In the good old days, most people had great, employer-sponsored healthcare plans. Patients simply provided their insurance cards at appointments, paid a $10 copay, and generally had low or no deductibles. Provider billers pushed claims out the door as quickly as possible, apart from holding claims for the first 30 days of the year when plan year deductibles reset.

Today, the healthcare landscape is quite different. For years, healthcare providers have watched the number of patients who are self-pay or on high-deductible health plans (HDHPs) grow. This has increased the already significant financial strain on healthcare providers. The good news is that there are ways to collect outstanding receivables faster — even when the patient is the payer.

The Downfalls of HDHPs for Providers and Patients

Because HDHPs are designed to shift cost away from the employer (plan sponsor) and to the worker, they have grown considerably:

• 294% increase in HDHPs compared to 2009 levelsⁱ
• 67% of large employers and over 50% of mid-size employers offer HDHPsⁱⁱ
• 50% of current workers are enrolled in a plan with an annual deductible of $1000 or higherⁱⁱⁱ

Yet there are major repercussions when patients, who previously were only responsible for a copay, start footing a much larger part of the bill. Providers are now left with the task of collecting the allowed amount directly from the patient instead of the insurance company.

As every biller knows, patients with unexpected expenses take longer to pay and there’s a higher risk of having to write off those dollars. Provider accounts receivable (AR) bad debt has ballooned in tandem with patient out-of-pocket costs. As a result, revenue for the healthcare providers has decreased across the industry.

ⁱ2023 Employer Health Benefits Survey, https://www.kff.org/report-section/ehbs-2023-section-8-high-deductible-health-plans-with-savings-option/. Accessed 17 December 2024.
ⁱⁱWaddill, Kelsey. High Deductible Health Plan Enrollment Hit Record High in 2021, https://www.techtarget.com/healthcarepayers/news/366603688/High-Deductible-Health-Plan-Enrollment-Hit-Record-High-in-202. Accessed 17 December 2024.
ⁱⁱⁱTozzi, John and Tracer, Zachary. Sky-High Deductibles Broke the U.S. Health Insurance System, https://www.bloomberg.com/news/features/2018-06-26/sky-high-deductibles-broke-the-u-s-health-insurance-system. Accessed 17 December 2024.