Younger consumers are morelikely to treat hospital bills much like their other consumerinteractions, and more willing than older patients to pay forservices with a credit card over the phone. (Photo:Shutterstock)

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A new report takes a close look at consumer satisfaction with the hospital billingprocess, and finds that hospitals are getting better marks fromconsumers overall. However, consumers also expressed a desire forclearer information on out-of-pocket bills. Andthe results suggest that hospital bills are more likely to be paidin full if consumers are happy with the billing process.

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The study, conducted by Connance, a health care analyticsfirm, surveyed 500 consumers about their last hospital encounterand their experience with the hospital business office. Thereport found that patient satisfaction with hospital billing offices has been increasing inrecent years; this survey found that 54 percent of respondentsrated their last billing experience as positive, saying they wereeither “very satisfied” or “more than satisfied.”

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Related: 30 percent of consumers don't understand what anEOB is

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On the other hand, high out-of-pocket costs may drive consumersaway from physicians or hospitals: the survey found that more than50 percent of patients indicate that out-of-pocket costs will havesignificant or highly significant influence on provider choice.

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“The unfolding transformation of health care is daunting andcomplex, but as this survey shows, also filled with sizableopportunities to improve and reshape the relationship betweenproviders and consumers. Consumers are expressing strong opinionsand preferences,” said Steve Levin, EVP of Strategic Alliances atConnance. “This survey provides some helpful insights into currentconsumer-provider relationships and where and how providers cantake actions that will improve the satisfaction with their mostimportant constituent, the patient.”

Consumer satisfaction tied to payment

One topic the study explored is the relationship between patientsatisfaction and full payment of bills. For example, when consumersreport being very dissatisfied with the hospital business office,just over 25 percent report that they have fully paid their bills.When patients say they are very satisfied with the experience, thepay-in-full number is nearly 75 percent. (The results also showthat some consumers are still in the process of resolvingbills.)

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“Payment activity shows some correlation to business officeinteraction, meaning improved experience should impact cash,” thereport said. “This is also not to say a bad interaction leads tofailure to pay. It simply implies that when patients have badinteractions, there is also likely a difficult collectionexperience. The bad interaction could be about confusion in thebill or some other dimension in the hospital-patientlifecycle.”

Surprise: consumers don't like surprises

The Connance study also found that larger out-of-pocket billsresult in more calls to the hospital's business office. For billsof $500 to $1,000, more than 50 percent of respondents said theyhad called the business office or planned to. For bills over $1,000that number is close to 75 percent.

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The study also found that when bills exceeded the patients'expectations, 63 percent said they had called or will call thehospital business office. When the consumers' paymentresponsibility met their expectations, 70 percent did not call thehospital. The study's authors say consumers need more clarity ontheir financial responsibility for services.

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“Larger consumer balances and surprises in the balance due areincreasing the need to speak to business office teams,” the studysaid. “The larger the bill, the more likely patients will call thebusiness office after service, which drives service center cost.Clearly, there is a potential benefit to moving engagement withpatients earlier and adding transparency.”

A generational difference

Another interesting finding from the study is that youngerconsumers are more likely to treat hospital bills much like theirother consumer interactions. They are more willing than olderpatients to pay for services with a credit card over the phone, forexample.

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Younger people are also more likely to ask a friend or healthcare expert to review their bill. Thirty percent of respondentsbetween the ages of 27 and 39 said they would do so; about halfthat number of the 40-to-64 age groups said they would be willingto have someone else review their bill. About 10 percent of thoseover 65 were willing to share their bill with a friend or healthcare expert. “This could be an opportunity to better engage andeducate [younger consumers] on the billing experience,” the studysaid.

Consumer confusion about providers and insurers

The survey also showed that many consumers continued to beconfused about the basics of health care billing, and the differentroles that hospitals and insurers play. For example, 25 percentsaid they did not know what an Explanation of Benefits was. Whenasked who they most trusted to provide the best estimate of servicecost, 53 percent picked insurance companies. Hospitals were insecond place at 19 percent, but that was also a virtual tie withthe “none of the above” category. Physicians' ability to give anaccurate estimate came in last with survey respondents.

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The report's authors conclude that better communication andinformation about billing will help both consumers andproviders.

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“Over the past few years, providers have invested in systems,people and process to improve the patient experience in billinginteractions,” the study said. “Those efforts have clearly paid offbut the journey is not over yet. There remains significantopportunity. If we listen carefully, consumers are telling us whereand how to invest and with progress, the industry should also seethe financial benefit.”

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