SearchAmerica Enhances Healthcare Scoring Model and Improves Accuracy

SearchAmerica today released the company’s latest version of the most sophisticated scoring model in the healthcare industry designed to give healthcare providers valuable information on predicting patient payment behavior. This data allows healthcare systems and providers to determine which patients are most likely to pay – or not pay — their bills and adjust workflow accordingly. Client results (based on millions of transactions) show that the SearchAmerica healthcare scoring model is more than 97 percent reliable in predicting payment behavior. This represents a more than 2% accuracy increase from previous versions and greatly exceeds the accuracy rates achieved by use of “traditional” credit scoring.

“Due to the rapid change in the reimbursement environment for healthcare providers, we are continually updating our algorithms to maintain our market leadership position and to provide the best possible return for our customers” says Daniel Johnson, CEO of SearchAmerica. “A more accurate healthcare-specific scoring model allows our clients to transform workflow more appropriately and achieve superior results, resulting in a healthier bottom line.”

The model employed by SearchAmerica allows healthcare providers to adjust front and back end collection workflow based on probability of payment. This is extremely important to the industry as recent studies show that adoption of consumer-driven healthcare in the market place is taking place at twice the rate of initial projections. Employers are abandoning long-standing healthcare purchasing models for options that shift a greater portion of the costs to their employees. This trend demonstrates that the patient self-pay responsibility is steadily increasing, and there is no end in sight:

• High-deductible plan: $2,000 deductible, 80/20 coverage
• Out-of-pocket maximums: $5,100 single, $10,200 family

Increasing healthcare costs and increasing healthcare-consumer debt will ultimately be the responsibility of the nation’s healthcare providers. Higher self pay will affect every hospital based on this fact, it makes sense for healthcare providers to become better prepared and have a new workflow approach based on a sophisticated, healthcare-specific scoring model.

The model used by SearchAmerica is customizable for each facility and “learns” with each transaction processed. SearchAmerica began working on the original model after discovering that a “traditional” consumer credit score is not necessarily predictive of how likely it is that a consumer will pay their healthcare bill. By evaluating an extensive list of patient characteristics in combination with consumer credit information and historical payment characteristics of the patient population, SearchAmerica’s predictions become more accurate over time. SearchAmerica attributes the latest accuracy increase to a significant increase in transaction and outcomes volumes in recent months.