Emmett Bernsohn
Patient payments have become one of the biggest challenges facing healthcare providers. As patients take on more financial responsibility, practices are left managing increasingly complex payment workflows while trying to deliver an experience that feels simple and supportive for patients.
In a recent interview, Rivia Health CEO Rachel Mertensmeyer shared her perspective on how healthcare organizations can rethink the patient payment experience, improve financial outcomes, and reduce the administrative burden on their teams.
From the changing economics of healthcare to the role of automation and AI, Rachel discusses why the future of patient payments is about more than collecting what patients owe. It is about creating a payment experience that works better for patients and the providers who serve them.
Key Takeaways
- Why Rachel’s personal experience with medical billing inspired her to start Rivia Health
- How rising patient financial responsibility is creating new challenges for healthcare providers
- How automation can reduce manual revenue cycle work and improve balance capture
- Why AI adoption needs to be intentional, secure, and centered on real customer and patient needs
- How Rivia Health is expanding its EHR integrations and helping providers solve increasingly complex revenue cycle challenges
Transcript: Rachel Mertensmeyer on the Future of Healthcare Payments
Why Rachel Mertensmeyer Started Rivia Health
I’m Rachel Mertensmeyer, and I’m the CEO and Co-Founder of Rivia Health.
I started Rivia Health because I had a personal experience with medical billing, where I had one injury that led to 38 medical bills across 11 providers and over $10,000 in medical debt. That really ushered me into the patient experience and barriers to payment firsthand.
I was sitting at my kitchen table with three stacks of paper bills, trying to figure out which ones were paid, unpaid, or question mark.
That really made me realize that there had to be a better way, and from my experience working with technology, I became passionate about solving that problem with better workflow solutions.
Furthermore, I did research and learned that medical debt was the number one cause of bankruptcy in the United States, and not all patients had the amazing safety nets that I had. In fact, women of color are the most likely to be sent to collections, have their wages garnished, and have liens put on their home.
That really hit me, especially considering that women of color and women in general often don’t have maternity leave in the United States, and women of color are those that have part-time jobs that don’t have insurance coverage.
That’s what really impassioned me to solve this problem.
The Growing Challenge of Patient Financial Responsibility
What I learned once I started researching the problem from the patient experience perspective, based on my patient experience, is that there is a significant need to solve this problem for the provider, as well.
What we’ve seen is that while the patient high deductibles have increased 70% over the last 10 years, the reliance on patient responsibility as a percent of revenue for the provider has increased from 2% up to 30 and 40% in a lot of cases.
That puts the provider organization in a position of becoming a debt collector, which no one in healthcare signed up to do.
On top of that, they have very thin margins, often 2% profit margins that are getting pressurized by administrative burden and operating costs, with the cost to collect a patient dollar being an average of around 56 cents.
With that situation, Rivia Health can come in and alleviate a lot of that administrative burden and cost to collect, while also keeping care at the center for patients and bringing an empathetic, patient-friendly approach to balance capture that is needed to keep those doors open and continue providing care.
How Rivia Health Uses AI and Automation
What that looks like is an AI-powered platform that improves revenue cycle workflows, fitting into existing workflows for our customers, preventing them from needing to retrain staff or work out of a separate system.
What we do is increase balance capture, reduce days in AR, and lower the number of hours that staff have to spend calling patients, collecting patient balances, and entering data into the system, while maintaining that empathetic, patient-first experience.
We are extremely energized by what AI is bringing to the industry today. Our team has adopted AI-first workflows, both internally and externally, in terms of the products we’re delivering to our customers.
It’s really important to us, though, to ensure that any AI adoption is intentional, maintains high security standards, and enhances the existing talent that we have on our team today.
Keeping Patients at the Center of AI
It’s also critical that any AI products enhance care for patients and continue to improve outcomes for providers, while keeping care for patients always at the center.
When we think about our product development strategy and how we implement AI, we always keep it customer-first and centered around real problems that we can solve for those customers.
Ensuring that whatever we build continues to enhance the patient experience.
What’s Next for Rivia Health
One of the things that we’re also excited about for the future is how we’re expanding the number of customers that we can reach and provide our services to.
This next year, we’re going to be opening up five or six different new electronic health record systems that we have a bidirectional integration with, further expanding the number of groups we can work with from that standpoint.
We’re also learning a lot with some of the enterprise customers that we’re working with today, solving more complex workflows and using an AI-first approach to solve their unique problems very quickly, and that’s also expanding our reach in the market.
Connect With Rivia Health
To learn more and connect with us about how we might be able to solve your pain points in revenue cycle, you can either book a demo on our website at riviahealth.com.
We also have a free AR assessment you can book as well if you’re not quite ready to book a demo, but you do want to understand where your organization stands with outstanding AR today and how we might be able to help.
