Industries Health

Top 10 Things We Heard at HFMA 2019

August 09, 2019 | John Talaga

During the HFMA 2019 annual event, Flywire held focus groups to learn what the leaders of hospital and physician business offices want and need. Below are the top 10 takeaways from those focus group discussions.

  1. Hospitals want a strategy that creates a seamless patient payment experience at every point of service. They want to work with solutions that can provide complete connectivity across accounts, from estimation to billing to payments to reconciliation.

  2. On a list of priorities, providers want to find a way to present a consolidated bill that includes healthcare services to all family members at any of their facilities. “I want my patients to get one bill across a guarantor and even facilities.”

  3. Vendors should be able to offer the stratification of self-pay and self-pay after insurance patients to determine if patients are eligible for charity or financial assistance, and for how much, even before service. Transparency from the very beginning of the interaction is key.

  4. They want to remove access barriers to healthcare because it prevents catastrophic care issues down the road—acknowledging that it is better to write off $2,000 today than $40,000 in two years.

  5. Hospitals want to play the long game, focusing on building community relationships. If a hospital can identify which patients can't pay or can pay something through a payment plan and can be sensitive to their financial situation, community loyalty to the hospital grows. When a patient's financial position or healthcare coverage improves, they will remember and select the hospital who worked with him or her.

  6. These leaders also want to find ways to connect with the uninsured population and be proactive in getting them the preventative care they need. As one person said, “I’m a community health provider. I don’t want to alienate anybody.”

  7. Revenue cycle leaders recognize that they cannot “squeeze water from a stone,” by chasing after bad debt and getting a zero or negative ROI. One participant said she was tired of spending “somewhere in the neighborhood of $200 on an episode of care to write off $1,000. So, it’s not $1,000 that I’m writing off; I’m now writing down $1,200.”

  8. Some revenue cycle leaders view Extended Business Office (EBO)/outsourcing as a short-term way to assist with transaction volume but, long term, want to focus on finding creative ways to leverage their own employees—“[They] are just more invested because they're already part of the community.”

  9. They are concerned about back-office management and want the workload to be refined with analytics to ensure that what they chase has real benefit to the hospital and the patient.

  10. Hiring good people is a challenge, they are looking for revenue cycle employees who have a heart for patients and find fulfillment in reducing the stress of paying for healthcare.


Revenue cycle management has becoming increasingly more challenging. With downward pressure on reimbursements and rising patient pay responsibility, being nimble and thoughtful about the balance between collections and patient/community relationships is critical. We want to thank our participants for their thoughtful and transparent feedback that reflects the broader industry.

John Talaga is the Executive Vice President and General Manager in Healthcare.

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