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How to Ease the Impact of Financial Worries That Undermine a Patient's Care

By April Wilson

People facing a health crisis deal with more than whatever it is that ails them.

They also can be knocked down by significant financial concerns that come with their serious health issues. Those deductibles, co-pays, and other out-of-pocket expenses add up, creating additional stress when the patient needs to focus on healing.

That's why it's critical these days that health care providers become familiar with the phrase "financial toxicity," an especially harsh fiscal reality that confronts a large percentage of patients whose expensive care devastates their pocketbooks even as illness devastates their bodies.

Here's a financial toxicity example: One recently published study looked into the impact that cancer, one of the most expensive medical conditions, has on a patient's net worth and debt. The researchers examined 9.5 million new cancer diagnoses that were made between 2000 and 2012, and found that a substantial portion of those diagnosed incurred financial toxicity. That is, worries about the money issues affected how well they responded to care.

Other expensive medical procedures and treatments also take a toll. The economic burden on transplant recovery is an example. Researchers around the United States are studying the effects of transplants beyond physical recovery. Stephanie Lee, MD, MPH, an investigator at the Fred Hutchinson Cancer Research Center who focuses on quality of life and transplant survivorship, is concerned that financial stress could potentially lower the success rates of transplants and, at the very least, drag the focus of the patient and family away from health and recovery.

Those bills you hand patients don't exist in some parallel world, separate from their overall wellness. The financial experience is an integral part of the overall experience, right from the moment you give them an initial cost estimate to the day when the final bill arrives.

That's why financial toxicity needs to be taken into account from the start. You aren't going to eliminate patient stress about the costs of their health care, but the following are a few ways to help mitigate it:

• Prioritize patient financial engagement. A key reason the overall health care experience can prove stressful and detrimental to healing is that the patient feels a loss of power or a disconnect from the process. It's important that, even prior to the first visit, you make use of phone, mobile, text, and e-mail to create a strong foundation of communication and make the patient feel at ease.

• Have conversations up front. The sooner you talk with patients about the costs, the better. Human nature sometimes causes us to put off the money talk and let the health concerns take center stage, but in truth most patients want to know sooner rather than later how much they will pay.

• Communicate clearly. Patients can be overwhelmed and confused when dealing with a serious medical condition. The financial side of things shouldn't add to that confusion, so make sure cost issues are clear, concise, and aligned with the patient's needs. Also, while bills are no fun, there are ways to design your statement to at least make the experience a little more positive. Ditch those cold, corporate black-and-white statements. Instead, use colors that evoke a sense of calm and professionalism. Make sure customer service phone numbers and e-mail addresses are prominent so the patient doesn't become frustrated searching for them or need a magnifying glass to read tiny type.

• Let patients pay the way they want. With the stress patients already face, there's no need for them to leap over unbendable billing hurdles as they seek to settle their account balances. Maybe they want to receive billing statements via their phones. Perhaps they want to split the payment over multiple credit and debit cards. A willingness to modify payment options to fit the patient's personal situation and preferences will help ward off the dangers of financial toxicity. If you don't have the technology in place to give patients the flexibility they need, it might be time for an upgrade.

Revenue-cycle decisions are an integral part of the patient experience, and patients rightfully expect an approach to their care that prioritizes end-to-end wellness. Make sure you're leveraging the right technology to achieve all your patient financial-experience goals.

— April Wilson is vice president of marketing and analytics for RevSpring (www.revspringinc.com), a company that provides patient engagement and billing solutions for health care providers. Since 1981, RevSpring has built the industry's most comprehensive suite of consumer engagement, communications, and payment pathways that is backed by consumer behavior analysis, propensity-to-pay scoring, intelligent design, and user experience best practices.