Accretive said it would develop the panel—which included high-profile industry, political and trade association leaders—after it came under scrutiny in Minnesota for its debt collection practices and alleged patient privacy violations. The company later settled with the state attorney general in an agreement that included a $2.5 million fine and ceasing its operations in the state for at least two years and up to six.
While Accretive might have kicked off the initiative, the HFMA and others in the industry picked up the momentum.
“These best practices provide an opportunity for healthcare organizations to renew their commitment to clear communication with patients about financial issues,” an Accretive spokesman said in an e-mail. “Accretive Health is pleased to have helped develop these practices and will play a leadership role in supporting their implementation.”
The guidelines come at a time when millions of Americans are facing higher deductibles, copayments and coinsurance. They cover issues like when and where to initiate a conversation on financial matters, who should conduct the discussion, how to handle care when a patient has an outstanding balance and how to measure compliance.
For instance, the guidelines state that patients should be given the opportunity to include an advocate or family member in the conversation. And they suggest that patients receive information and phone numbers for financial assistance programs with their discharge paperwork.
They also allow providers to evaluate their own practices and identify as HFMA “Patient Financial Communications Adopters.”
Former HHS Secretary Michael Leavitt led the 12-month process to develop the guidelines, which also had the support of advisers including former University of Miami president Donna Shalala, a former HHS secretary, and former Sens. Tom Daschle (D-S.D.) and Dr. Bill Frist (R-Tenn.)
A steering committee included not only Accretive Health but representatives from industry associations, academia, health systems and patient advocacy groups.
For instance, the guidelines state that patients should be given the opportunity to include an advocate or family member in the conversation. And they suggest that patients receive information and phone numbers for financial assistance programs with their discharge paperwork.
Aaron Crane, chief financial and strategy officer at Salem Health, who served on the steering committee for the initiative, said the standards help define business practices and procedures that haven't been previously addressed in other guidance, like the HFMA's Patient Friendly Billing project, which deals with pricing transparency.
He added that, since June, some of the improvements to the draft guidance have included more information on how a provider can do a self-audit or how it can be independently audited.
Salem Health itself is implementing technology that will help it comply with the best practices, such as providing the likely cost of services.
Marcus Padgett, senior vice president for revenue cycle solutions at Passport Health Communications, said “not very many” systems are fully prepared to adopt the guidelines. While most hospitals are used to checking financial information, the hardest part will be providing cost estimates in advance of services as well as making sure the organization is in compliance with the guidelines.
“In order to tell a patient what they owe is a very complicated system,” he said. “The investments are both in people and in systems.”
Padgett also said the guidelines didn't address communications around how to collect money and how to implement the best practices.
Joe Fifer, HFMA's president and CEO, told Modern Healthcare in June that the new standards add greater specificity to the current guidelines from the HFMA and the American Hospital Association.
The final version of the guidelines make only small changes to the draft released in June, and mainly involve changes to language, such as changing the title from Patient Financial Interactions to Patient Financial Communications, according to Fifer.
"The comments really didn't change the essence of the best practices," he said.
Organizations can undertake their own self-review now, and starting in 2014, the HFMA will also begin auditing organizations that voluntary adopt the guidelines and want to be designated "Patient Financial Communications Adopters."
Follow Beth Kutscher on Twitter: @MHbkutscher
