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HIStalk Interviews Tom Cox, President, Experian Health

November 15, 2021 Interviews No Comments

Tom Cox, MBA is president of Experian Health of Franklin, TN.


Tell me about yourself and the company.

The mission of Experian Health is to simplify administrative processes and improve operational efficiencies so that we can improve the healthcare journey. We primarily do that through patient access, revenue cycle management, and identity services. I’ve been with the company for two years, having joined through the acquisition of MyHealthDirect.

We’ve heard for years that collection of patient financial responsibility would become significant, and not only has that finally happened, investors are rewarding companies whose technologies and services support that collection. What trends do you see?

You will continue to see an acceleration of the digitization of healthcare. Certainly we’ve seen that through the pandemic, as folks were operating in a more remote environment. We saw the digitization of registration scheduling and even telehealth become more important. That trend was absolutely accelerated by COVID and I think you will see that trend continue in the future.

That dynamic of consumers paying a higher portion of their healthcare will drive a number of facts. First, it will require the whole healthcare system to operate much more like the rest of the economy. That is, to provide a better consumer patient experience from the beginning of the process through payments and collections on the back end. That will continue to accelerate.

From the provider’s perspective, the patient is paying a bigger portion, and what the patient pays is the hardest part to collect. Getting the right data upfront and collecting as much of the cost upfront will also be important for all providers and health systems.

How will healthcare use technology more other industries that use technology instead of handing their customer a clipboard and photocopying their documents?

You touched on a number of them. You will see scheduling, registration, and payments being digitized. You will also see healthcare start to use more data about consumers to improve the process of reviewing social determinants of health, understanding what challenges people might have in accessing the healthcare system, to make it easier for them to access the healthcare system and to improve their healthcare results. We know a lot about individuals that we’re not taking advantage of today to improve the healthcare system. You’ll see that change over time.

How do you see providers using consumer data insights, rather than just their own EHR data, to engage with their patients differently before, during, and after a visit?

That is still pretty nascent in healthcare. That provides a big opportunity for a company like Experian, which has a lot of consumer insights. The retail environment reaches out to individuals based on their desires and their wishes, engaging them in the process and then all the way through the process. That should happen similarly in healthcare. We know when patients need to engage in the healthcare system, so we should reach out to them proactively and get them engaged in the healthcare system so that they get the care that they need in a timely manner and improve their overall health. That’s what I think you’ll start to see changing going forward, but it’s still pretty early.

What technologies does Experian offer that would help providers treat their patients more like members?

We have a number of those tools to help the patient feel more like they are a valued patient, which is maybe is a better way to say it instead of as a member. I always worry about member because that tends to get associated with a health plan. From the consumer insights on the front end to anticipate the needs of an individual patient using our data and insights on consumers, to using our tools, to engage staff members through outreach, and to patient communications. Then facilitating the entire process, making that process easy for the patient along the entire journey through digital scheduling, digital registration, and online payments as a seamless, touchless process.

How do you see propensity-to-pay being used in a consumer-friendly way?

Having a propensity to pay will have help patients make more informed decisions. One of the challenges with healthcare, historically, has been that you make a very large purchase decision without any knowledge up front. Many times you only find out about that purchase decision on the back end. We are doing  couple of things to help that process. We provide estimates to patients so that they can make make an informed decision. Then, based on your ability to pay for that, you can then arrange different ways to pay for those services. Most healthcare systems are flexible in their payment terms because they know the patients need the care. They want to make that process as easy for them to get the care as possible.

Some diagnostic radiology practices offer patients a big discount if they pay cash upfront instead of using insurance or being billed. Will we see more of that?

I absolutely think that providers will continue to do all that they can to get the payment upfront. Providing that estimate is the best way to collect that upfront.

I recently experienced that myself with a procedure. I was offered a discount to pay in advance and certainly wanted to take advantage of that. The key to that process, though, is ensuring that the estimate is accurate so that there is no surprise on the back end. You are creating an expectation with the patient or with the consumer that your estimate is correct. When you make that advanced payment, you are not expecting to get another request on the back end. An accurate estimate is critical.

A significant part of patient satisfaction comes from the front end, such as ease of getting an appointment, to the back end, in getting a timely, accurate, and understandable bill. How are providers using those practices for competitive advantage?

In the US, the healthcare that individuals receive is always of really high quality, so you don’t get many complaints about care. The complaints come from the administrative processes, both on the front end of the process — scheduling, registration, asking for the same information repeatedly — and then on the back end, the lack of understanding of the billing, the explanation of benefits, and the statements. Providers are definitely realizing that improving those front-end and back-end administrative processes is a way to differentiate themselves in the market. Convenience and simplicity are the easiest outcomes to measure in healthcare and they drive how how many healthcare consumers make their decisions.

How important is it that providers react to negative patient feedback as part of their marketing efforts?

It’s important for the healthcare systems to engage with those patients who didn’t have a positive experience so they can learn and improve their processes going forward. Again, it’s most likely not related to the care that they received. It’s going to be most likely related to something on the front end or the back end of the administrative process.

What are the benefits of identity management beyond the obvious ones of efficiency, fraud prevention, and patient safety?

A number of benefits come from our identity solution. The first is eliminating any duplicate records that might be created when you’re going through the registration process or the intake process. Understanding that an individual may have moved or changed their names and making sure that you’re not creating a duplicate record. That has downstream effects of making sure that you have a complete view of that individual when you’re providing care, so that you don’t have a fragmented health record and information showing up in two different places.

A key element that we are seeing with identity getting access to digital tools. With COVID vaccinations, most health systems drove patients to their portals to register and then schedule the vaccines. Ensuring that the right identities and the right patients were getting the right vaccinations and attached to the right records was a key component that drove a lot of our growth for identity through the pandemic.

Would having a national patient identifier provide the benefits that people expect?

Having a unique identifier would certainly simplify things in healthcare. We have 328 million unique individuals that are represented through our universal identity manager tool. Using a tool like that, having a universal identity would make it easier to link your records from disparate systems to provide a holistic view of medical information.

Where do you see the company and the industry going in the next few years?

We are excited about the future and feel like the company is well positioned for growth. We think that many of the trends that were accelerated by COVID, like the digitization of healthcare, will continue. We think we are well positioned for that trend and are excited about our opportunity to deliver on our mission of simplifying the healthcare journey for all.

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