the psychology of choice in patient payment: behavior...

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

[email protected]

• 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


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


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.


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


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,


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


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.


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


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%


Financial impact of COVID-19

Percent of respondents who are very concerned about paying general

medical expenses cuts across all income brackets.



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.


Consumers need better payment alternatives


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


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


Speaks to consumer

expectations

Budget-friendly flexibility

Keeps patients out of default

Shows provider cares


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


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


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


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


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:


Strategy #3

Offer a payment plan that covers all patients

Creates greater satisfaction and goodwill

Increases collection rates

Strengthens provider’s brand


Strategy #4

Establish revolving accounts

Multiple Accounts One Convenient Account

LabInpatient

Ambulatory Anesthesiology Physician

Flexible payment plan

(Ambulatory, Inpatient, Lab,

Anesthesiology, Physician costs)


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


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

[email protected]

linkedin.com/in/markspinner1

the psychology of choice in patient payment: behavior...

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