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Pay Flex CEO Shines Light on Opportunity for Payers, Providers to Collaborate on Revenue Cycle

March 09, 2018 | Innovation


When it comes to health care costs, many consumers feel left in the dark. In fact, the No. 1 reason people do not pay their health care bills is due to confusion over the often antiquated and clunky payment process.

At the HIMSS Annual Conference & Exhibition in Las Vegas this week, PayFlex CEO and President Erin Hatzikostas hosted a session, >“Equipping Consumers To Be The Chief Financial Officer Of Their Own Health Care,” to discuss how providers and health plans can work together to engage consumers to better understand and manage their health care expenses. PayFlex is a part of the Aetna family.

With the rise of consumer directed health plans turning patients into larger financial stakeholders in their care, “Consumers are left woefully behind in getting the information they need,” said Hatzikostas.

Consumers cannot make informed choices about their elective health care if they do not know what it costs. Furthermore, even after patients receive care, they are often left in a thicket of mail from providers and their insurer, including Explanations of Benefits (EOBs) which may look like bills, bills from providers that look like EOBs, etc.

While this is confusing for the patient, it also negatively affects doctors who performed services with the promise of getting compensated quickly. Collections typically take 3-5 months to process and only 17 percent of bills are collected. This delay is not linked to an unwillingness or inability by the patient to pay – three-fourths of people are willing and/or able to pay for their health care costs – but a lack of understanding of the payment system and process. “The No. 1 reason is that people were confused,” said Hatzikostas.

As a complex issue, the health care payment crisis requires a complex solution. Convenience and consumerism are hard to balance and simple solutions will not work.

In 2014, PayFlex launched Money Square for Health to help equip consumers to be better financial stewards of their health care. After just three years, the service earned over 200,000 users, with many repeat users. Beta testing confirmed the huge opportunity in the ecosystem to engage consumers and, with the learnings from Money Square for Health, Aetna launched AetnaPay to further empower consumers to become the CFO of their health care finances.

There is still much work to be done in supporting consumers to own their health care finances, but progress is being made. As we continue to shine a light on the payment black box, it will be imperative for providers to collaborate with health plans on solutions and work together to share quality data and advance work flows.