The world record for the high jump remained unbroken for years. Do you know what had to happen to break it? Somebody decided to try jumping backwards…Today we are going to look at how healthcare can jump backwards, not it time, but doing something totally different and far from its comfort zone.
My wife and I had finished having dinner at a nice restaurant and we were waiting for our check. The waitress brought it. I looked at the amount and it was only twenty percent of what I had expected. A moment later the wine steward appeared and laid a slip of paper on our table—forty-five dollars. In turn came the busboy, the sous-chef, the maître d, the dishwasher, the pastry chef, and the head chef. All told we received eight separate bills for our meal, and no single bill showed the total amount.
To say the least it made for a confusing experience.
When we bought our house, our bill—the settlement statement—showed what we owed down to the penny. We did not get separate invoices for the plumbing, the windows, the fireplace and the roof. We also did not get an invoice so detailed that it itemized every nail and every tube of caulk. Somehow those costs were folded in to other costs. Do you know how they avoided the problem of multiple bills, paid to multiple contractors with multiple terms? The builder acted as the general contractor.
It made for a much better experience than if we had been invoiced separately.
Since we all know where this is heading, I’ll head there quickly.
- There is no organization acting as the general contractor
- Multiple invoices from multiple vendors
- Different payment terms by vendor
- Different coverage by payer
- Excruciating line item detail—itemizing Tylenol
- Nothing showing what is covered and what is owed and why
- More complexity than a detailed IRS tax return
- Patients do not know what they owe and to whom they owe it
- Patients do not know what is covered and why other things are not covered
- Patients do not know what anything cost ahead of time
- Hospitals do not know their costs—they only know what they charge
- Two people having the same procedure at the same hospital will not be invoiced the same amount
The entire hospital billing process makes for an awful patient experience. Healthcare is the only service someone can purchase without having any idea what they owe and why. If the amount is large enough it remains an awful experience for months and years until the amount is paid.
I’m guessing, but I would be willing to bet that not one person in fifty in a hospital could accurately explain a patient’s total charges.
The entire billing process could be reimagined, it could be reinvented. And the reinvention could include a single bill. For those screaming at their PCs that it cannot be done, the only reason it cannot be done is that it has not been done, and that is not a reason.
Patient experience has to do with dozens of things that are very important to patients, things that hospitals have not changed in decades.
To be the hospital of choice you have to be the hospital people choose, and people will choose the hospital that is the easiest to do business with.