As high deductible health plans, coinsurance and tiers of copayments become more prevalent in the health care world, collecting money from both patients and payers becomes more complex for providers. The 2012 Trends in Healthcare Payments annual report from InstaMed contains interesting information on the payment process. (InstaMed Report) Payment processes have become more important to providers because patient bad debt, estimated at about $65 billion in 2010, is obviously quite serious and the administrative costs of trying to collect frequently eat up a big chunk of whatever is eventually paid. According to InstaMed, patients are continuing to be responsible for an increasing fraction of overall billed charges, and payers are reimbursing an astonishingly low 20% of billed charges, the bulk of the difference being accounted for by greatly inflated nominal prices on the part of providers, but patients are now responsible for an average of over 20% of allowed charges. Payers are mandated to support electronic bill submission and payment in 2014 and most have the capability already. Providers are less prepared for an all electronic process, but in 2012 over 50% of payer payments were made by electronic funds transfer. Providers are trying to encourage patients to make payments at the time of service, with deductibles and coinsurance, it is often hard to figure out the patient amount owed. Providers are also trying to get patients to pay online and these payments accounted for about 12% of all payments in 2012. Overall, 80% of patients take more than one month to pay their bills. Overall the report gives a good sense of the complexity of payment processes.
✅ Subscribe via Email
About this Blog
The Healthy Skeptic is a website about the health care system, and is written by Kevin Roche, who has many years of experience working in the health industry. Mr. Roche is available to assist health care companies through consulting arrangements through Roche Consulting, LLC and may be reached at [email protected].
Healthy Skeptic Podcast
This is an outstanding report on total global drug spending and trends, with projections out to 2025. It helps you understand this important area of health care, which does much...
June 1, 2021
MedPAC 2019 Report to Congress
June 18, 2019
Cano Health apparently cannot, as it declares bankruptcy due to too much debt. Building primary care centers to serve Medicare, Medicaid and commercial populations, which is Cano’s business, was hot...
February 6, 2024
Turquoise health raises a fresh $30 million in capital for its price transparency platform, as the market for funding health care companies isn’t quite dead yet.
January 24, 2024
I am co-f0under of a company that manages cell and gene therapy for health plans. Cell therapy has made a big difference for many cancer patients but like all new...
January 24, 2024
Access ACO Care Management Chronic Disease Comparative Effectiveness Consumer Directed Health Consumers Devices Disease Management Drugs EHRs Elder Care End-of-Life Care FDA Financings Genomics Government Health Care Costs Health Care Quality Health Care Reform Health Insurance Health Insurance Exchange HIT HomeCare Hospital Hospital Readmissions Legislation M&A Malpractice Meaningful Use Medicaid Medical Care Medicare Medicare Advantage Mobile Pay For Performance Pharmaceutical Physicians Providers Regulation Repealing Reform Telehealth Telemedicine Wellness and Prevention Workplace