Everyone knows healthcare in the United States is expensive. In fact, healthcare spending in the U.S. is the highest in the world, above Switzerland and Luxembourg. But while Switzerland has the highest life expectancy at 83.7 years, the United States’ life expectancy of 78.6 years doesn’t make the top ten. It doesn’t take a banker to know that’s a bad return on investment.

Healthcare’s aim is to keep people healthy, and there are many healthcare professionals working tirelessly toward that goal. But overall, the healthcare system is not only expensive but also complex and ineffective for patients and healthcare providers. Some big changes need to be made, and can’t be completed overnight, but in the meantime help is coming from a somewhat unlikely source: Commerce Bank.

This year, Commerce launched CommerceHealthcare^® to help address the healthcare industry’s challenges. To learn more about what’s going on with healthcare, and what a bank is doing to help, we sat down with Rick Heise, senior vice president and director of specialty healthcare services at CommerceHealthcare®.

What are the biggest challenges facing healthcare?

One of the biggest challenges healthcare providers face today is navigating the transition from fee-for-service to value-based care. While the industry is shifting towards a model where providers are incentivized to keep people healthy, revenue is still largely tied to service.

Healthcare organizations, and the industry as a whole, are also seeking solutions for meeting the increasing cost of medical care. There are several factors driving up healthcare costs, including an aging Baby Boomers population, and patients’ tendency to hold off on care until a bigger issue arises.

Under healthcare’s complex billing system, providers struggle to get paid. Patients also have a hard time navigating the system, understanding the cost of treatment, and keeping track of their bills. High-deductible healthcare plans are also forcing patients to cover an increasingly large portion of the financial aspect of care.

Unsurprisingly, patients are starting to challenge the healthcare status quo. Alternate options are popping up – like independent care clinics – and patients are increasingly practicing consumerism. Similar to other industries, consumerism is driving innovation in healthcare. Providers are heavily focused on efforts to improve customer experience and effectiveness of care, while also identifying opportunities to decrease costs. 

What changes can we expect to see in the future?

Healthcare organizations have already started to implement better customer experience tools for streamlined registration, scheduling and bill pay. Behind the scenes, providers will be improving the processes by which they get reimbursed, so they can recover payment more quickly and decrease costs. We’ll also see more consolidation, through which standalone hospitals form a larger healthcare system. That way, they can create scale, make efficient use of resources and drive down costs. 

Long-term, healthcare organizations may adopt alternate payer models altogether. Some providers are taking on a capitated payment, which incentivizes them to keep people healthy. The organization is paid a set amount for a population of people, and they’re responsible for the costs associated with treatment that group may need. To maintain their business model, the organization proactively reaches out to members of the community to encourage preventive health measures like taking medication and scheduling check-ups. 

What role would a bank play in all of this?

Improving their finances can help healthcare organizations act more like a business to reduce expenses and respond to consumerism. The same financial tools and technology we use in other industries can be applied to help with healthcare’s unique challenges. Our focus is on improving the patient experience, driving down costs for the provider and taking the friction out of healthcare’s financial processes. 

Our solutions help reconcile accounts receivable more efficiently, improve cashflow and automate processes to help the provider get paid more quickly and lower their operating costs. Then we’re improving billing for patients by extending a zero-interest line of credit they can use to pay their bills on their own terms. We’re even rolling out a solution that helps healthcare organizations issue refunds directly to patients’ deposit accounts.

So, after more than 150 years in banking, why is Commerce focused on healthcare?

We’re patients, too. Healthcare affects all of us, and we want to help everyone get to a healthier place. We figured, if we have the capabilities to help, we need to rise to the challenge. We’re tailoring our financial tools and technology to the specific needs of the industry. Our goal is to establish a healthcare financial system that makes sense and puts the patient at the center.

And, like healthcare, banking is a highly-regulated industry, so we understand and can work with healthcare compliance standards. Our experience in deposit banking also allows us to scale to meet even the largest healthcare organizations’ needs. 

As a country, we spend 17% of our GDP on healthcare. For that investment, we deserve better outcomes. At Commerce, we’re working to help our healthcare clients tackle their biggest challenges to improve the patient experience and increase effectiveness. To learn more about CommerceHealthcare^®, visit our website.

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Also See

• How healthcare providers can use automation to get paid faster.
• Care, not collections, in a high-deductible world.