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The healthcare payments industry is growing and changing rapidly, and this change is influencing the way that many in the industry, including billing services and their clients, do business. Data from the 2012 Trends in Healthcare Payments Annual Report shows that as the healthcare payments industry evolves, billing services must take steps to accommodate these changes.

Efficiency, payment best practices, interoperability, and security will be crucial areas to focus on in the future as the industry continues to change and grow. Below are the key market trends featured in the report that identify how billing services can prepare for the future in the healthcare payments industry.

1) Simplify the Payment Experience
Of providers surveyed, 37 percent said that their primary revenue cycle concern is the increase in patient responsibility.

As patient responsibility continues to rise, patients have more influence in the healthcare payments process. By delivering additional channels for consumer payments, billing services and their clients will collect more payments

Of providers surveyed, 83 percent said it took more than one month to collect from a patient after claim adjudication.

Today, billing services send out multiple paper statements and make follow-up phone calls to collect patient payments. Facilitating payments at every patient interaction point will be a key factor in reducing the time and costs to collect.

2) Expand Payment Channels
Of patients surveyed, 72 percent said they would like to pay their healthcare bills online.

It is estimated that U.S. consumers will spend more than $300 billion online in 2016. To collect more payments, billing services and their clients must look to the online payment best practices used in other industries to meet patient payment expectations as consumers.

In addition to leveraging technology, billing services must foster cultural changes among staff and patients to better prepare staff members to collect and for patients to pay. Tools and policies such as prompt pay discounts, staff incentive programs, minimum payment requirements, and scripts to use when discussing payments with patients are effective ways to collect more revenue.

3) Achieve Interoperability to Increase Efficiency
Of providers surveyed, 71 percent said that a lack of system interoperability is a major barrier to health information exchange.

Continuing provider consolidation will drive a greater need for system interoperability. The industry must also focus on administrative interoperability, including payment-related systems and processes. By integrating heterogeneous systems, billing services and their clients will automate more processes, simplify compliance requirements, and streamline employee training.

4) Focus on Data and Security
In the last decade, cloud usage in the U.S. has grown by more than 150 percent.

As billing services deliver more channels for consumer payments, private cloud technology will be crucial to efficiently collect, post, and reconcile all payments. However, cloud usage also presents new risks such as long-term downtime and loss of data during disasters. To protect data in the cloud, billing services must ask cloud vendors about disaster recovery and prevention policies and procedures.

In 2012, 27 percent of all reported data breaches occurred in the healthcare industry.

As patient payments increase, more consumer payment cards and bank accounts are exposed, which greatly increases the risk of a data breach. The financial and reputational costs of a payment card data breach are high and may result in bad publicity and loss of business. To reduce the risk of a breach, billing services should consider implementing methods to ensure payment card security and to meet the Payment Card Industry (PCI) standards more easily. In order to protect sensitive information when collecting payments, organizations will leverage new technology such as encryption at the point of interaction (POI) and prepare for the upcoming mandate around Europay, MasterCard, and Visa (EMV). The new EMV standard requires payment card issuers to include a chip that will add a layer of authentication to go along with the current magnetic strip on the back of cards. The industry is quickly beginning to issue and mandate processing for chip-based cards, including:

  • starting April 1, 2013, banks and financial institutions were required to process EMV chip transactions; and
  • starting October 1, 2015, liability for counterfeit transactions will shift to merchants when processing an EMV card transaction on non-EMV capable devices. Additional information can be found at

Click here to read the article originally published by HBMA.

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