Last week I wrote about one of the two major conferences we recently attended, the 2016 ACA International Convention & Expo. At the end of June I also attended the HFMA ANI Conference in Las Vegas. While Cornerstone Support has been a consistent attendee and exhibitor at the ACA Convention for nearly 20 years, this was the first time we’ve attended the annual conference of the Healthcare Financial Management Association.
More than 4,000 revenue cycle management professionals got a glimpse of what’s coming to healthcare in the near future – not just medical technology and clinical breakthroughs, but also changes in payment responsibilities and creative approaches to limit the growing financial burden of healthcare costs. These providers were joined by close to 2,000 representatives from more than 350 exhibitors and sponsors of the event. Quite an impressive turnout.
This conference was a real education for me. So much has changed in billing and collections for major healthcare providers since the Affordable Care Act (ACA) became law in 2010. Due to the high cost of premiums, many consumers are opting for high deductible health insurance plans which place a greater financial responsibility on the individual for repayment of medical care. At the same time, hospitals are coming under increased regulatory pressures to maintain their tax-exempt status.
Three of the eight education tracks included timely presentations for companies involved in medical collections:
- Compliance & Legal Updates
- Revenue Cycle & the Patient Experience
- The Impact of Consumerism
Here are some interesting and disturbing statistics I learned:
- 62% – percentage of adults in the U.S. who have less than $1,000 in checking and/or savings accounts to pay for unexpected emergencies
- 4% – 20% – percentage growth in high deductible healthcare plans from 2006 to 2014
- 52% – percentage of all collection tradelines on consumer credit reports that are the result of medical debt
- 69% – percentage increase in healthcare premiums for individuals between 2004 and 2014
- 81% – percentage increase in worker contributions to company sponsored health insurance premiums
- 15% – current percentage of hospitals’ accounts receivable that is designated as “balance after insurance” (BAI)
- 30% per year – expected percentage annual increase in BAI
- 35% – expected BAI percentage of hospitals’ A/R by 2018
- 43 million – number of consumers who have overdue medical bills on their credit reports
- $46.4 billion – the amount of uncompensated care provided by hospitals in 2014
- 13% – percentage increase from 2014 to 2015 in out-of-pocket maximum costs and average deductibles for consumers
What does all this mean for the collections industry? In one sense, this should lead to a substantial increase in outsourcing to first and third party collection agencies.
One leading industry consultant estimates that outsourcing to external agencies will grow by 119% by 2018.
On the other hand, though, increasing consumer regulations and oversight by federal agencies such as the CFPB and FTC have made it clear that hospitals (and other medical providers that place accounts to external collection agencies) are fully accountable for the actions and business practices of their vendors. There will be significantly heightened scrutiny and ongoing monitoring of a collection partner’s licensing, insurance, complaint history and consumer litigation experience.
So it looks as though healthcare revenue cycle management professionals will rely more than ever on collections partners – but only with those companies that incorporate compliance as an integral part of their business philosophy and practices. If you have any questions about how well prepared you are, let the professionals at Cornerstone Support provide you with a no-cost evaluation.