Blog, The Hospital Finance Podcast®

Resolving Medical Debt [PODCAST]

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In this episode, we’re pleased to welcome Braden Pan, Founder & CEO of Resolve Medical Debt, to discuss resolving medical debt.

Learn how to listen to The Hospital Finance Podcast® on your mobile device.


Highlights of this episode include:

  • What makes medical debt such an issue for hospitals and patients in the U.S.
  • Incentives to help patients lower their bills
  • Most common issues with medical bills
  • Enhance revenue while maintaining a patient-centric approach
  • Successful strategies hospitals have implemented to educate patients

Kelly Wisness: Hi, this is Kelly Wisness. Welcome back to the award-winning Hospital Finance Podcast. We’re pleased to welcome Braden Pan, founder and CEO of Resolve Medical Debt, a company that negotiates medical bills on behalf of patients. To date, Resolve has saved patients nearly $30 million. In 2016, Braden received an outrageous medical bill for a 15-minute consultation visit. After navigating the complex medical billing system to correct his bill, he knew there had to be a better way. Researching the complexities of the medical billing system led Braden to deeper-rooted problems with medical debt in the United States. He founded Resolve on the belief that everyday medical bills shouldn’t bankrupt everyday Americans. Prior to founding Resolve, Braden led product development, marketing, operations, and sales at Vocate, a VC funded EdTech company. He also led operations and project management at Distributed Sun, an early-stage renewable energy finance and development company. He received a BA from William & Mary, and an MBA from the Tuck School of Business at Dartmouth. In this episode, we’re discussing resolving medical debt. Thank you for joining us today, Braden.

Braden Pan: Thanks for having me, Kelly. I’m really excited to be here.

Kelly: Well, let’s jump in. What makes medical debt such a pervasive issue for both hospitals and patients in the United States?

Braden: Yeah, glad you asked. So, there’s a lot of reasons, but I think at its core, it’s just how complex and confusing the system is. And because of that, how one-sided it ends up feeling to patients, right? As most listeners know, hospitals and insurance companies have teams of people who deal with the billing aspect of healthcare because it gets really, really complex. And unfortunately, patients are left stuck in the middle and have to figure all of this stuff out for themselves. I had to figure this out for myself, before I founded this company, with absolutely no knowledge of the healthcare billing system. And it just took a lot of time and effort to do that. And so if you think about sort of a comparison on this, if you were to go to Home Depot for home repairs, and your homeowners insurance was going to pay for some of it, but you went in, you didn’t know the price of anything. The price was dependent on your homeowner’s insurance, but wasn’t clear. Your homeowner’s insurance would cover some stuff, but not other stuff. You didn’t know what it was. And on top of that, you don’t even know what you need to buy for getting those repairs. It would be extraordinarily difficult to figure all of this out, to figure out how you wanted to go about actually getting those repairs. But unfortunately, that’s kind of the situation the patients are in. They have no visibility, no understanding of what’s going on and what it’s going to cost them.

And the end result of this is this cycle where patients, without this information, end up with these large and unexpected bills that feel complex and difficult to understand. It actually causes a loss of trust amongst patients. They feel wronged by the system. And either they just can’t pay the bills, right? They just have no means out, or they feel so wronged that they won’t pay. And then this creates a system where hospitals then have to adjust their prices to account for the fact that they’re not collecting from patients. And it costs them a lot of money to collect from patients. Insurance companies, at the same time, are creating these high deductible health plans that are shifting more of a burden to patients, which is then exacerbating everything, causing prices to go up, causing more of a burden on patients, causing more frustration from patients. And so that they don’t actually want to or can’t pay. And so our focus has been on actually alleviating this cycle and saving patients that time, that stress, and that anxiety, helping them understand what’s going on, helping them to lower the cost that they have, but still get to a resolution that works for all parties.

Kelly: That makes a lot of sense. What incentive do hospitals have to help patients lower their bills? Doesn’t that just take money away from them?

Braden: I mean, theoretically, it could, but generally speaking, hospitals collect 20 to 30 cents on the dollar of the patient portion of medical bills. So, they’re not collecting 70 to 80 percent of what they charge a patient. It also costs them on average five times to collect from patients as it does from insurance companies. So, it’s costly to do so. They’ve got long accounts receivable cycles from patients, right, because they’re spending a lot of time trying to just save them money, which means cash management even harder. And then finally, if they really push patients too hard and take extraordinary collections activity, they run risk of regulatory or PR backlash. There have been tons of instances of news articles and news cycles about hospitals suing patients for small dollar amounts, and that hospitals having to walk that back. And then there’s also patient concerns here. Creating financial toxicity, actually just driving and trying to collect patients and putting them in a financially worse position actually creates significantly worse health outcomes for patients and ultimately drives the costs higher.

And so we get hospitals 40 to 50 cents on the dollar through helping to rebuild trust that patients have lost in the system, convincing them to pay something, figuring out what it costs the hospital, so at least hospitals get what they recouped. It also helps them lower their costs to collect. And it helps them to get their money more quickly. So, at the end of the day, we’re actually helping hospitals get more than they otherwise would have through both a combination of getting patients to at least pay something and making sure insurance pays their fair share.

Kelly: Yeah, no, that makes a lot of sense there. So what are the most common issues you see with medical bills? And how do you work with hospitals and healthcare providers to solve them?

Braden: Yeah. So, I’m going to take that sort of common issues from the patient perspective, right? When a patient looks at a hospital bill, in their opinion, the common issue is, one, it’s confusing, and, two, it’s overwhelming. They don’t fully understand what they’re being charged for and why, especially if there are multiple bills coming from what a patient views as a single procedure. At the same time, as those bills increase, it becomes overwhelming to patients because they see no way out. They want to pay their hospital bills, but many people don’t have the cash in the bank to make a $500 emergency payment, much less a $5,000 emergency payment. And so they get to a situation where they have this really big bill, and they see that there’s no real way out for it. So, from a patient perspective, it’s confusion and the sort of that overwhelming anxiety. From sort of a more dispassionate perspective on what are the things that are wrong, we see improper insurance denials. Sometimes there are errors in bills. It’s a problem. It’s not overwhelming from a cost perspective, but it happens quite frequently. And then from a hospital perspective, I think there’s a lack of insight into the totality of the patient’s situation. I don’t think hospitals even have the ability to fully understand the totality of the patient’s situation, what their financial situation is, whether or not they’re getting medical bills from other providers that may not be there. And so hospitals don’t really understand the burden that patients are facing.

Kelly: No, I’ve been in that situation, and yes, that makes a lot of sense what you just said. How can hospitals and providers enhance their revenue while maintaining a patient-centric approach in resolving medical debt?

Braden: Yeah. It’s hard to do that. I think there’s a lot that goes into it. I think transparency in what’s going on is important, but it’s not in itself sufficient. I think if you just give patients too much information, it creates confusion. And so you have to give patients information in a way that allows them to understand and also sets expectations appropriately. But at the end of the day, I think the most important thing for hospitals is a willingness to work proactively with patients to come to a reasonable conclusion for all parties. And I think reasonable means things like flexible patient options. I think it means a willingness to accept discounts in exchange for payments in full by taking into account the totality of the patient’s situation, as I was mentioning, where patients are financially and what they could feasibly afford to do as well as what cost the hospital to provide the procedure itself, so that hospitals can at least recoup their costs, but they’re not putting patients in a financially tenuous situation.

Kelly: Got it. So, what is the most challenging part of working with hospitals and providers to find solutions for medical bills?

Braden: Yeah. So, from a patient perspective, it’s just navigating the system and understanding what’s going on, why they’re being charged what they’re being charged, and potentially what can be done about it. From our perspective, what we need to do is find the right person. The person who’s motivated to help solve the situation and has the authority to help solve that situation. Now, we need to understand the ways that we can solve the situation that works out well for both parties. And then we need to present that resolution in a clear way, in a way that allows that person at the hospital to get a win, but it also allows the patient to win. It allows the patient to get to a situation where they can pay something on their medical bills, but they have a path forward to getting out of debt so that they can focus on other things in their life, their health, their family, their job, just continuing to move forward. And so the key here, I think, is that we work best when we work with hospitals who don’t have a completely rigid outlook on how they treat all patients, but who are able to adapt to the situation that the patient is in.

Kelly: So, what are some successful strategies hospitals have implemented to educate patients about available financial assistance programs and resources to alleviate medical debt burdens and maintain their revenue?

Braden: Yeah. Absolutely. So, I mean, look, it’s really hard to do that. And there’s a lot of standard things that a lot of hospitals have done and implemented that have helped and sort of moved the needle for that. Things like clear and comprehensive billing explanations or better patient education materials. Offering everything as a single bill versus sending patients multiple bills. Having proactive financial support and setting up patient friendly payments. Even collaborating with insurance, or sorry, with community organizations. All of these things are helpful, but I don’t think they’re fully sufficient. Even the best hospitals in this arena, the ones that are doing all of these things and doing them well still very often struggle with patient collections and have patients who struggle with debt due to medical bills. And so at the end of the day, I think the key thing that hospitals need to do is recognize that each patient views their situation with their medical bills is unique, because to them, it is a unique situation. And they need to be able to adapt to that uniqueness and build out a solution that works for everyone involved, including the patient. And that actually ends up being a lot of what we do. We understand the uniqueness of that patient’s situation. We package that situation in a way that hospitals can structurally deal with and suggest a conclusion and then ultimately get to a conclusion that works for everybody, with the patient in the hospital.

Kelly: Those are some great tips. Thank you. How can hospitals best work with companies like Resolve?

Braden: Yeah, I mean, I think there’s three things. One is streamlined and clear communication. Two is continuing to have that openness to collaboration and partnership. And the third is maintaining that patient-centric approach. So streamlined and clear communication, making sure that they’re very clear about who companies like Resolve should be talking to, what the expectation on the hospital side is and what the desire and the hospital side is so that companies like us can actually build up a solution that works. I think there’s collaboration and partnership. There’s actually willingness to work towards common goals with patients and with hospitals, and willingness to give us an understanding of what the hospital wants, and willingness to dive in to get an understanding of what the patient wants. And that feeds into that patient-centric approach. Approaching patients as individuals who need help and not just looking at them as numbers to collect money from, I think, is key to helping patients out of the situation.

Kelly: Thank you so much for joining us today, Braden, and for sharing all this valuable information on such a hot topic.

Braden: Thank you. It was really great to be here. I really appreciate it, Kelly.

Kelly: And if a listener wants to learn more or contact you to discuss this topic further, how best can they do that?

Braden: Yeah. So go to our website, resolvemedicalbills.com. We’ve got a phone number there or a contact email there to reach out to us.

Kelly: Fantastic. And thank you all for joining us for this episode of The Hospital Finance Podcast. Until next time…

[music] This concludes today’s episode of the Hospital Finance Podcast. For show notes and additional resources to help you protect and enhance revenue at your hospital, visit besler.com/podcasts. The Hospital Finance Podcast is a production of BESLER | SMART ABOUT REVENUE, TENACIOUS ABOUT RESULTS.

 

If you have a topic that you’d like us to discuss on the Hospital Finance podcast or if you’d like to be a guest, drop us a line at update@besler.com.

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