Why Non-Emergency Surgery Volumes Could Depend on Early Financial Engagement

By Mark Spinner, President and CEO, AccessOne

More than half of all consumers plan to delay non-emergency but medically needed care (58 percent) or diagnostic tests (56 percent) following the COVID-19 outbreak, and the length of care delays increases among vulnerable populations, such as families with children and minorities, an AccessOne survey shows.

With hospitals relying on the return of elective surgeries to boost financial health, ensuring patients feel financially comfortable to proceed with plans they had for treatment prior to the coronavirus pandemic will be key to strengthening hospitals’ financial health. Targeted communications that seek to address the financial fears of specific populations before and after a procedure also are critical.

Taking a Closer Look
Data from the survey of 1,004 consumers, conducted April 3-5, demonstrate the extent to which the financial stress of a COVID-19 environment could impact consumers’ healthcare decisions once hospitals and other providers are able to return to near-normal levels of care:

  • 68 percent of consumers are concerned about their ability to pay for general medical expenses this year.
  • Among consumers who plan to delay care this year, one in three would consider delaying non-emergency but medically necessary care—like a knee replacement—for up to six months due to cost.
  • About one-third also would delay diagnostic tests—like a colonoscopy—for up to six months.

These numbers rise among certain populations, like families with children and younger generations (Gen Z through Gen X), who are most concerned about the impact of COVID-19 on their financial wellbeing and their ability to afford care.

Families with children. Seventy-nine percent of families fear their income will be impacted by the pandemic, and one-third of families are very concerned about losing their health insurance. In the face of economic uncertainty, families with children are more likely to postpone care for long stretches: 44 percent would delay a medically necessary surgery for up to six months, and 45 percent would delay diagnostic procedures. Sixty-four percent are very or somewhat concerned about their ability to pay for medical care this year.

Younger generations. Younger generations, including Gen X, are most concerned about the impact of COVID-19 on their finances, compared with one in two baby boomers. Most consumers in younger generations also are worried they will lose their jobs due to the pandemic, and half are afraid they will lose their health insurance. Their financial anxiety is reflected in their perception of their ability to pay for care: Two-thirds of Gen Zers, millennials and Gen Xers are very or somewhat concerned about their ability to pay for medical expenses in 2020. About one in three Gen Xers would delay a surgery for up to six months to avoid the financial expense, along with 44 percent of Gen Zers and 41 percent of millennials.

It is clear that consumers will have to overcome fear of financial stress to undergo a medically necessary but non-emergency surgery or procedure in 2020. That’s one reason why a proactive patient financial engagement strategy—with a focus on reaching vulnerable populations—is essential to enabling access to needed care and improving the financial standing of most healthcare organizations.

Here are three tactics leaders should consider.

Ensure all patients benefit from early and seamless patient financial communications. Provide out-of-pocket estimates for surgeries or procedures via the patient’s preferred communication method: email, phone, secure patient portal, or text (with a link to the patient portal). Then, provide a single contact for cost-of-care and billing inquiries, taking care to assess and address the language needs of consumers. This gives consumers a knowledgeable resource to turn to with financial concerns and explore nontraditional options for payment, where needed, well in advance of a potential or scheduled procedure.

Offer flexibility around payment—regardless of income level. All-inclusive, flexible financing is a vital step toward helping patients feel financially comfortable undergoing a needed procedure. Consider not only establishing long-term, interest-free plans, but also providing patients the option to lower monthly payments even further with low-interest plans to manage income disruption. This assures consumers that they are empowered to adjust their terms if financial circumstances change.

Double down on contact with surgery patients whose accounts are past due. When patients who entered into payment plans prior to the COVID-19 outbreak suddenly stop paying on their account—especially true among vulnerable populations—engage these patients right away to ask why. Then, offer practical solutions that meet the patient’s needs while protecting the hospital’s financial health. For instance, when patients have either lost their job or are concerned about a reduction in income, options could include:

  • Lowering monthly payments for a specified period
  • Eliminating late fees for consumers during the pandemic
  • Offering a grace period for patients that have lost their jobs

Establishing a proactive patient financial communication and engagement strategy for vulnerable populations will be essential to addressing the new consumer psychology around medical expenses while protecting surgery volumes in a post-COVID-19 environment.