Patient-Pay Revenue Cycle Management: 2024 Predictions and Beyond

2024 Forecast for Physician-Owned Practices

1. Ballooning Healthcare Costs

   The industry is well aware of the exorbitant costs associated with even the most routine, preventive levels of care. Despite best efforts, healthcare will become even more expensive in 2024. The cost of care is projected to spike by as much as 7% in the coming year, thanks to continued labor shortages, costly contracts between providers and payers, and uncontrolled drug price increases.¹ This cost jump is larger than increases seen in both 2022 and 2023.¹

   However, higher costs do not reflect a greater ability to pay. As more patients struggle to meet their financial obligations, it’s up to practices to make the necessary self-pay billing optimizations to prioritize the patient experience and maximize collections.

2. Regulatory Pressures

   Growing concerns around price transparency and artificially inflated costs necessitate updated compliance policies and increased billing oversight. Compliance begins in the billing process — meaning in-house teams are responsible for staying current on new billing regulations and requirements. This is a major ask that will inevitably overstretch even the most experienced and efficient billing office.

   The challenges don’t stop there. The proposed 2024 Medicare physician pay schedule is rife with threats to your bottom line, from a 3.4% reduction in the Medicare conversion factor to budget neutrality cuts from the Evaluation and Management (E/M) add-on code.²

3. Patient-Centric Billing Moves

   High-deductible health plans (HDHPs) already stretched the limits of patient budgets in 2023. 2024 will heighten this financial burden, with the minimum deductible for self-only coverage increasing from $1,500 to $1,600 and the minimum family deductible increasing from $3,000 to $3,200.³ These cost-sharing updates, driven by inflation pressures, will make it harder than ever for patients to pay their bills.

   To offset potential losses, practices are proactively adopting patient-centered billing solutions, centered around transparent pricing, paperless billing, and more financial assistance options — all critical changes necessary to move patients forward in the payment process. These optimizations are an all-hands-on-deck effort that consumes large portions of practice resources and staff time. An extra pair of hands from a patient-pay partner can help streamline account management and enhance patient satisfaction.

4. Cybersecurity as a Paramount Concern

   The digital revolution has fundamentally transformed the billing process, yet mounting pressures around data security create yet another hurdle that practices must tackle in 2024. A total of 463 healthcare data breaches occurred from January to August of 2023, with over 71 million patient records stolen.⁴ The HHS’ Office for Civil Rights reported a staggering 21.4% month-over-month increase in data breaches in August.⁴ Healthcare is home to the most expensive data breaches, with a running total of nearly $11 million in breach costs in 2023.⁵

   Industry leaders are calling for robust cyber resilience initiatives to slow the trend of cyberattacks and data breaches. These protocols include frequent security audits, state-of-the-art cybersecurity software, and stringent access controls. Failure to do so not only risks practice profitability and reputation but also harms patient satisfaction and loyalty.