Bringing Financial Wellness into the Conversation

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Bringing Financial Wellness into the Conversation The opinions expressed are those of the presenter and do not necessarily state or reflect the views of SHSMD or the AHA. 2016 Society for Healthcare Strategy & Market Development

Introductions Nicole Turgeon Senior Marketing Manager CarePayment In her role at CarePayment, Nicole works with providers to market financial services to their patients. Nicole has 15 years of marketing and communications experience, on both the corporate and agency sides, in industries ranging from transportation and real estate to health care and technology. Ellen Bristol Director, Internal Communications & Public Relations Metro Health Ellen brings more than 25 years of experience, of which 15 years are in health care, to her role at Metro Health. She is Metro Health s story teller and has the ability to break down complicated topics into words and stories patients and employees can easily understand. 2

What was it like before? PR and marketing in healthcare Little to no discussion with consumers about prices Insurance provided through employers The annual media call: Are you raising prices?

What was it like before? Financial management in healthcare Insured patients with little out-of-pocket expenses Uninsured patients with little to no expectation of payment Operational focus on the back end For Metro Health Insured patients pay little attention to costs Insured patients give little thought to purchasing insurance Uninsured patients face possibility of financial disaster

And then 2008 Impact on Western Michigan With the automotive and general manufacturing industries at the heart of Michigan s economy, many people lost their jobs and health insurance benefits. Impact on Metro Health Physicians report patients are asking about pricing and are delaying or canceling appointments. Patients are taking longer to pay

Metro Health s Response Metro Care Program Three components A discount to uninsured patients Live Healthy lectures and health screenings CarePayment, a 25-month interest-free payment program

Current Environment What is financial wellness and why is it important?

The Healthcare Affordability Gap Half of Americans don t have enough in savings to cover $1000 in unexpected medical expenses 1. The vast majority of HIX enrollees have chosen silver or bronze plans with family deductibles averaging $6,078 and $10,386 respectively 2. 31% of Americans or their family members put off medical treatment in 2013 because of cost; 22% for a serious condition 3. Approximately 51% of patients owe more than $1,000 in bills to their healthcare providers. 77% owe more than $500 4. Providers collect only 11% of balances larger than $500 5. Sources: 1. Bankrate.com, Money Pulse Survey, Dec. 2015 2. Health and Human Services Department, January 13, 2014 3. Gallup Poll, November 2015 4. TransUnion Healthcare, June 2016 5. Connance, 2014 8

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The Rise of High-Deductible Healthcare Plans 36% of insured Americans are covered by highdeductible health plans compared with ~25% in 2010. 1 Patients out-of-pocket healthcare costs have increased 230% since 2006. 2 Patient payments to hospitals are expected to increase at a compound annual growth rate of 10% from 2015 to 2019. 3 Sources: 1. CDC, 2015 2. Kaiser Family Foundation, 2016 3. Aite Group, April 2015 10

The Rise of Consumerism 95% of patients surveyed say it is important to know their costs upfront. 96% of those surveyed feel it is important to understand their payment options in advance. Consumers expect to pay in a variety of ways, including online and via mobile devices. Options like automatic payments, estatements, and paperless billing are basic expectations. 11

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Demographics: Generational Changes Millennials (aged 18-34) are now the largest cohort in the United States 1. Millennials are now the largest group of workers in the U.S 2. 71% of millennials want their provider to offer mobile apps 3. 41% of millennials are likely to request estimates before undergoing treatment 4. 86% of Millennials said it was very important to understand payment options before receiving medical care 5. 54% of millennials postponed or skipped treatment (vs. 37 percent of Baby Boomers) 4. Largest group of healthcare consumers retirees have unplanned out-of-pocket expenses they didn t plan for, and many are on fixed incomes. Sources: 1. U.S. Census Bureau, June 2015 2. Pew Research Center, May 2015 3. Salesforce, 2015 State of the Connected Patient 4. PNC Healthcare, March 2015 5. CarePayment patient survey, 2015 13

Retailization 82% of consumers are open to trying new, nontraditional ways of seeking medical treatment 1. Three-quarters of consumers are willing to receive immunizations at a pharmacy or retail clinic 2. CVS now has 1,100 retail clinic locations 10 million people visit a retail health clinic annually 3. Sources: 1. PWC, 2014 2. McKinsey, 2015 3. Forbes, 2015 14

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New Approaches Patient Financial Engagement Best Practices Workflow Improved communication Pricing, patient responsibility, and payment options Financial assistance policy Using multiple channels: email, text, website Focus on point-of-service Collections Agreement on payment alternatives

New Approaches PR and Marketing in Healthcare Greater emphasis than ever on prevention Emphasize stories of successful patients Integrating healthy living messages from the doctor into everyday living Electronic messaging with physician We re talking ease, convenience those elements that contribute to satisfaction

Metro Health Initiatives Right care, right time, right price Emphasis on when to go to the ED Opening of an Urgent Care Prevention Call the doctor when you need to

Metro Health Results HCAHPs Consistently high performing in patient experience questions. 2016 90 th percentile for inpatients Bad debt - Leveled off while others were rising Loyalty, satisfaction and differentiation drive revenue Media and awards In June 2012, Metro Health received the 2012 Ludwig Community Benefit Award from the Michigan Health & Hospital Association for its Metro Care program. The award recognizes organizations that have aided their communities in extraordinary ways.

Metro Health Results Stats 2011 22,920 uninsured persons received discounts totaling $9,927,333 77,482 CarePayment enrollees. Of these, 19,512 used the program more than once. Achieved 28.6 % net collections rate on self-pay balances after 60 days vs. national average of 8% (250% increase)

Metro Health Results An outcomes study of the CarePayment Program funded by a grant from the W.K. Kellogg Foundation found: 93% of patients are more satisfied with Metro Health because of CarePayment 88.5% of patients are more likely to return to Metro Health 93% of patients would be likely to recommend Metro Health

Net Promoter Score

Linda s Story

Recommendations If you re not talking with your patients and your community about the cost of primary care vs. Urgent Care vs. the ED, get started. When reporters ask you about cost, highlight the fact that in health care, what we charge is NOT what we accept as reimbursement. The old adage about spending money to make money applies here. Know that making money might be avoidance of loss. Incorporate information about your approach to financial services in your messaging.

Q&A Thank you! The opinions expressed are those of the presenter and do not necessarily state or reflect the views of SHSMD or the AHA. 2016 Society for Healthcare Strategy & Market Development