By Kelly A. Briganti, Editorial Director, G2 Intelligence
A new report released this month by PricewaterhouseCoopers (PwC) describes the U.S. health care industry’s billing and payment system as “a horse-and-buggy in a world contemplating driverless cars.” The report indicates that current reforms and increasing deductibles are giving rise to consumer demands for more transparency, convenience, affordability and options with regard to health care billing and payment.
The report, Money matters: Billing and payment for a New Health Economy, was prepared by PwC’s Health Research Institute (HRI), based on a survey of 1,000 adults, health care executives interviews and a review of 34 million Americans’ commercial payer claims in the Truven Health MarketScan® 2012 database. HRI’s claims analysis revealed that in 2012, 80% of the 34 million Americans whose claims were reviewed didn’t hit their $1,000 deductibles. Thus, it concludes that Americans will be paying more out-of-pocket for health care expenses and will demand new billing and payment options. The survey revealed that consumers want a variety of payment options, “seamless” and convenient payment methods, transparency (knowing costs ahead of time and ability to compare prices), and discounts (for self pay and paying up front).
The report recommends simplicity in billing and pricing and offering patients choices in how they manage and pay their medical bills. For pricing simplicity, the report references Theranos, which lists its pricing online, and Walmart, which has a flat $40 fee for visits. The report concludes that health care organizations that implement some of the recommendations in the report “operate with the assumption that an informed consumer with choices will pay more of their bill more quickly, and that seamless and clear billing and payment can be a differentiator.”
You can find the report at www.pwc.com