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Self-Paying Patients and Re-Inventing the Healthcare Experience

Patients have now become the new payers due to fundamental shifts disrupting and redefining healthcare. The American healthcare system's traditional reliance on third-party payment that has shielded patients from the actual cost of the care being received has become less relevant and these increasing cost responsibilities are forcing patients to more carefully consider the value they are getting for their care.

Why Now? Five Shifts Disrupting Healthcare

#1 - Increasing high-deductible health plan (HDHP) enrollments have left patients shouldering a greater percentage of their medical costs. In addition to HDHP plans, patients in traditional benefit plans are also paying an ever-increasing portion of their healthcare costs. This is forcing consumers to fully engage in healthcare spending decisions.

#2 - COVID has disaggregated healthcare and fundamentally reshaped consumer behaviors and attitudes.

#3 - Insurance plan contracted prices and discounted cash prices for services are now required by law to be posted by hospital systems.

#4 - Outpatient revenue continues to grow as a share of total hospital revenue.

#5 The millennial generation readily engages with innovative digital platforms and is increasing its rate of healthcare service utilization and spend.

In addition to these shifts, consumer dissatisfaction has increased due to patients receiving multiple bills from different service providers for the same encounter, a lack of payer/provider coordination and post procedure denials of coverage. This has confused patients and alienated them from the healthcare system to the point that care is only accessed when necessary.

Improving the Patient Experience

With the rise of the self-pay patient, providers must re-orient their practices to attract new patients and retain existing ones. With the days when a patient paid a $10 copay to see a specialist now long gone, better approaches must now be taken to accommodate proactive, self-paying patients whose expectations have been informed by more convenient experiences in retail and hospitality that address affordability and provide convenience. To achieve this, successful providers of the future will build their practices with the following consumer-centric value enhancing capabilities:

#1 - A retail-like set of technology solutions that better address consumer satisfaction, cost transparency and payment/financing challenges.

#2 - Technology solutions that integrate with a practice's workflow while providing an easy online scheduling and communication interface between the patient and provider.

#3 - Transparent and consistent upfront price information that is readily accessible by existing and prospective patients.

Healthcare is slowly re-orienting itself to meet the demands of cost-conscious patients. By effectively leveraging technology that truly enhances their value proposition, providers can better meet the demands imposed by this new reality. This will not only be good for their practice but will fundamentally reshape the entire healthcare experience for patients and providers alike.

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