by James A. Bacon

Just as they’re borrowing billions to pay for college, and automobiles, and credit cards, and houses, Americans are borrowing billions to pay for their share of healthcare costs that their insurance doesn’t cover — $88 billion, according to a 2019 Gallup poll. Adding insult to injury, Americans are subjected to a bewildering blizzard of paperwork from insurers, doctors, and hospitals.

Two years ago Roanoke-based Carilion Clinic, the healthcare system that serves more than a million people in western Virginia, knew it had a problem. More than half the health system’s patients wanted to pay off their hospital bills monthly, but 28% could afford no more than $250 a month.

“We realized that we did not have the technology in place to meet our patients’ and their families’ expectations in today’s environment,” said Don Halliwill, Carilion CFO in a Visitpay white paper, “Why CFOs Should Start Thinking Like Patients.”

The white paper describes how Carilion partnered with Visitpay to overhaul its patient billing process. Needless to say, the Visitpay paper puts a positive spin on the solution it devised to help Carilion. I don’t write about it here to tout the solution, but rather to suggest that there are better ways to do things. In Virginia, hospitals have come under intense criticism for antiquated and confusing billing and abusive collections practices. Carilion provides one possible model — I make no endorsements — for taking some of the pain out of the process.

As described in the white paper, Carilion’s primary motivation was to improve the patient experience. “We made the decision based purely on a set of criteria focused on the patient experience,” said Halliwill. “Our goal was not to necessarily have a financial impact, but to avoid a negative financial impact while delivering a better experience to patients.”

As it turns out, the financial impact has been positive.

Carilion Bill Pay launched in January 2020 to offer patients transparent billing and flexible payment options. More than 30,000 patients have registered. Enrollees have repaid 60% more of every dollar owed than patients still using traditional payment methods. “Our payment rates are up. Even amid COVID, they’re up,” said Halliwill. The new bill pay system “has been a win for us. Eleven months in and it has exceeded our expectations.”

The system has four building blocks:

• Flexible payment options. Patients’ financial circumstances vary widely. Carilion offers a variety of payment options, and plans are tailored to each patient.
• Consolidated EOBs (explanation of benefits). Participants want access to a consolidated bills that account for all charges. Consolidated bills reduce confusion and build consumer confidence.
• Tailored messaging. Communications preferences vary. Some people prefer text, others email, and others paper. Carilion delivers messages by the preferred channel.
• Digital front doors and back doors. The “front” door welcomes patients into the system. It provides customer-friendly features like online financial platforms to help patients plan financially for care. The “back” door covers the communications that happen after a patient leaves.

Hospital billing in Virginia is a mess. But not every mess requires a government remedy. Carilion thinks it has found a better solution. Hopefully, other hospital systems can learn from its experience. Visitpay is more than happy to share its knowledge.