InstaMed Blog

The U.S. healthcare payments market is growing and changing rapidly – in fact, it is estimated to have reached $2.7 trillion as a total of payer and patient payments (IDC Health Insights).  The fast evolving healthcare payments industry is impacting the way both payers and providers do business.

This week, the 2012 Trends in Healthcare Payments Annual Report was released to highlight the trends impacting the growing industry and the steps that many payers and providers have taken to accommodate for these changes.  Below are a few of the key market trends featured in the report.

Click here to download the report.

While electronic remittance advice (ERA) and electronic funds transfer (EFT) transactions increased in 2012, many payers will still be implementing the technology to meet the ERA/EFT mandate in 2013.  Regardless of how ERA/EFT is achieved, payers should include several key considerations in the project scope from the beginning, including increasing provider adoption and understanding compliance requirements.

72% of patients said they would like to be able to pay their healthcare bills online.

As patient responsibility continues to rise, patients have more influence in the healthcare payments process. Therefore, to collect more patient payments, healthcare will look to the online payment best practices from other industries to meet patient payment expectations as consumers.

In addition to leveraging technology, providers will focus on fostering cultural changes to better prepare staff members to collect and patients to pay at every interaction point. Tools and policies, such as prompt pay discounts and minimum payment requirements, will be effective as providers need to collect more from patients.

71% of providers said the lack of system interoperability is a major barrier to health information exchange (Bipartisan Policy Center).

Consolidation in healthcare will continue as larger provider organizations acquire practices and clinics, driving a greater need for system interoperability, including the payment-related systems and processes. By integrating heterogeneous systems, providers and payers will automate more processes, simplify compliance requirements and streamline employee training.

In the last decade, cloud usage in the U.S. has grown by more than 150% (Internet World Stats).

As providers and payers deliver more channels for patient payments, private cloud technology will be crucial to enable providers to efficiently collect, post and reconcile all payments. To protect data in the cloud, it will be an organization’s responsibility to ask its cloud vendor about disaster recovery and prevention policies and procedures.

With the increase in payment card payments from patients and payers, the risk of a payment card data breach may also increase. To reduce the risk of a breach, organizations will need more effective methods to achieve payment card security and to meet the Payment Card Industry (PCI) standards more easily.

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