Patient Financial Responsibility and Physical Therapy: No Escaping It

Patient Financial Responsibility in Physical Therapy
To say that healthcare costs have been rising may be stating the obvious. To those of us who have been at the receiving end of high costs, it can be painfully obvious.
  • The number of people with employer-sponsored insurance accompanied by deductibles increased from 63% to 82% in the past 10 years, and deductibles went up from $826 to $1,655, on average.
  • The share in High Deductible Health Plans, defined as having a deductible of at least $1,350 for single coverage and $2,700 for family coverage, has also been growing.
This situation of course predates the pandemic, which in turn has, if anything, made the challenge even harder. Physical therapies are likely more impacted by the cost escalation given the higher level of commitment required from patients.

Patient Financial Responsibility: High Deductibles Became The Norm

Back in the early 2000s, new reforms came into play that encouraged employers to offer high deductible healthcare plans to their employees. One of the goals was to get more people covered by some form of health insurance. Another was to lessen the burden of expensive healthcare costs on employers. The belief was that if high deductible plans were offered, employees would avoid unnecessary procedures and healthcare expenses since they had to bear more of the cost of these procedures. Unfortunately, in just a few years after these reforms were introduced, the economy took a turn for the worse. The Great Recession that began in 2008 and carried on for several years left consumers weighed down by the increasing premiums and deductibles. To adapt to this, some patients began to skip routine treatments and medications. Not quite the outcome that had been envisaged perhaps.

Patient Financial Responsibility: Confusion Continues to Prevail

Fast forward to today and consumers continue to be less than fully informed about what a particular intervention might cost them until they receive the bill itself. One of the reasons may be difficult to understand insurance plans. Insurance coverage details are sometimes complex and confusing, leaving consumers on the hook for care received that they did not realize they would have to pay for out of pocket.
  • Medical Billing Errors/Confusion Medical billing errors are fairly common. Some estimates say that as much as 80% of all medical billing contains at least one error. This frustrates patients and providers alike, and it contributes to ongoing issues with patient financial responsibility.
  • Financial Responsibility Outweighs Wage Increases While consumers? financial responsibility burden for medical expenses continues to climb, wages have remained stagnant. This pattern has put pressure on consumers and left them unable to meet financial responsibilities of their healthcare.

Patient Financial Responsibility: What is the Physical Therapy Practice to do?

Unlike other forms of healthcare, physical therapy tends to be characterized by a higher frequency of treatments. The sticker shock for patients could be higher. Getting patient buy in and more engaged in their care plan so that they clearly see the value can provide a way out. Some of the steps could include:
  • Communicating the detailed physical therapy care plan and regular progress updates to produce a shared sense of ownership.
  • Establishing a template to communicate benefits to patients and what they should expect to pay for their physical therapy so that there are no surprises.
  • Making physical therapy payments readily accessible: Pay online, pay via text message, pay through app so that when patients are ready to pay, they lose no time in actually doing so.
  • Developing a physical therapy payment plan to cover the full cost of care over time and lower the impact by enabling patients to pay for care at set intervals.
  • Setting up automatic payments to keep patients committed to their physical therapy care plan and pay plan.
Most of this could of course be readily set up in the EMR and Practice Management system. Having a conversation with your EMR/Practice Management provider may be a good way to get changes going in case you have not already done so. No escaping Patient Financial Responsibility but easing the pain may go a long way.