At the Margins

2 ways hospitals can help Covid-19 patients with their bills (without suspending billing)

Rachel Matthews

Over the past two weeks, several major health systems announced that they are suspending all patient bills related to COVID-19 testing and treatment. CommonSpirit Health, Bon Secours, Providence St. Joseph Health, Prisma Health, and Advocate Aurora make up the growing list, with several others no doubt on the way.

How to bill for COVID-19 testing and treatment

It's a bold move, especially when hospitals face increased costs and declining cash flow as traditionally lucrative surgeries are placed on hold.

"This gives us the necessary time to align with insurers, testing, and lab partners, and our state and federal governments involved in providing various elements of COVID-19 health care," a spokesperson from Providence St. Joseph told Axios. CommonSpirit Health's CEO, on the other hand, cited the patient as their motivating factor, saying, "The most important thing now is for people who experience symptoms of the coronavirus to contact their health care provider and seek medical care if directed to do so."

But not all hospitals can afford such a move. Many small systems were already fighting to stay afloat before the epidemic hit. Now, many safety net and rural hospitals are in financial crisis, struggling to make payroll and turning to bank loans. Chicago's safety net Norwegian American Hospital is one example, with the CEO saying the hospital has enough cash to make the next two payrolls, but not much more. Add the likely increase in the number of self-pay patients as more workers are laid off, and a voluntary suspension of bills may be next to impossible.

Here's what you can do

If your system can't afford to suspend patients' COVID-related bills, focus on what you can control: the patient financial experience.

Providers need to be cognizant of the public perception of billing for COVID-19 treatment. Although several payers have recently waived cost-sharing for COVID-19 treatment (including Aetna, Cigna, and Humana), self-pay patients and those under other commercial payers remain vulnerable to treatment costs. Any provider that appears to charge inflated rates should expect to face at least some degree of public backlash.

Our previous research identified six fundamental questions that all hospitals and health systems should address within the patient financial experience:

While best practice organizations will proactively answer all six questions for their patients, we know it's a tall ask for some members, especially during an epidemic. Because of that, we recommend providers prioritize two resources that are proven to increase a patient’s propensity to pay.

1. Offer patients a financial counselor as soon as possible. Most COVID-19 patients will enter the care episode with fear. Some of that anxiety will be financially related, especially as more patients report surprise bills from COVID-19 testing and treatment.

Introducing financial counselors early in the journey can eliminate much of the uncertainty patients may face. Specifically, counselors can assist patients with price estimates and eligibility screenings, explain payment options, and answer any other questions patients may have.

2. Payment plans are a need-to-have. While most patients want to pay their medical bills, few have the financial resources to immediately front the cost. In 2019, an estimated 39% of Americans said they wouldn't be able to pay a $400 emergency expense without taking out a loan.

Customized payment plans empower patients who may not otherwise have the ability to pay. These plans are particularly crucial for the uninsured and high deductible health plan patients. Systems can establish payment plans in-house, through a third-party vendor, or via partnership with a local bank.

It's an extraordinary time for health care. Now more than ever, our nation needs hospital doors to stay open. While large systems can leverage their size and strength to pause patient bills, we know that not all hospitals can afford to follow suit. By focusing on financial counselors and payment plans, financially vulnerable systems can have a similarly helpful impact without threatening their solvency.

 

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