CASE STUDY
Patient Self-Service Payment Plans
CASE STUDY
Patient Self-Service Payment Plans
Growing out-of pocket costs and an increase in high-deductible healthcare plans pose a challenge for both patients and providers. As healthcare costs continue to swell, more patients are unable to manage their payments, and providers are struggling to collect.
Although many athena practices offer payments plans manually, a self-service option for patients was nonexistent.
COMPANY
athenahealth
MY ROLE
UX Design
UI Design
Research
Accessibility
Scrum Support
THE TEAM
1 product owner
2 designers
4 engineers
THE PROBLEM
Payment plans can only be created by practice staff, which causes the following issues:
- Most practices set up statement-based payment plans because autopay plans require collecting an email and signature. Statement-based plans drive up statement generation costs and are less likely to collect the full balance (Patient Pay Yield).
- The administrative burden on practice staff may contribute to burnout.
- There’s a lack of awareness among patients regarding payment plans. Unless the practice staff verbally offers it or a patient seeks it out, patients aren’t aware they are eligible for a payment plan.
- There's a lack of control with patients regarding payment options. Patients are limited to the option(s) the practice staff offers in person or over the phone.
BUSINESS IMPACT
This feature will impact various business metrics:
- Improved patient and practice satisfaction
- Imrove Patient Pay Yield (PPY) on larger bills (>$200)
- Increase in the % of AutoPay Payment Plans (AutoPay Plans have a 6.44% higher yield than Statment Plans)
- Reduction in paper statement generation costs
THE SOLUTION
Provide patients the ability to create a payment plan online, without needing any practice assistance.
DESK RESEARCH
After collaborating with Sara Wells (lead designer) and Tejas Kashyap (product owner) to gather business requirements, I conducted desk research. Generative discovery had already been conducted by the time I joined the team. My desk research consisted of consuming that generative discovery work and combing through external sources for information and inspiration.
My initial questions:
- What do our users (the patients) need?
- What do our clients (the practices) need?
- How do we compare to what our competitors are doing?
- What can we learn from what adjacent experiences are doing?
Findings from desk research:
- The most common reactions to receiving large medical bills are shock, confusion, distrust, and anxiety.
- Patients are more likely to make a payment if they are given flexibility and control over their financial decisions.
- Clients are excited for this feature because it will alleviate the administrative burden of setting up payment plans manually. But the majority of practices would like to only offer autopay payment plans (i.e. no statement-based payment plans). And they want control over the minimum balance threshold and max duration of the payment plans.
- athena's competitors do offer their consumers self-service payment plans. Though they're ahead of us there, the offering is a bit outdated and uninspired.
- Many online retailers and credit card companies are offering consumers modern and flexible self-service payment plans. This is the space to look for inspiration.
DESIGN CHALLENGE
How do we limit the number of decisions and provide guidance to relieve patients’ anxiety... while also providing patients sufficient flexibility and control over financial decisions?
EARLY EXPLORATIONS
Early explorations focused on showing progression through the payment plan setup process, editing a previously completed step, and providing the right amount of reassurance.
USER TESTING
Though real patients/users are always preferred, UserTesting.com was sufficient for this work because there were fewer unknowns.
Research goals:
- What are users' overall first impressions, and how does this UI feel?
- Is the entry point/CTA clear?
- Does this feel like enough payment options?
- What will users do if the payment options presented don't work for them?
- How intuitive is it to edit a previously completed step?
- How clear is the progession through the payment plan setup process?
The "Hub & Spoke" design approach was validated to move forward. Users described the experience as "simple," "intuitive," "just enough information," and "professional but also friendly."
DESIGN APPROACH
The final design approach prioritized guiding focus, providing flexibility and control, and creating reassurance in order to ease anxiety and uncertainty in a likely stressful situation. Accessibility is also at the forefront of my design progess.
RESULTS
As of June of 2023, the Self-Service Payment Plans feature has gone Beta and launched for 40+ clients across the United States. I'm actively monitoring conversion metrics and analyzing patient and client feedback for future improvements. In the meantime, there's a lot to celebrate:
- At 61%, this feature has the highest conversion rate of all payment related workflows at athena.
- All targeted business metrics have been blown out of the water:
- Increase in Patient Pay Yield (PPY) on larger bills (>$200)
- Significant Increase in % of autopay plans (in relation to statement-based payment plans)
- Reduction in paper statement costs
- 95.35% of actual users surveyed are somewhat or extremely satisfied with this experience.
- Direct user quotes:
- "It was great to have the option to make a payment plan. I have other bills in addition to this medical bill. This has made my life less stressful."
- "It was perfect and a great stress relief to have this option. Thank you!"
- "This was incredible."
- "Thought it was a very smooth process."
- "This helps me a lot. I'm able to pay my bill easier than paying in full."
- "It couldnt have been any easier! I dont see the need for any changes at all."
- "I appreciate it. My husband has cancer and it's a hard time for us right now. Thank you so much. This works great at this time."
- There have been no complaints from practices participating in the Alpha and Beta (no news is good news!).
CONSTRAINTS, HURDLES, AND PIVOTS
Although this case study may look perfect (I hope!), there are always a few unexpected hurdles along the way.
- athena's patient facing design system changed midway through this project. These designs were initially created in a design system that was launching soon. But because of unforeseen issues, the purple-dominant rebrand was pulled back. So I had to go back to the drawing board (Figma really) and make these designs work for a blue-dominant design system.
- athena's data infrastructure for payment plans was non-existent. I diligently worked with product, engineering, and other subject matter experts to figure out what was actually feasible.
- The elements of animation in these designs were new to athena and new to my dev team. When I first showed my engineers the inspiration for this project, they were horrified: "We can't do that," "That's going to take forever." But sure enough, I got buy-in and excitement eventually. This work has been a milestone not only for me, but also for the engineers.
CREDIT
Sara Wells (Principal Designer) - Authentication and legal considerations, practice admin page, strategic oversight
Tejas Kashyap (Product Owner) - Feature scoping, cross functional liaising
Greg McNew (Principal Developer), Zona Gilreath (Lead Developer) - Back-end build
Jacob Roseland (Lead Developer), Harshvardhan Dewangan (Senior Developer) - Front-end build