Failures in the practices and handoffs along that path are angering patients and damaging their credit scores, said Chad Mulvany, a technical director at the HFMA. As medical debt increasingly hinders consumers from the car and home purchases counted on to juice the economy, lawmakers are paying attention.
Patients paid $307.7 billion out-of-pocket for healthcare services in 2011, according CMS actuaries. That's above and beyond what consumers pay for insurance, noted Mark Rukavina, a principal with Community Health Advisors and former executive director of the Access Project, a healthcare consumer advocacy group.
A significant portion of medical debts on credit reports are for sums less than $100, Rukavina said, and surveys suggest that many of the accounts reach that stage because patients didn't understand their bills. "I live and work in this world and I'm very confused at times," he said.
The broad outline of recommendations shared Wednesday include multiple attempts to "screen and scrub" accounts for insurance coverage, eligibility for charity care and Medicaid, death and bankruptcy. Members also emphasized the importance of making multiple attempts to reconcile information, so the collections agency isn't in the dark about payments made or other changes in the account.
The task force also concluded that outside billing vendors and even collections agencies should have a broader array of patient information at their disposal so they can communicate meaningfully when they get patients on the phone.
The members are also studying the feasibility of making "full file reporting" a standard practice for medical debt. That means a full record of the payments a patient has made on the account goes to the credit reporting bureau along with the sum that is owed. Those payments can have a positive effect on the consumer's credit score. And if patients know that, they are more likely to make an attempt to pay down the balance, even if they can't afford to pay it off, said Dan Johnson, president of Experian Healthcare, a division of credit reporting firm Experian.
There are at least two pending bills in Congress seeking to address elements of the process, said Lucia Lebens, director of governmental affairs for ACA International, a trade group of the collections and credit agency. One, for example, would ensure that medical debts are removed from credit reports within 45 days after a patient pays the balance. Another would require collections firms to give consumers a clearly stated deadline for when the balance would hit their credit report.
The industry also expects the new federal Consumer Financial Protection Bureau to dig into the matter.
The HFMA's Mulvany said the work of the task force, along with the association's related work on patient financial interactions and price transparency, could be the "last chance we as an industry have to get this right."
If they don't, he said, Congress is likely to address it for them. "It's not going to be a solution we like."
Follow Gregg Blesch on Twitter: @MHgblesch
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