Seven Questions to Guide Evaluation of Financial Payments Solutions

CommerceHealthcare^® recently published an e-book, Innovation and Integration in Healthcare Payments, which offers perspectives on current trends in financial technology; in particular, its importance in addressing the urgent issue of workforce shortages. The report explores the role of system integration in optimizing process automation in patient financing, accounts payable, remittance management and lockbox. This companion article proposes seven questions capturing “on the ground” considerations for finance and IT leaders in choosing payment solutions that deliver automation to alleviate workforce constraints.

Does the technology provide strategic, meaningful efficiencies through automation?

Providers seek technology/services suppliers who demonstrate understanding of how to use healthcare payments technology effectively to derive significant staff efficiency through task automation. A vendor’s strategic orientation should also encompass:

• Attention to tomorrow’s needs as well as today’s. 
• Emphasis on value creation as the end goal, not just having the latest technology.

Do proposed financial solutions rest on a strong technology foundation?

Too much financial technology remains in the immature “hype cycle” stage. A core platform that reflects contemporary architecture should underpin a vendor’s financial automation solutions. Desirable platform characteristics include enabling flexible deployment of solutions and ensuring component and workflow coordination so that software is not merely a collection of “bolt-ons.” Also important is a robust integration engine supporting API-first integrations to multiple systems. File transfer capabilities permit data exchange where APIs are not feasible.

Does the solution “play well” with the existing IT environment?

Hidden cost and productivity loss are often incurred when payment solutions fail to respect two areas:

• Systems. The best suppliers are system agnostic, designing solutions that can work productively with a variety of incumbent electronic health records, enterprise resource planning and other systems. This helps avoid the costly “rip and replace” syndrome that providers face too frequently. 
• Workflows. Revenue Cycle Management (RCM) automation solutions should offer readily configurable workflows to meet varying requirements (by user type, location and other variables). The goal should be to avoid forcing use of proprietary tools that conflict with beneficial existing workflows. That situation frequently leads to inefficient manual user workarounds. 

Is the vendor innovative?

As they pursue long-term digital transformation, providers want to “future proof” their IT environment by incorporating innovative technology, services and functionality. Preferred vendors contribute by monitoring technology trends, embracing innovations and maintaining logical solution roadmaps. To complement active internal development, institutions such as Commerce Bank expand their platforms with emerging features through relationships with financial technology firms.

Can solutions be deployed at the organization’s preferred pace of change?

Many products enforce a particular rate of customer adoption. Accommodating individual variation and often fluid requirements demands vendor flexibility, deriving from:

• A portfolio of financial/RCM solutions. For example, patient financing platforms must have options to manage convenient electronic refunds as an organization expands into financing based on pre-service estimates.  
• Commitment to seamless transitions. This attribute promotes new solutions and changes being implemented smoothly and with minimal resource drag on internal IT/operations.
• Coverage of the full transactions spectrum. Healthcare involves both business-to-business and business-to-consumer financial processes, from supplier payments to e-commerce in support of telehealth. Banks bring to their solutions understanding of all types of transactions gained through extensive daily execution.
• Avoidance of a “once size fits all” philosophy in product development. 

Are high security levels maintained? 

Cybersecurity is a major concern from the C-suite to frontline administrators. Data breaches abound, ransomware attacks are rising and costs of response are high. One study estimated the average cost per breach at over $9 million and observed that healthcare’s cost has led other industries for the past 11 years.¹

Solutions must conform to multiple standards and guidelines, including HIPAA, the payment card industry, the National Institute of Standards and Technology and others. Integrated financial automation solutions should incorporate best practices security features and offer strong audit trail and archiving. New security risks stemming from two avenues must also be taken into account:

• Remote work. Substantial numbers of finance and RCM workers perform their work remotely, and studies suggest the trend will continue. According to one survey, 66% of hospitals foresee continuation of their pandemic remote work levels for administrative staff.²  Other studies portend greater use of hybrid remote-onsite models. These situations complicate the security profile. 
• Organizational complexity. Health systems, hospitals and practices are not static. As healthcare adapts to changing economics and new competition, organizations continue to pursue acquisitions and partnerships. Sixty-two percent of healthcare CFOs plan to undertake a transaction in 2022.³  These moves often introduce into the security mix disparate and legacy systems, and workflows.

Monitoring and responding to these requirements can be a daunting effort for small, specialized firms. Commercial banks adhere to some of the strongest security mandates of any industry and are monitored by the Federal Reserve, SEC, Cybersecurity and Infrastructure Security Agency, and numerous other federal and state regulatory agencies. Banks place considerable resources behind system testing and monitoring as well as staff training. 

Is the technology backed by quality, experienced people?

Experience has shown that customer support is one of the most critical differentiators in vendor success. Companies that deliver value support their technology with a team—not just one representative—possessing the healthcare experience, skills and commitment to provide:

• System implementation and training that does not disrupt or burden IT and revenue cycle staff.
• Consistent ongoing execution, fast response to technical issues and regular communication.
• Market surveillance to anticipate needs, offer trusted advice and ensure solutions remain appropriately tailored.

Many benefits for technology acquisition and management

Using these seven questions, health systems, hospitals and practices can analyze and compare solutions to help find a “best match” with individual requirements. Several technology/services acquisition and management benefits provide further rationale for pursuing this interrogation:

• Vendor efficiency. As they need to “do more with less,” providers are looking to form deeper relationships with a tighter range of vendor-partners. That approach helps mitigate security exposure to outside firms, reduce business associate contracts and lessen technology and integration risk that arises when a desired solution set is built from many suppliers.
• Overcoming limitations from workforce shortages. Partners who offer tailored solutions with easy implementation and consistent ongoing support help providers alleviate barriers that arise from significant staffing shortages. A 2021 survey of healthcare executives found that 21% are experiencing shortages in coding/revenue cycle and 19% in IT.⁴ The need to improve productivity of existing staff is paramount.
• Enhanced agility. Healthcare organizations need far greater degrees of agility and resilience to be responsive to rapid industry change. Twenty-six percent of provider executives told a recent survey their organizations have changed significantly due to the pandemic.⁵ The right solutions along with collaborative vendor relationships strengthen a provider’s matrix of flexibility. 
• Promotion of interoperability. The government’s push for interoperability rules and standards that foster system integration and robust data exchange is accelerating. Many of the desirable vendor characteristics described in this report help further the cause of interoperability: being system agnostic, committed to APIs, and taking a complete enterprise perspective.

Many criteria are used to evaluate payments technology and services. The process is not always easy, and determining the right choice for an organization’s particular situation is important. Taken together, the seven questions offered here can help leaders make efficient and effective assessments and lead to healthy, productive and long-term vendor relationships.

CommerceHealthcare^® solutions are provided by Commerce Bank.

Disclosures:

1. IBM Security and Ponemon Institute, “Cost of a Data Breach Report 2021”, July 2021.
2. M. Hagland, “Kaufman Hall Report: Pandemic Continues to Rock Hospitals on All Levels,” Healthcare Innovation, October 19, 2021.
3. V. Bailey, “Healthcare CFOs Plan to Invest in Patients, Partnerships in 2022,” RevCycle Intelligence, February 17, 2022.
4. American Hospital Association, 2022 Environmental Scan, December 2021.
5. Boston Consulting Group, Health Care’s New Reality is Dynamic, Digital — and Here to Stay, December 15, 2021.