Jane Hermansen, Immediate Past-President of the Clinical Laboratory Management Association (CLMA) 
Lâle White, CEO & founder of XIFIN,
Imagine having to make a large purchase, but not having any insight into how much it will cost or if you will be able to access it after you have purchased it. Most consumers wouldn’t make an investment like that; they would demand information into where their money is going and what they would be bringing home with them. But as patients, this is a scenario that can be all too familiar: we aren’t sure what we’re going to have to pay and then don’t have much if any, understandable information to look at afterward.
Fortunately, the consumerism movement is now impacting the healthcare industry, and the way patients engage with their providers and their own health information is evolving. Patients are becoming more empowered when deciding how and where they receive healthcare services and are demanding more information about their own cost responsibility. Consumerism is also extending to data access with patients wanting to be able to review their records, results and overall health information.
We’re now seeing these expectations reach the diagnostic laboratory industry – a traditionally non-patient-facing healthcare provider. With patients footing more of the bill now more than ever, lab leaders must be ready to adapt to the changing healthcare landscape. Laboratories that are transparent and communicate useful patient data, including the exact cost and results of a test – not just how much the patient will be charged – will transcend in healthcare’s shift to consumerism.
Improving Patient Engagement and Cost Awareness
With changing co-insurance ratios, increasing bad debt write-offs and patient bills spending longer amounts of time in accounts receivable, the more financial burden is being transferred to the patient. When we take into consideration this increasing patient responsibility, along with labs and pathologists having little to no patient-facing interaction, it’s obvious that a greater effort must be made to both educate patients and proactively communicate with them about the diagnostic services that are being performed.
The lab industry can improve cost transparency by improving patient engagement and experience – including providing insights into patients’ out of pocket responsibility. For example, by stocking the offices that have a high volume of referrals with introductory letters that include information on labs and their role in healthcare, providers and labs can provide patients with the opportunity to become educated in the process prior to specimen collection, preparing them for any next steps or for a bill they may otherwise not expect.
Below are some keys ways technology innovation combined with information-sharing strategies like the above can improve patient engagement and cost transparency:
– Keep the Communication Lines Open: Consider technologies that offer the ability for the laboratory to proactively contact a patient after a test, but before they receive a bill so they can be educated on what their laboratory bill might look like.
– Contact Patients Using a Variety of Channels: As technology-based interactions gain popularity, it’s important for laboratories to offer a variety of options in communications, such as text, email, and online patient portals, in addition to standard mailed statements and call centers, for billing support.
– Embrace Technology to Determine Eligibility and Minimize Denials: Automated eligibility tools are extremely beneficial for verifying patient insurance, deductibles, co-pays, and demographics, while also preventing unnecessary denials. Solutions with real-time feedback will be most valuable in preventing unnecessary patient inquiries down the road.
– Offer Options to Price-Sensitive Patients: Some patients may opt to decline services based on their financial status. It may be desirable to develop a process to address these situations, which may include a payment plan, discount for cash payment, or information about a charity program if testing is performed in a non-profit organization.
Meeting Patient Expectations Around Diagnostic Data
No matter the generation, patients will continue to require increased access to and interaction with their health information, and lab data is an important part of this picture. Improvements in technology and engagement strategies are already helping to improve patient connectivity with their data. Leading-edge labs are adopting patient portals that not only provide appointment information, and view and pay bills, but share results electronically as well.
In 2018, a survey conducted by Accenture Consulting reported that the majority (67 percent) of U.S. residents who access their electronic health records found lab test results to be the most helpful EHR information among physician notes, prescription medication history, and more. People cited a need to stay informed as the primary reason for using their EHR, which points to the importance of having an effective means of communication between patients and healthcare professionals about their lab data.
In addition to having an open line of communication between labs, physicians and patients to deliver and clearly explain diagnostic data, labs can also develop or partner with diagnostic manufacturers to leverage solutions that provide and translate data into actionable insights. However, today there are so many tests and various ways to interpret lab data that patients often don’t know where to begin when they receive their results. This is where diagnostics and physicians can work together to help communicate lab results and translate them into actionable information for their patients.
Dexcom is one of a number of companies that make a glucose monitoring system that translates glucose measurements into dynamic data and is a prime example of how hungry patients are for these kinds of diagnostic tools. Patients have found this information so useful that they’ve hacked into Dexcom’s and other glucose monitoring companies’ devices to enable the data flow directly to their mobile devices in combination with other useful nutrition and exercise information so they can be notified 24/7 and act immediately on lifestyle or medicinal decisions rather than waiting for information that must be aggregated and interpreted.
With this, patients are driving change in the industry and showing that the demand for labs to get on board with the consumerism trend is greater now more than ever. In the coming years, labs will need to adapt and meet the consumer demand for data access via digital and mobile devices. We’ll continue to see an evolution in where and how lab testing is being performed, from home-based testing, becoming more prominent to genomic profiles taking the place of certain tests.
In order to get there, diagnostic providers (laboratories) must take that first step towards initiating patient engagement and transparency by realizing that as a non-patient facing community, they must work even harder to achieve better patient engagement. Relationships with the patient should not start when they receive an invoice, but rather from the moment their physician orders a lab test. The good news is, the technology that exists today gives labs the ability to drive better patient engagement, providing them with the cost and healthcare data information they expect. Providers that embrace healthcare consumerism will experience a more open continuum of care and improved connectivity between the patient, pathologist, and provider.
About The Authors
Lâle White, CEO, and founder of XIFIN
As founder and CEO of XIFIN since 1997, Lâle White has helped diagnostic labs and health systems process more than 60 million lab visits per year, realizing more than $3 billion in cumulative net cash collection gains. Lâle is a nationally recognized expert in medical financial management and regulatory compliance, with over 35 years of experience in information systems development and medical billing.
Jane Hermansen, Immediate Past-President of the Clinical Laboratory Management Association (CLMA)
Jane Hermansen has over 30 years of clinical laboratory experience, within a community hospital and academic medical center settings. As the Outreach and Network Manager at Mayo Clinic Laboratories, she manages the outreach consulting and health plan contracting network activities for hospital laboratories across the country. Jane has also served as the president of the international Clinical Laboratory Management Association (CLMA) from March 2017 – April 2019.
