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Addressing Patient Financial Stress Reaps Benefits


The focus of the Affordable Care Act is on access to insurance. However, what it doesn't address is the cost of health care, which has become part of the national conversation.

A recent commentary in the Journal of the American Medical Association recommends that physicians pay almost as much attention to patients’ financial health as they do to their medical health. The commentary goes so far as to suggest that all patients be screened for financial stress.

Robin Gelburd, president of FAIR Health, a not-for-profit organization focused on bringing current and reliable health care cost information to all parties within the health care system, isn’t surprised by the recommendation.

“In the past consumers played a much smaller role in the financial model impacting their care,” Gelburd explains. “In the past the transaction was primarily between the insurance company and the physician. But I think now, with high deductible health plans and health savings accounts and this economic climate and new reimbursement models, consumers are now bearing a much larger share of their health care costs. So it’s really bringing that conversation into sharper relief now.”

And for physicians, that’s a conversation worth having.

Cost transparency

Gelburd points out that the focus of the Affordable Care Act is on access to insurance. However, what it doesn’t address is the cost of health care. And with millions of uninsured and underinsured individuals about to enter the system, the issue of cost has become part of the national conversation.

“That intense focus on the Affordable Care Act is now causing everyone to discuss the financial impact of health care transactions, fairness and equities in those transactions, and transparency,” she says.

Not to oversimplify, but when consumers walk into a restaurant and read the menu, they know what their meal is going to cost well before it’s served to them. But in health care, the costs are not nearly as apparent, and the stakes are much greater.

“It’s one thing to know what your $25 dinner will cost, but people are being exposed to thousands upon thousands of dollars in balance bills and costs that they have to bear, and costs they have been totally in the dark about,” Gelburd explains. “We’re not talking about just a simple dinner bill. We’re talking about, potentially, a $10,000 surgical bill. So I think it’s well past time that that kind of light is beginning to shine on what the costs are associated with medical services.”

Helpful tools

FAIR Health has developed both a consumer tool, the FH Consumer Cost Lookup and a provider tool, FH Fee Estimator to ensure that all parties have access to the right information so they can be more in control of their healthcare finances. The consumer tool features a homegrown curriculum of information regarding all aspects of health care. The provider tool can help physicians better engage their patients on the sensitive topic of finances.

“We provide a window to the marketplace that allows physicians to make responsible decisions about the way in which they’re going to configure their own fee schedules,” Gelburd says.

But the provider tool does much more. Doctors are focused on their clinical practices as they should be, and they may not be well equipped to provide that educational foundation to patients. What the fee estimator offers is free downloads of FAIR Health’s educational materials, or educational content, that physicians can make available in their waiting rooms as handouts to patients. Or they can license the videos for patient room monitors, to help supplement the written material.

“And if a provider wanted to brand the material as their own, there are those opportunities as well if they were to go forward and license our data products,” Gelburd explains. “We really make it very easy to incorporate that kind of educational foundation for cost transparency into their practices.”

Little effort, major reward

Gelburd stresses that physicians should not be frightened about the burdens of providing patient education and consumer engagement information. She says that it can be done in a very seamless way, and it can be done in a way that yields tremendous benefits, and saves them time at the end of the day. Furthermore, paying attention to these issues helps with the physician’s financial planning, Gelburd adds.

“If they have these conversations on the front end, there’s a meeting of the minds before the care is rendered,” she says. “The practice knows exactly what it should anticipate from the patient, and it eliminates or reduces out-migration of your patient flow. Because the more that patients are frustrated with the financial aspects of their care, or feel like they’ve been kept in the dark, it doesn’t breed a strong tie with their provider. And they’ll vote by leaving a practice.”

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