a monthly billing cadence. From credit cards to heat to Hulu, this is how modern billing operates. Allow consumers to pay a monthly minimum until the balance has been paid down.

Ultimately, the Fathom solution requires payers and providers to rethink their roles and responsibilities and decrease the fragmentation of patients’ financial relationships to the system.

Systemic changes will take time, but it’s exciting and encouraging firms like Fathom across the country are up to the challenge.

Authored by Emily Kastner.

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