The future of healthcare payments: Predictions for 2021

While 2020 has been a year of challenges and uncertainty, it has also been a time of incredible growth, with organizations quickly pivoting and finding innovative technology solutions to emerging healthcare challenges. Companies navigating the disruption raised record-breaking funding rounds and experienced unprecedented levels of M&A activity as the pandemic accelerated the need for and adoption of digital health tech. 

Going into 2021, uncertainty still looms but one thing is for certain: technology will continue to transform the healthcare landscape. Looking specifically at the financial aspects of care, we’ll see more providers embrace technology that frees them from the administrative burden associated with billing and payments. Here is what I predict for the year ahead. 

Telehealth exploded this year, as patients looked for care alternatives while social distancing. Healthcare organizations that had never before, or only occasionally, offered virtual care began to see it as a lifeline. It offered both a way to reserve in-person care for the patients that needed it most, as well as a way for others to seek care from the safety of their homes.

For the many healthcare providers still facing significant financial difficulties, 2021 will be a sink-or-swim year. Those who adopt and leverage modern technology, such as systems that enable telehealth, will be better poised to succeed in the months and years to come. To bolster their competitive edge, I expect to see providers focusing on improving their telehealth offerings—including finding ways to better integrate them with payments and revenue cycle technology—to offer a more convenient digital experience for patients. 

As patients take on an increasing amount of the financial responsibility for healthcare, they are becoming more discerning shoppers and expect more convenience from their healthcare experience. This includes a demand for greater predictability and transparency around prices and billing. America’s system of paying for healthcare has long remained complex and opaque. Amidst this complexity, providers and patients bear the burden and risk. Providers want and deserve clarity around payment for health services they have performed. Patients, on the other hand, often receive care without knowing the price for those services in advance and experience confusion with unexpected or surprisingly high medical bills. A recent Waystar survey found that consumers are often more concerned about medical billing than the quality of care they receive.

Encouragingly, Waystar’s survey also found that consumers have a strong interest in better understanding their financial responsibility. 67% of patients are willing to explore the cost of care before going to the doctor. However, there’s more to be done—54% found that pricing estimates were not completely accurate compared to their final bill. With the final rule on price transparency going into effect on January 1, we expect to see demand for technology that provides patients with improved visibility into healthcare bills. Patients will expect to see more accurate and personalized estimates of what they’ll owe and easier, more convenient ways to pay. 

Technologies that streamline and modernize payment infrastructures have made a major impact within banking and financial services to shore up back-end operations, digitize analog processes and provide better customer experiences. The healthcare industry is primed for this exact transformation, and I expect we’ll see an immense shift in how providers get paid. 

Today, it takes more than 30 days on average for a provider to receive payment for their services due to complexities inherent in today’s reimbursement models. This makes it difficult for providers to predict cash flow. The slow and inefficient process of submitting a claim, waiting for the claim to be adjudicated by the payer and potentially facing denials that need intervention, wastes significant time and resources. Along with this lag, uncertainty around exactly how much will be collected from both the payer and patient only adds to the financial and administrative woes providers face.

Healthcare can learn from the payments models of other industries and improve this process by tapping into the assets at their disposal. With massive data sets, technology and smart algorithms, we’ll eventually see a shift to healthcare payments occurring in near real-time—at the point-of-care—creating a more seamless, less confusing experience for patients and faster, more efficient billing processes for providers.

Technological innovation can solve the biggest challenges within healthcare payments—streamlining and modernizing how providers, insurers and patients interact with every aspect of paying and receiving payment for care. Healthcare providers owe it to themselves, and their patients, to take advantage of the technologies and data sets that can make the process easier on everyone. 

As the COVID-19 pandemic continues to unfold, I remain optimistic about our future, especially as our healthcare system becomes increasingly tech-driven and consumer-centered. We’ll see organizations that embrace modern technology adapt more easily to shifting environments, succeed financially and remain focused on improving patient care. 

Waystar can support healthcare organizations that are looking to transform their payments processes and get a clearer picture of their finances. Click here to see how we help healthcare organizations nationwide get paid faster and in full, while creating a better financial experience for patients.
 

Matt Hawkins is CEO of Waystar, a cloud-based platform that simplifies and unifies healthcare payments. Matt is passionate about technology’s ability to transform healthcare and is ranked a top 50 healthcare CEO.
 

Waystar provides market-leading technology that simplifies and unifies healthcare payments. Their cloud-based platform streamlines workflows and improves financials for healthcare providers of all kinds and brings more transparency to the patient financial experience.