the psychology of choice in patient payment: behavior...
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The Psychology of Choice in
Patient Payment: Behavior
Change in Consumers and
Providers is Key
MAY 28, 2020
Introduction
Proprietary and Confidential. Do not distribute. 2
Mark SpinnerPresident & CEO
AccessOne
AccessOneMedcard.com
AccessOne
mspinner@myaccessone.com
• Entrepreneurial executive at the intersection
of technology, finance and healthcare
• Career in growth companies, corporate
finance, mergers and acquisitions with
transactions representing over $13 billion
spanning two decades
Proprietary and Confidential. Do not distribute. 3
Learning objectives
Learn how cost shifts to the patient are affecting their ability to pay and
mindset towards healthcare decisions as a consumer
Gain patient engagement strategies that increases collections, reduces
bad debt and leaves patients feeling empowered
Understand how increased flexibility changes payment behavior as part
of a patient-friendly billing strategy
Consumer Trends
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Consumer decision-making process
Need recognition
Information search
Evaluation of alternatives
Purchase
Post purchase satisfaction
or dissatisfaction
Cultural,
social,
individual and
psychological
factors affect
all steps
The five stages of decision-making in the consumer journey has remained
consistent throughout the years, and has now entered into healthcare
decisions.
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The consumer’s digital world
Online shopping has increased 74% since March in response to
COVID-19
Consumers engage with digital content 8.8 hours a day, younger
generations 11+ hours
use multiple devices to
complete everyday tasks
of mobile searches lead
to action within an hour
use mobile devices to conduct
research prior to purchase
90% 70% 40%
Source: Engine Insights, Adobe Consumer Content Survey
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Breaking down the consumer experience
What are consumers saying?
would stop doing business with a brand they loved after one bad
experience1
Consumers are 7x more likely to purchase and 15x more likely to
spread positive word of mouth from leaders in consumer experience2
say the experience a company provides is as important as its products
and services3
32%
7x
84%
Source: 1 PWC 2018, 2 Qualtrics 2019, 3 Salesforce 2019,
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What about money behavior?
Consumers employ a structured strategy to pay bills, most of which center
around paydays but these structured approaches are not paying off.
40% 23%pay bills late pay within
30 days after
the due date
pay after 30
days
never pay
on time
46% 23% 5%18%
These tools have rated the highest in helping consumers pay on time:
• Payment reminders
• Real-time or card bill payment
• Online customer communication
• Pay by text
The Affordability Crisis
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What % of families are concerned about losing their
jobs since COVID-19?
a. 10% - 20%
b. 21% - 40%
c. 41% - 60%
d. 61% - 80%
Survey
Consumer Impact of Covid-19 Crisis
Thesis: COVID-19 and the effect it is having on the economy could create
a large bad debt bubble in 2020-2021 as a void in the US consumer’s
primary sources to pay bills is being created.
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Consumer Credit is Shrinking
“Planned moves by banks include
approving fewer consumers with lower
credit scores, asking for more income
documentation and placing lower
spending limits on new credit cards.”
Income Gap, Unemployment Surging
Source: Department of Labor 5/28/20
AccessOne surveyed 1,000 consumers to understand how COVID-19 is
affecting attitudes towards finances and health.
AccessOne Survey: COVID-19 Consumer Sentiment
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of families are concerned about losing
their jobs
of survey respondents expect a loss of
income
69%
Source: AccessOne/Engine Insights Survey, April 2020
of families are concerned about their
ability to pay general medical expenses
67%
64%
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Financial impact of COVID-19
Percent of respondents who are very concerned about paying general
medical expenses cuts across all income brackets.
Source: AccessOne/Engine Insights Survey, April 2020
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Behavioral impact of COVID-19
56%
of respondents would
delay a diagnostic
procedure
58%
of consumers would
delay a non-
emergency but
medically necessary
surgery
58%
of respondents did not
include medical bills
in their top 5 priority
household expenses
Patients are very likely to delay diagnostic procedures and medically
necessary surgeries. Payment of medical bills is not considered a priority.
Source: AccessOne/Engine Insights Survey, April 2020
Consumers need better payment alternatives
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Life happens in normal times. In today’s environment, an unexpected
bill or expense takes on even more weight. People need help.
1GoBankingRates Survey 2019 2Bankrate 2019 3Wall Street Journal March 2020 4Kaiser Family Foundation 2019
27 million are putting
medical debts on
credit cards4
#1 source of
bankruptcy in the US
APR average 20.71% (March 2020)
Many don’t qualify
69% of Americans
have less than
$1,000 in savings1
70% of Americans
live paycheck to
paycheck2
Payday loan interest
rates up to 400%
Borrowing from 401k
stunts retirement
savings
A New Approach to Patient Payments and Financing
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Do you currently have an internal payment plan?
If so, what are the monthly terms?
a. Yes, 3 months or less
b. Yes, 3-12 months
c. Yes, 13 months or longer
d. No, we don’t offer in-house payment plans
What’s your patient payment plan?
What is patient financing?
Features or approaches may or may not involve:
• Accelerated cash (fully funded program) with associated recourse*
• Interest charges
• Flexible patient choices
• Patient qualification and associated credit reporting
• Automated processes for the provider or the patient
* Recourse is the money paid back if patient defaults
Ideal Patient Financing Program = Good for Patient + Good for Provider
Traditional
Medical
Credit Card
Interest Free
Program OnlyVariety of features and approaches
PATIENT FINANCING CONTINUUM
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Speaks to consumer
expectations
Budget-friendly flexibility
Keeps patients out of default
Shows provider cares
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The power of payment plan choices
50% of households with children
would switch providers for 0% or low interest financing
40% of individuals
Source: AccessOne/Engine Insights Survey, September 2019
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New psychology of patient payments
How Likely Are You to be Paid in Full?
Average of $2,000 BalanceLonger term
Lower
monthly
payments
with interest
Consumer
friendly service
options online
for patient
0% options
Consumers expect to self-service accounts
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Having a secure, mobile optimized
portal that allows patients to maintain
all of their accounts under one login
is a driver of satisfaction.
Patient portal features
• All payment types, recurring and quick pay
• Text and email notifications
• Secure messaging or live chat
• Payment history, tax reports
• Add charges
• View, print statements
• Save and manage pay methods
• Add additional authorized users
5 Strategies to Increase Patient Payments
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Strategy #1
Have payment plan discussions with patients
70% 59%
Source: AccessOne/Engine Insights Survey, September 2019
77%
want to speak to their
provider about
payment plan options
40%
are willing to switch
providers to receive
payment plan options
74%
said their providers did
not speak to them
about payment plan
options
Proprietary and Confidential. Do not distribute. 24
Strategy #2
Increase payment flexibility
“The set-up process was easy - I could even
choose the date and method of each payment.
The payment plan also didn’t impact my credit.”
Melissa – Patient Payment Plan User
• Low monthly payments
• Higher net collection rates
• Long-term patient engagement
• Patient loyalty
Melissa of Palm Beach Gardens, Florida narrowed where to have her baby to two
health systems, and then ultimately chose the health system who had a flexible
payment plan available to help her with delivery costs.
With a flexible payment plan option, both Melissa and her provider benefit:
Proprietary and Confidential. Do not distribute. 25
Strategy #3
Offer a payment plan that covers all patients
Creates greater satisfaction and goodwill
Increases collection rates
Strengthens provider’s brand
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Strategy #4
Establish revolving accounts
Multiple Accounts One Convenient Account
LabInpatient
Ambulatory Anesthesiology Physician
Flexible payment plan
(Ambulatory, Inpatient, Lab,
Anesthesiology, Physician costs)
Proprietary and Confidential. Do not distribute. 27
Strategy #5
Empower self-servicing of accounts – Atrium Health example
52% growth rate of
patients opting
into payment
plans
30,000 payment
plans
established
Customer
service speed
to answer
improved 67%
16,000 new
electronic
statement
opt-ins
Providers are
realizing gains from
fully exiting pay plan
admin business:
• Make CSR job
easier
• Focus on pay in
full
• Frees CSRs to
help patients with
other customer
service issues
6 month period after payment plan exit:
Patient
Reach
Provider Reach
Track
Record
User Experience
Summary/What to look for
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Patient Reach• Cast the widest net
• 100% acceptance
• Programs for all use
cases
Varied Funding Models• Fully Funded
• Managed Funding
• Unfunded
Patient Experience• Drives goodwill – no
negative outcomes
• Self-service
opportunities
• Easy to use
Experience & Innovation
• Specializes in Patient
Financing
• Innovates/evolves with
market
Thank You!
Mark Spinner
mspinner@myaccessone.com
linkedin.com/in/markspinner1
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