There is a “new payer” in town


There’s a new kid in town” … remember the hit song by the Eagles?

  Eagles / New kid in town (Live 1977) – YouTube

I recently asked some of my physician clients: What is your largest revenue stream?

Without hesitation, they quickly named one or two of their commercial insurance payers. Until recently, commercial payers have accounted for the largest revenue streams in private practices; however, this is not the case today.

There’s a new kid in town – “a new payer” as a direct result of today’s unstable healthcare landscape; it is impacting your revenue and must be addressed with a sense of urgency.

One of the lines in the song says, “There’s a new kid in town, I don’t want to hear it.” Well, let’s just leave that line in the song, because based on the survey conducted by HIMSS Analytics earlier this year and the reasons below, you do want to hear it. There’s a “new payer” in town!

Furthermore, the fast pace at which the industry is embracing emerging technologies and solutions to tackle this “new payer” is gaining momentum and is breathtaking.

The new payer in town is the patient who makes up your patient revenue stream; managing this revenue has never seen the “white glove treatment” commercial payers get, until now.

6 Reasons the patient has become the new payer

  • Today, the patient responsibility bucket equals or surpasses the commercial payers bucket.
  • Providers say that roughly 33% of all payments are successfully collected from patients, compared to 76-100% of reimbursements collected from commercial payers.
  • High-deductibles mean patients are paying more for their healthcare than ever before, increasing the overall patient responsibility.
  • Lack or delay of payment from patients continues to escalate and write offs continue to increase.
  • Confusion from multiple paper statements and difficulty getting the bill explained.
  • The growing patient responsibility means growing revenue cycle risk.

Now that the cat is out of the bag, is your practice experiencing this new payer in town?

The sense of urgency to prioritize your patient responsibility processes and align them with the rest of the commercial payers is critical.

Stay tuned for upcoming posts on how these trends and technologies are improving the performance of the patient revenue stream to levels closer to that of the commercial payers.

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