Back in the good old days patients’ out-of-pocket responsibility for healthcare costs was negligible. Remember the $5 office visit co-pay, just as an example? As a result hospitals and physician offices set their billing and collection systems up to work with health plans and government payers. Consumer billing was an afterthought, bills were hard to understand and to reconcile with insurance company statements, and collection rates were low. No one really cared if the patient paid or not.
Out-of-pocket costs have gone up dramatically for most commercially insured patients, especially the increasing number who have high-deductible health plans. Providers have realized that this is an important revenue source but in general tools for billing and collection have lagged. Providers that have focused on this area have often used heavy-handed methods such as being forceful about demanding payment upfront and referring overdue accounts to collection.
A handful of startups have seen the opportunity and gotten into the space. They have made the process more consumer oriented, with the idea of improving collection rates, lowering administrative costs, and increasing patient satisfaction with the process. I’ve interviewed the CEOs of two such companies, Simplee and PatientPay.
This morning Simplee announced a significant milestone: the Simplee Pay platform is collecting over $1 million per day and the company expects to have collected a total of over $1 billion by the end of the year. Simplee makes a number of plausible claims: 80% of patients pay right away, 40% move to self-service, 15% use mobile for payments, and collection costs drop by more than 10%.