© 2015 Citigroup, Inc. All Rights Reserved. Any reproduction of this material requires the express written consent of Citigroup, Inc. Impact on Patient

© 2015 Citigroup, Inc. All Rights Reserved. Any reproduction of this material requires the express written consent of Citigroup, Inc.

Impact on Patient Financial Expectations

DISCLAIMER: The views and opinions expressed in this presentation are those of the author and do not necessarily represent official policy or position of HIMSS.


Your speaker: Stuart Hanson

• Director, Healthcare Business Development, Citi Retail Services, Money2

® for Health

• Chair of the Healthcare Revenue Cycle Improvement Task Force for HIMSS

• Over 15 years experience in healthcare RCM


The Road Map to 2025

Healthcare is facing important changes, making the move toward “consumerism”


Consumer healthcare payment patterns

1 – 2013 MadPow Consumer Survey, commissioned by Aetna

patients compare their provider’s bill to their health plan Explanation of Benefits (EOB)1

71%

consumers preferred to pay healthcare bills online1

69%


Current patient payment experience

What is this bill for? Does it match what my health insurer shows?

I’m tired of writing checks to so many doctors…

Logging on to multiple sites to pay...

There has to be better way!

Doctors and hospitals surveyed often wait 75-150 days for payment*

*Source: Citi analysis based on individual interviews with doctors and hospital administrators, conducted by Boundary Information Group (June 2013)


Current provider collection experience is time-consuming

According to a 2013 survey of health care providers:

– Doctors and hospitals often wait 75-150 days for payment

– 50% of patient obligations go unpaid

Source: Citi analysis based on individual interviews with doctors and hospital administrators, conducted by Boundary Information Group (June 2013)


Current provider collection experience is time-consuming …and expensive

Projected financial impact for providers

In 2011, patient non-POS Write-offs totaled $102 billion

Billed Collections

Patient Write-Off

POSCollections

By 2019, patient non-POS Write-offs are estimated to exceed $189 billion

Patient Write-Off

Billed Collections

POSCollections

Source: Citi analysis, based on 2011 data from the U.S. Dept. of Health & Human Services and Center for Medicare & Medicaid Services.


Patient obligations are growing

• Patient payments averaged 30% of revenue in 20121

• 13% of providers interviewed state higher copays and co-insurance are most pressing payment issues2

Sources: 1 Citi analysis, based on 2011 data from the U.S. Dept. of Health & Human Services and Center for Medicare & Medicaid Services. 2 Citi analysis based on client interviews, conducted by Boundary Information Group (June 2013)


Patient obligations are growing


And billing experience is important to overall patient satisfaction…and to providers


Highlights from recent Citi research

“The only way to function efficiently is to use "bolt-ons" to the HIS (Health Information System). We "bolt-on" four or five just up front, including address verification, an estimator, eligibility/benefits checking and other special functionality. A problem with this approach is that any one of these "bolt-ons" might fail or delay processing and then the whole process gets delayed.”

- Hospital Revenue Cycle Executive

“We want to move the process up to the patient's smart phone, tablet or via a portal pre-visit, and are not making a big investment in kiosks. Smart phones and portals will replace kiosks.”

- Hospital CFO

Source: Citi analysis based on individual interviews with doctors and hospital administrators, conducted by Boundary Information Group (June 2013)


Patient Financial Experience: Solution Example – Value PropositionAnticipated provider advantages

– Receive payments from more patients quicker*

– Receive consolidated electronic payments

– Lower collection and processing costs

– Improve cash flow

– Improve the patient experience

Consumer benefits

– One website helps make paying healthcare bills easier

– Alerts let patients know when your invoice arrives

– Easy to understand patient bill obligation

– Link to health plan EOB portal

– Easy to schedule payments or pay immediately

– Pay via web, mobile or tablet* Processing fee applied to each payment registered providers receive from Money2 for Health.


Solution Example: Money2® for Health helps simplify

the healthcare payment process for consumers

Aggregated payer and provider data Link to Explanation of Benefits easily

Bank agnostic Consumers can fund their online health care wallet with funds from any bank, and most HSA, FSA, debit or credit cards

Powered byConsumers can feel secure knowing it’s backed by a recognized leader in payment processing

Access any time via web or smart phone

Simple to set up, easy to use

Just one website to pay most providers


Confidential Information Disclosure

IRS Circular 230 Disclosure: Citigroup Inc. and its affiliates do not provide tax or legal advice. Any discussion of tax matters in these materials (i) is not intended or written to be used, and cannot be used or relied upon, by you for the purpose of avoiding any tax penalties and (ii) may have been written in connection with the “promotion or marketing” of any transaction contemplated hereby (“Transaction”). Accordingly, you should seek advice based on your particular circumstances from an independent tax advisor.

Any terms set forth herein are intended for discussion purposes only and are subject to the final terms as set forth in separate definitive written agreements. This presentation is not a commitment to enter into the Transaction or any other business arrangement. By accepting this presentation, subject to applicable law or regulation, you agree to keep the information contained herein and the existence of and proposed items for any Transaction.

Prior to entering into any Transaction, you should determine, without reliance upon us or our affiliates, the economic risks and merits (and independently determine that you are able to assume these risks) as well as legal, tax and accounting characterizations and consequences of any such Transaction. In this regard, by accepting this presentation, you acknowledge that (a) we are not in the business of providing (and you are not relying on us for) legal, tax or accounting advice, (b) there may be legal, tax or accounting risks associated with any Transaction, (c) you should receive (and rely on) separate and qualified legal, tax and accounting advice and (d) you should apprise senior management in your organization as to such legal, tax and accounting advice (and any risks associated with any Transaction) and our disclaimer as to these matters. By acceptance of these materials, you and we hereby agree that from the commencement of discussions with respect to any Transaction, and notwithstanding any other provision in this presentation, we hereby confirm that no participant in any Transaction shall be limited from disclosing the U.S. tax treatment or U.S. tax structure of such Transaction.

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© 2015 Citigroup, Inc. All Rights Reserved. Any reproduction of this material requires the express written consent of Citigroup, Inc. Impact on Patient