Major healthcare payment trends are emerging, and they will transform the healthcare industry in the next few years. These trends revolve around frictionless experiences, personalization and patient-centered care, transparency and accountability, data sharing, and value-based reimbursement.
Payers are now transitioning to value-based reimbursement models while patients demand greater transparency and control over their data. In addition, providers need to adopt telemedicine services to improve care outcomes and reduce costs wherever possible. Let’s take a closer look at these trends to get ahead of the game before they become commonplace.
Customers in today’s market expect their interactions with healthcare providers to be open, honest, user-friendly, and cost-effective. Providers who operate healthcare payment systems that are difficult to understand run the danger of seeing a decrease in their patient population, as well as a tarnished online reputation, should dissatisfied individuals take their complaints to social media.
Healthcare providers can boost their revenue as well as patient satisfaction rates by implementing payment systems that are streamlined, up-to-date, and convenient. This would result in a huge win for the revenue cycle of any healthcare provider.
One of the biggest healthcare payment trends is the rise of consumerism in healthcare. Consumers are demanding greater transparency, better experiences, and more control over their data, which is reshaping the industry.
In terms of transparency, patients want to understand how providers deliver care and where costs come from. They want to be able to hold providers accountable, and they want to know that they are receiving value for their insurance premiums.
To achieve this level of transparency and accountability, healthcare organizations must adopt standardized data formats, open APIs, and other mechanisms that allow data to flow freely between organizations. Consumers will also expect more control over their data, such as which providers they share data with and what information they can access.
Blockchain is a distributed ledger technology that allows organizations to track supply chain activities in real-time and with transparency. It also enables secure peer-to-peer transactions, eliminating the need for a third-party intermediary. Blockchain can improve data transparency, security in the healthcare industry, and patient engagement.
For instance, blockchain can be used to store patient data and create health records that are accessible to healthcare providers. The blockchain healthcare payments trend is expected to grow in the next few years because it can help organizations reduce costs and improve transparency and data security.
Healthcare organizations are collecting increasing data, yet they are not always using it to provide better care. Many organizations are not even sure how to use their data.
For example, approximately 70% of U.S. hospitals are not using available EHR systems to their fullest potential. Healthcare providers are collecting data without actually using it to improve care. However, providers are starting to recognize that they need to use data to improve care and reduce costs.
Millennials are especially interested in data-driven healthcare because they are more likely to seek preventive care. As these individuals grow older and start families, they expect providers to use data to improve care and ensure that patients receive the right care at the right time.
Healthcare organizations are collecting an increasing amount of data, yet most providers are storing and analyzing data at the organizational level. This means that data is not making its way to other providers.
As a result, healthcare organizations are not reaping the full benefits of data. For example, patients may visit different providers, yet these organizations may not share information. This is a missed opportunity to improve care outcomes and lower costs.
Collaboration between healthcare organizations will be a top healthcare payment trend in the next few years. As health organizations transition to value-based care and start sharing data, they can provide patients with personalized care and reduce costs.
Healthcare organizations are investing heavily in EHR systems to improve workflow and outcomes. Yet many providers struggle to achieve their full potential with their EHR systems.
According to a recent survey, approximately 70% of hospitals need to improve their EHR systems. Providers struggle to implement their systems effectively and are not reaping the benefits. EHR systems are a major healthcare payment trend because they can improve workflow, reduce administrative costs, and facilitate better care outcomes.
For example, EHR systems can help providers organize patient data and improve care quality by enabling providers to access the latest information about patients, such as lab results and allergies.
Patients are seeking ways to reduce costs as healthcare costs grow. One method to accomplish this is to get more involved in their care. Engaged patients are more likely to adopt a healthy lifestyle, stick to treatment regimens, and avoid avoidable hospitalizations.
Healthcare organizations are beginning to appreciate the value of patient participation and are taking initiatives to promote it. Patient portals are one example.
While more providers are using EFT for transactions with payer systems, only 1% of providers accept EFT with a cost, while over 87% prefer EFT sans fees over personal checks. According to MGMA statistics, over 17% of insurers levy a fee for third-party vendor EFT payments. Even though prices may have hampered the electronic payments system, ERA/EFT transactions increased by 102% between 2018 and 2021.
These statistics are critical indicators for the creation of RCM hospital billing plans for healthcare businesses in the future. Keep this market intelligence in mind as you plan the next stage in revenue cycle management.
Doctors, clinics, and other health professionals have traditionally been paid fee-for-service. Each doctor visit or operation component is billed separately under the fee-for-service paradigm. The doctor, anesthesiologist, and facility all bill a patient who has surgery. They are charged for their lodging, drugs, and medical supplies.
For example, the ambulance provider will bill them for transportation if a person is involved in a car accident. They will also be examined in the emergency department and billed at the higher emergency room charge.
Many experts believe that fee-for-service healthcare increases healthcare expenses. This is because clinicians are paid to prescribe medication, order testing, and execute medical procedures.
To put it more simply, changes are being made to healthcare payment mechanisms, however, gradually. But, business-to-business (B2B) payer-to-provider corporate medical transactions have been slower to embrace electronic payment methods despite the rapid transition to digital payments in consumer-based payment systems.
Healthcare organizations have many payment trends to contend with, and the ones discussed above are particularly relevant. Given the state of affairs in healthcare, all organizations should be prepared to face changes in the coming years. As providers transition to value-based reimbursement models, they will be expected to achieve better outcomes at lower costs.
As patients, they will expect more personalized care, more control over their data, and higher transparency from providers. Organizations should integrate emerging technologies, such as blockchain and EHR systems, wherever possible to facilitate better data sharing and engagement.