Analytics sharpen focus on self-pay consumer trends
Patient segmentation and credit scoring tools improve collections
Maria Conte is in favor of any tool that makes life at the office easier. Conte and her team of 20 manage the collection of nearly 100,000 active self-pay accounts per month across the eight facilities that comprise Adventist's Florida Hospital in and around Orlando, Fla.
Like many hospital business office managers, Conte has seen a rise in the number of self-paying customers in recent years. The questions for collections personnel: Who are our consumers, how do we identify those most likely to pay and how do we encourage them to do it?
Some are turning to patient segmentation and credit scoring products developed by Connance, a Mass.-based analytics firm and TransUnion, the nation's third-largest credit bureau.
Conte's preferred tool is the Connance Self-Pay solutions, which have driven Florida Hospital's collection efforts for the past three years.
"We've seen dramatic improvement with collections," said Conte. "We're calling and reaching people who are truly going to pay."
The first year Florida Hospital used Connance products, in 2010, Conte said she saw an improvement in collections of 43 percent. The second year, there was an additional gain of 32 percent. In 2012, collections are expected to improve 14 percent over 2011. "The percentages are going down, but we're still seeing growth year after year," she said. "Basically, we've collected $9 million more than we did before we used Connance. It works. The proof is in the numbers."
Florida Hospital is using the Connance EVI suite, developed in partnership with FICO specifically for healthcare's self-pay challenge. The program does not use credit bureau data. For each account, Connance's EVI analytic calculates what patients will owe for a given procedure, how they are likely to pay and to what prompts they are most likely to respond in the collection process.
Whether through statements, automated calls or calls from customer service staff, Conte said, Connance "suggests what to say, how to say it and when to say it."
Connance partners with PARO Decision Support to identify patients living in poverty. The PARO program helps identify people who are eligible for financial counseling and hospital charity programs.
"You can have the best solution in the world, but your client needs to be able to execute it," said David Franklin, co-founder and chief development officer at Connance. "We work with clients to develop solutions that make sense for them."
TransUnion's Healthcare Division offers similar solutions through its ClearQuote patient payment estimator, which analyzes historical charges, payer contract terms and patient benefit levels to predict what patients are likely to owe for services provided.
The ClearQuote tool can be integrated with other TransUnion Healthcare solutions like Insurance Eligibility and Patient Financial Summary to improve collections processes and help eligible patients access financial counseling or charity services.
As consumer-based care grows, said Jim Bohnsack, vice president of the Healthcare Division at TransUnion, it's important to recognize how information gathered for collections purposes can help shape an organization's response to the needs of its consumers.
For example, the demographic data collected at registration creates a snapshot of who is coming through the door, down to the neighborhood block level.
"As we're shifting toward consumerism in healthcare, hospitals and health plans are starting to mine this data," said Bohnsack. "Can I gain additional insight into patient trends so I can better provide services and options to them? Should I be marketing to a population that doesn't know I offer spectacular orthopedic services?
"There's the here-and-now use for this data," he said, "and a long-term strategic and marketing use for it. Healthcare is applying lessons learned in other industries."
