Healthcare RCM

4 Trends in patient financial experience

Healthcare RCM

4 Trends in patient financial experience

Healthcare RCM

4 Trends in patient financial experience

Every year, companies devote hundreds of millions of dollars to improving customer payment experiences — through reducing buying friction, adding payments options, investing in customer support, and so much more. 


Simple. Every company who is any company knows that they must ensure the experience people have with their processes are ideal — not just ideal for facilitating a payment, but also for meeting the consumers goals, needs, and of course, expectations. 

Another version of those expectations exists in healthcare. When a consumer is actually a patient, the financial experience changes, both in process and importance. To patients, every interaction begins and ends with considering their health; financial health is just one contributing factor. 

Hospitals and health systems have recognized the importance of this experience, as well, and are investing in the full cycle of servicing a patient’s financial experience — or PFX — just like customer experience leaders are investing in the customer journey through to payments.

This PFX investment acts both as a response to and a catalyst for the continued significance of patient financial experience improvements and their effects on revenue recapture. 

Aside from “continued investment,” what else is happening in PFX? What else is fueling that investment? What are the major defining moments we’re seeing this year, and how will this impact revenue cycle servicers going forward?

4 trends in patient financial experience

In the first half of this series, we’ll discuss the trends that are fueling continued investment. Next week, keep your eyes open for our follow-up on how, exactly, improvements are happening. 

RCM trends fueling continued PFX investment

As the RCM market continues to grow (largely due to the prevalence of unstructured data and processes), challenges and opportunities grow, too. 

1. Profitability demands continue to increase

Hospitals lost an enormous amount of money in 2021. 

Operations remain cost inefficient. 

Profitability suffers. 

These demands continue to increase in the upcoming fiscal year as hospitals and health systems struggle to react to last year’s losses; every area of the business, including all of its vendors, needs to focus on increasing their margins

RCM providers, for their part, can approach increasing profit (and future profitability) one or both of these ways:

  1. Reduce operating costs in any arena (QA efficacy increases, agent productivity increases, RPA for coding, etc.)
  2. Increase revenue via stopping revenue leakage and/or increasing recapture (Part and parcel with RCM work)

Whatever approach they take, improved PFX should both be an outcome and support the goal. 

Prediction: RCM providers will continue to call out and respond to the profit squeeze of the last two years with a focus on doing more with less. One area of focus will likely be the RCM workforce.

2. Workforce losses 

Perhaps not surprisingly, 20-30% of the healthcare workforce has been lost since 2020. And it’s not just nursing staff. Hospitals are struggling to support both care and operational needs. 

The labor issue is just one of many ways profit continues to erode. More importantly, it affects care provision. So it’s top of every health system’s list of stressors — making staffing a key priority. Staff who support the patient's financial experience, either at the point of care or during the rest of the revenue cycle, are no exception. 

Additionally, the workforce losses make it all the more necessary for hospitals and their operating centers to incorporate automation and other time-saving measures through technology. 

Prediction: Investments in staffing won’t create total coverage of lost profits or sufficiently support the exact patient experience requirements strong RCM groups are attempting to advance. Consequently, workforce shortages will continue to push hospitals and their vendors to find technology that acts as a force multiplier for both goals. 

3. Payer mix changes

Over the next five years, we can expect to see a continued increase in the percentage of government payers (who should make up 52% of the hospital payer mix by 2028.) This increase comes alongside increased consumer demand for self-pay options for patients. 

Payer mix changes put everyone on the back foot when it comes to patient financial experience. How does a patient find satisfaction with the financial experience when hospitals and RCM groups must constantly retool it in order to maintain revenue integrity?

Prediction: Hospitals will continue to increase their focus on eliminating major operational expenses in the revenue cycle as a response to demographic and economic changes. 

4. Requirements for health equity

A reckoning on health inequity has been long boiling. We know that Black Americans are far more likely to carry medical debt (2.6 times more likely) and face worse medical outcomes than white Americans. 

Health equity is less of a trend and more of a requirement. Revenue managers must continue to commit to making patient financial experiences more equitable — and to supporting all marginalized populations by improving the parts of the experience they have the power to improve — often, contact with the individual. 

Prediction: Achieving greater health equity will motivate revenue managers to make major PFX investments in the debt servicing process. 

What's coming next for patient financial experience?

All signs point to a fiscal year full of the above pressures and opportunities. 

So far, what trends have we seen in the way revenue service providers are responding? That’s coming up in Part 2 of this series on patient financial trends. 

In the meantime, check out our other healthcare resources, or learn more about patient experiences by connecting with our team below.

Healthcare RCM