“A Bill You Can Understand” Design and Innovation Challenge: Helping Patients Understand Their Medical Bills and the Financial Aspect of Health
Patients in the US struggle to understand their medical bills and the medical billing process. Providers, payers, and consumers all benefit if we fix the current system. This design and innovation challenge will tackle current consumer pain points to deliver solutions that result in clearer, less complex, and more understandable medical bills that ultimately seek to improve the patient financial experience. Many health care organizations have been doing important work to address the complex problems that individuals face when navigating the medical billing process. A national challenge presents a unique opportunity to both support these ongoing efforts and catalyze innovation by bringing new players that may traditionally be outside the health care space—designers, digital tech start-ups, entrepreneurs, and other innovators—to the table.
More often than not, medical bills are a source of confusion for patients and families. Consumers rarely know the cost of health care at the time of service, and commonly receive bills from multiple sources for the same episode of care long after the encounter. There is currently no standard for consumer medical billing documents; bills vary in content, presentation, and use of jargon. Patients are often surprised by costs incurred, unsure how to verify whether the bills received are correct or complete, and what amounts are due. This can result in anxiety or frustration leading to inaction, non-payment, or incorrect payment of medical expenses. At the same time, consumers are struggling to understand the portion of expenses that their insurance plan may cover, and may not realize that they have received out-of-network care or non-covered services until it is too late. Consumers may not understand how a deductible impacts their financial responsibility for services, or miss opportunities for proactive financial planning. Confusion and surprises related to medical bills undermine patient satisfaction with both providers and payers. Furthermore, negative experiences with the system and financial hardship may cause patients to avoid seeking the care they need to stay healthy.