What You Should Know:
A new AKASA survey highlight the challenges hospitals and health systems face when trying to prevent surprise medical bills.
AKASA™, the developer of AI for healthcare operations, today released findings from a new survey highlighting the challenges hospitals and health systems face when trying to prevent surprise medical bills. Commissioned by AKASA, the survey fielded responses from 514 chief financial officers and revenue cycle leaders at hospitals and health systems across the United States through the Healthcare Financial Management Association’s (HFMA) Pulse Survey program between September 30, 2021 and October 17, 2021. The national survey was designed to assess the adoption of automation in revenue cycle operations at hospitals and health systems across the U.S.
Financial leaders at hospitals and health systems ranked the following four key barriers as all high stressors in the push to prevent surprise medical bills:
1. The inability to predict reimbursement for various providers of contracted clinical services who participate in procedures (i.e. anesthesiology)
2. Limited resources and staffing to support patient financial counseling
3. Delayed or erroneous responses from payors on eligibility inquiries
4. Inaccurate or insufficient information collected during the patient registration process
Impact of Surprise Medical Bills on Patients
Unexpected charges and surprise medical bills frequently haunt patients. According to the Kaiser Family Foundation , one in three insured adults (18-64) indicated their family had an unexpected medical bill, and one in six had a surprise medical bill related to an out-of-network. Those bills often required $500 or more in payment required – creating undue financial hardship on patients and their families.
Regulators and policymakers have taken note of the widespread prevalence of surprise medical bills: the No Surprises Act , which goes into effect on January 1, 2022, protects patients by restricting excessive out-of-pocket costs caused when consumers are unknowingly treated by out-of-network providers. While this is a step in the right direction, errors in the medical billing process are still a major issue and the rise of high-deductible health plans often leaves consumers confused about what they’re required to pay.
Adopting a Patient-First Policy to Protect Patients
“A patient-first policy requires taking a close look at revenue cycle operations as this function serves as the foundation for the patient’s financial experience with providers,” continued Raymond. “To protect patients from erroneous, surprise medical bills at-scale, solutions are needed to address the root causes of the problem. When automation is embedded to make revenue cycle operations more efficient and accurate, it can help ensure patients get the care they need without surprise medical bills.”