The Chief Operating Officer of Adventist Healthcare has proposed a radical shift in how all bills — deductibles, copayments, and insurance payments — are billed and collected, advocating that it be health insurer, not the provider, who is in charge.
A copy of the proposal, which was authored by Jeff Sackett of Adventist and published in Health Affairs can be accessed by clicking here.
Called the “Consumer Protection Realignment,” the proposal calls for simplifying and streamlining the billing and collection process by putting insurance companies in charge. Hospitals and healthcare providers would be free to concentrate on their core competencies, taking care of patients.
“At its core, CPR would enable providers to focus on patient relationships and clinical issues; enable health plans to focus on financial issues; and provide clearer, consistent, information to consumers about the cost of care and their potential out-of-pocket exposure,” Sackett writes. “This would protect consumers by streamlining billing communication and processing, creating a more competitive market with incentives to reduce costs and enable more consumer choice, and reducing “surprise” balance billing.”
Insurers are the best option for dealing with billing and collections, Sackett argues, because they are the “keepers” of patients’ financial information and already have an existing financial relationship with patients. The arrangement would allow providers to lower their costs because they would not have to worry about collecting on unpaid debts and insurance companies would be motivated to “manage population health,” Sackett writes.
Patients would benefit because they would no longer receive multiple bills from multiple providers and would receive one bill.
