Talking to Your Patients About the Deductible Reset

Three key points:

• Many patients do not understand basic healthcare terminology, including the annual deductible reset.
• Discussing the annual deductible reset helps your patients make better healthcare decisions.
• A better understanding of the annual deductible reset can lead to better revenue recovery.

More and more Americans find themselves on high deductible health plans (HDHP). In fact, in 2023 51-percent of private industry workers participate in HDHPs. Couple this with the number of people that don’t understand health insurance terminology and you have a recipe for trouble.

One of the biggest issues patients face in health insurance literacy is understanding how their deductible works, especially the annual deductible reset. Reminding your patients about how their responsibility can change at the beginning of the year can cause a significant cost difference for the care they receive. By educating your patients about the deductible reset when the calendar flips, it can help improve patient collections, boost the patient financial experience, and strengthen the patient-provider relationship. Read on to understand how to engage your patients in those conversations about the deductible reset and the importance of this talk.

The Annual Deductible Reset Talk

In the past, the health insurance norm was a simple copay when a patient would visit the doctor. But that time has passed and now the majority of patients deal with HDHPs. In 2023, HDHP plans had a deductible of at least $1,500 for an individual or $3,000 for a family, though some plans may have even higher deductibles. Many patients may work to plan ahead and manage their finances accordingly, but then January 1^st comes and suddenly that procedure or service is their full responsibility due to the deductible reset. Patients may be confused about this change which can have a negative effect on the patient-provider relationship. This doesn’t have to be the case when you are proactive and educate your patients about the patient deductible.

At the beginning of the year when the deductible resets, patients are responsible for the entire deductible amount before their insurance coverage begins. In addition, many also have to pay monthly premiums that continue to rise for everyone. By helping your patients understand that the bill is accurate, they are more comfortable paying it which can improve the patient experience. Even those that are aware of the annual deductible reset may not feel comfortable mentioning financial worries, choosing instead to delay the care they need. When they postpone that care, it can lead to higher healthcare costs over time. This is part of the reason it is important to have those conversations about the deductible reset and changes in patient responsibility. Talking about payment flexibility and financing options can help patients manage the cost of care.

High Deductibles and Providers

Patients aren’t the only ones affected by HDHPs; they impact providers also. Patients that don’t have a grasp on the deductible reset and aren’t in a good financial position can force providers to absorb those costs if patients are unable or unwilling to pay. Uncompensated care has been on the rise with hospitals providing more than $745 billion of uncompensated care.

Your ability to provide the best care possible could be strained by this financial burden. The increase in uncompensated care impacts your ability to pay your staff and physicians and obtain needed supplies, as well as lower your ability to bring health and wellness initiatives to your community. By educating patients on the annual deductible reset, you could reduce the uncompensated care you provide by increasing the likelihood of collecting patient payments.

How to Start the Deductible Reset Talk

Having financial discussions with your patients is never easy, but when you have an idea of how to talk with your patients, it gets a little easier. Not every patient is in the same situation, so here are some ideas of how to speak with your patients when their annual deductible resets.

• Get ahead of the game. That first visit of the year is a good time to incorporate the annual deductible reset into your visit. By reminding them of the reset and helping them to understand what it means as far as their responsibility, it may make it easier to understand. Also, when talking about their health goals and treatment plans, you can talk about any financial barriers that may require a change to your plan.
• Get patients involved. Remind your patients that they have the power to ask questions. The customer service number for their insurance providers is readily available and they can ask questions like;
  • What is my deductible?
  • When does my deductible reset?
  • What are my out-of-pocket costs? What is the maximum?
  • What type of appointments count towards my deductible?

If your patients are part of the more than 50-percent that don’t have a clear understanding of their health insurance, providing your patients with a glossary of terms can help them feel more confident calling their health insurance company.

• Consider the options. With increasing healthcare costs, many facilities are finding ways to work with their patients financially. Understanding the options your hospital has for financial assistance or flexible payment plans makes it easier to talk to patients about it.
• Preventative care works. Under the Affordable Care Act, most private insurance and group health plans are required to provide preventative care at no out-of-pocket cost to your patients. Encouraging your patients to utilize these services can help them identify and address potential future health issues that can be taken care of later.
• Prioritize the plan. When cost becomes a concern with the annual deductible reset, work with patients to prioritize their needs. Your patients may be able to address certain health issues sooner, waiting until they’ve met their deductible to take care of other health issues without compromising their care.

Conclusion

When you become a source of accurate, easy-to-understand healthcare financial information, the trust between you and your patients grows. An annual deductible reset is the perfect time to be proactive, ensuring your patients are educated and ready to face their financial journey. You have the perfect opportunity to improve the relationship between you and your patients by talking with them about the annual deductible reset.