HIMSSCast: About 40-50% of hospital patient balances go unpaid, says Cedar President Seth Cohen
Fast-growing high deductible plans have changed the billing and patient experience, Cohen says.
Photo: Tetra/Getty Images
The Hospital Price Transparency Final Rule that went into effect in 2021 does nothing to help patients who want to know what they'll be paying out-of-pocket for services, according to Seth Cohen, president of patient billing experience company Cedar.
Due partly to the trend towards high deductible health plans, 40 to 50% of patient balances remain unpaid in this country, Cohen said. Some clients, he said, are writing off as much as 80 to 90 percent of what they're owed.
Patients want to pay their bills, he said, but can be confused about the bottom line when their Explanation of Benefits from their insurance company differs from their hospital bill.
What's needed is a more coordinated relationship between payers and providers, said Cohen, who talks about the issues and Cedar's integrated platform in an interview with Susan Morse, executive editor of Healthcare Finance News.
Talking points:
- Patients are grateful for care, but in general, consumers are less motivated to pay for something they've already received.
- About one-third of the time the EOB does match the bill coming from the provider.
- There needs to be a reconciliation between the EOB and bill for the patient to feel confident in paying the amount.
- Many patients struggle to find clear path to pay.
- Price transparency is a challenging topic and the focus should be on what the consumer owes, not what the service costs.
More about this Episode:
Patient groups press government to do more on medical debt
HIMSSCast: The entangled legal battle over the No Surprises Act
Integrated Highmark and Allegheny team with Cedar to align the billing experience
Hospitals see challenges around price transparency, technology and resources
Survey finds just 14% of hospitals are compliant with price transparency
Twitter: @SusanJMorse
Email the writer: SMorse@HIMSS.org
Dr. Manish Kohli will offer more detail during his HIMSS23 session "Digital Bridges: Bringing Hope and Healing to Those Hurting Most." It is scheduled for Thursday, April 20, at 1-2 p.m. CT at the South Building, Level 4, in room S406 A.
