Healthcare affordability is now a hard-hitting issue for providers and healthcare consumers across most income levels today. Even for people who sincerely want to pay, healthcare affordability is a challenge. Operational approaches to code, bill and collect on healthcare receivables that were acceptable in simpler times are unsustainable in this complex environment.

The only way for healthcare organizations—from ambulance companies to large healthcare systems—to thrive is by working smarter, not harder—or even faster. As we manage the complex self-pay world, here are four key trends to consider.

Patient Responsibilities and Realities

Self-pay accounts have increased dramatically; both in the value of these accounts, and their sheer number. In fact, self-pay dollars comprise more than 25% of all accounts receivable. This percentage is projected to keep rising. What’s more, employees are now responsible to cover over 40 percent of the total cost of care in employer- provided PPO insurance coverage. Another self-pay reality is consumer bad debt. Bad debt for medical expenses is projected to grow at a rate of 30 percent annually in some hospitals.

Three Goals: The New Self-Pay

The increased shift in payment responsibility from payer to patient means a higher volume of self-pay A/R. New industry realities call for new strategies to get paid. Here are three goals to strive for:

  1. Inspect—Gain more transparency in managing self-pay A/R. Know the stated value of your self-pay accounts.
  2. Valuate—Identify payment risk factors and valuate self-pay A/R accounts. Know the collectability of your self-pay accounts.
  3. Communicate—Discuss coverage, charity care and payment options with patients and their families—early and often.

Self-Pay Tools

The volume and dollars associated with self-pay are increasing as never before. This strikingly fast growth in the amount of self-pay patients is driving transformative change in revenue cycle workflows, technologies and management strategies.

Using intelligent software systems to achieve greater account transparency is key. Payor Logic offers actionable analytics that affect reimbursement, self-pay account performance and balance after insurance. Click here to learn more about our solutions >

Medicaid Expansion—EMS Rates 2016

In Medicaid expansion states, EMS providers saw more trips—but less uninsured. This indicates that coverage expansions are requiring providers to analyze changes that have occurred and to likely retool for the years ahead. Download this infographic to see a mix of expansion and non-expansion states »

To learn more about how PayorLogic is helping providers integrate technologies and reallocate resources through technology, contact one of our EMS experts today via email at:

Want to keep the conversation going? Leave us a comment and stay tuned for our next post: Two Strategies to Simplify EMS Self-Pay Accounts