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June 19, 2017

More hospitals are offering financial counselors

Daily Briefing

To help patients navigate complex and often costly bills for treatment, hospitals are increasingly employing financial counselors to help patients assess their coverage, payment options, and—when needed—arrange financial assistance, the Associated Press reports. 

The finance leader's resource guide

What do financial counselors do?

According to AP, a financial counselor will approach each patient differently depending on their needs and treatment. Generally, however, a counselor might begin the process by determining the scope of the patient's insurance or whether a different option—such as worker's compensation or an auto policy for those in a car crash—might help cover some of the cost of care. In addition, counselors provide patients with estimates on the cost of care based on their insurance or notify patients of any coverage restrictions, such as if an insurer needs to approve a treatment before it's provided.

Margie Barton, a financial counselor at the IU Health Melvin and Bren Simon Cancer Center, said, "Many patients rely on us to explain how their health benefits work." She added, "They're preoccupied with just getting well again."

Counselors can also help patients find and apply for financial assistance. For instance, they might be able to tell a patient if he or she qualifies for charitable care, or help the patient access discounted or no-cost drugs from a manufacturer. Counselors might also be able to identify charitable organizations that connect eligible patients with funding for groceries or help get them to medical appointments. 

For instance, at the cancer center where Barton works, the financial counselors assess the treatment plans for each of the hundreds of patients who receive care there each week. According to Barton, roughly half of patients whose plans are reviewed will require some financial assistance—a proportion that she said has increased substantially over the past few years as more patients enroll in high deductible health plans.

Second opinions aren't just for medical treatment

While these services can be helpful for people tackling confusing and costly health care bills, patient advocates recommend people always seek out a second opinion before committing to any substantial financial decision. Caitlin Donovan, a spokesperson for the Patient Advocate Foundation, pointed out that many not-for-profits will help patients determine the accuracy of bills and negotiate for the lowest possible price (AP/CBS News, 6/7).

Patients are shopping for prices. Are you making it easy for them?

Demand for price information is increasing, but many providers struggle to generate meaningful estimates.

Prices vary significantly with patient-specific inputs, and even if providers come up with an estimate, it’s often inaccurate or confusing.

Every provider's price transparency strategy will depend on internal capabilities, brand strategy, and their price point relative to the market. Based on Advisory Board research, we compiled best practices we've seen when it comes to implementing price transparency.

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