A new report, the 2019 Healthcare Consumer Study, was commissioned by Cedar to identify trends in the financial experience for patients. Results show one-third (34%) of U.S. healthcare consumers say they have experienced a medical bill going into collections.

However, most of these outstanding bills were not the result of astronomical statement amounts. More than half of the statements in collections in 2018 were for less than $600.

For the most part, Cedar found, these bills in collection were the result of poor billing practices on the part of the practice or healthcare organization — or so patients thought.

Per the study, 60% of those interviewed said they tried to find out-of-pocket cost estimates before their visit, but the information was lacking. Of those that looked for it, less than 60% found it. These same patients also said they looked for payment options, and they would take on a credit line from the care center if offered. Half said they expected more clarity on their bills.

Likewise, most people interviewed said they are concerned about receiving paper bills in the mail, with three-fourths saying this frustrates them.

Just under half (49%) of healthcare consumers said they are frustrated about a lack of adoption of digital administrative for online bill pay and access to insurance information by their caregivers. Sixty percent of healthcare consumers requested out-of-pocket costs from providers ahead of care and 51% of those that sought it were not able to get the information efficiently and accurately.

A third of consumers say they don’t think their healthcare provider is doing enough to improve the patient billing and payment process.

When asked to rate the worst part of their experience with a provider, most said pre- or post-visit administrative processes outside of care were the problem. For the worst phase of the patient journey, 45% said post-visit billing, insurance follow-up, etc.; 38% said pre-visit scheduling, co-pays, check-in, cost estimates, etc.; and only 17% reported in-visit interactions with providers and staff as the problem.

The majority of healthcare consumers cite several things that could improve healthcare billing:

• 56% say out-of-pocket cost estimates could help them understand their responsibility
• 56% say payment flexibility via creative payment plan options is needed
• 50% say more bill clarity and easier-to-understand bill explanations are required
• 33% say there are better digital payment options needed

Patients said they are willing to change doctors because of these payment-based hassles; 41% said they’d consider switching to a provider who offered a better digital experience.

As expected, younger Americans are the most frustrated with patient billing processes and the most likely to switch providers if they have a poor experience.

More than double the number of adults aged 18 to 24 indicated frustration with their healthcare provider’s lack of digital patient administrative processes compared to those aged 65 and older. Three times more adults aged 18 to 24 were three times as likely to consider switching doctors if they don’t provide more digital experiences compared to those aged 65 and older.

According to Cedar, consumers expect convenient options that promote transparency for their healthcare payments, which translates to improved financial outcomes for providers. The findings point to several suggestions for improving the process:

• Congruent end-to-end administrative experiences: Address the patient journey holistically, rather than in piecemeal fashion. Pre-visit activities, such as insurance capture and co-pay collection, are ultimately connected to the post-visit payment experience.
• More flexible payment plans: Make care more affordable by leveraging patient data to craft personalized payment plans.
• Out-of-pocket cost estimators: Empower your patients to become more informed about upfront costs with online cost estimators versus standard chargemasters or pricing menus.
• Consolidate bills from within the same system: Alleviate frustration for patients and drive more revenue by enabling patients to view all bills associated with an episode of care in one place.
• Digital payment options and real-time support: Reduce friction and make it easier for patients to view and pay their bills by offering online billing applications and live chat support.

There were 1,607 online respondents interviewed from Aug. 27 through Sept. 1, including U.S. adults 18 years old or older who visited a doctor or hospital and paid a medical bill in the last 12 months.