Consumer Deductibles Reset in January: What This Means For Your Practice


As the effects of the ACA continue to ripple through the world of medical care, providers have seen their first quarter revenue cycle fall into disarray in recent years. Because patient deductibles reset in January, they'll face a use-it-or-lose it situation from now until the end of the year. Further, many deductibles have risen to levels many patients will find difficult to bear financially. Coupled with higher deductibles will be higher co-pays and possibly severe reductions in coverage for those whose insurance comes through an employer. What does all this mean for your practice?

These strategies will help practices optimize for January

Expect a Busy Q4

January deductible resets are nothing new, and most providers annually see waiting rooms teeming with patients seeking covered services before the new year. This year, however, could see new highs in consumer demand. With more out-of-pocket expenses on their horizons, and fewer services covered by insurance plans, many customers who have already met their deductibles will try to receive covered treatment before the reset, which could mean more billing for co-pays.

Expect Crickets in Q1

For many practices, the bolstered activity of Q4 won't carry over to Q1. Your practice should be prepared to undergo a first-of-the-year business drop. The usual slow down may be compounded by patients suffering sticker shock with the new deductible and co-pay costs. Sadly, many patients will enter the new year woefully under-informed on the coming increases. Your intake staff could be facing the challenging effects of patient surprise.

{GUIDE} How to retool when deductibles reset

How long the usual dry spell will extend in 2017 will be the wild card. With higher deductibles and less coverage, the load on patient budgets may be such that any non-emergency medical issue, whether covered after the deductible or not, may be left untreated. Should this prove an eventuality, medical practices may need to rethink their billing strategies and marketing plans to encourage patients to seek services regardless of budget difficulties. Encouraging preventive care services and retooling their approach to patient billing could be the answer for many practiices.

Revenue Cycle Management May Suffer

First of the year struggles may well carry on throughout the year as patients adjust to higher self-pay costs. Many practices could see a sharp increase in slow-pay accounts and delinquencies. For those consumers who cannot forestall treatments but also haven't the resources to pay their full portion all at once may believe they have little choice but to pay over time. Without a prearranged agreement for billing installments, too many irregular and sluggish accounts could mean a stressed out billing department, distressed patients and uncertain budget forecasts.

Consider a Medical Collections Partner

Anticipating future collections challenges, now may be a good time to consider partnering with a technology-based medical billing and collections company. With check-in kiosks that collect the patient's portion prior to rendering services, your intake procedures can prevent confusion and slow-pay collections from the outset. Your collections partner, armed with the details of payer plans and patient responsibilities, can prepare your patients in Q4 with information on the coming changes. In this manner, fewer patients will feel they were ambushed in January with unexpected higher self-pay costs.

Managing patient expectations before the deductible reset in January will be your best opportunity to forestall difficulties in your revenue cycle. By compassionately alerting them to changes and collecting their payments up front with a convenient payment system, your billing partner can keep your practice healthy in spite of the January deductible reset.