Engagement at the individual level is about much more than just the clinical care patients are receiving. In a delivery system that's rapidly becoming more consumer-focused, patient finances and your chief financial officer also should be driving your engagement strategy, experts say.

In this month's H&HN, our second installment of the four-part patient engagement series explores how hospitals and health systems are trying to make it easier for clinicians to stay in touch with their customers, often using electronic tools. Another part of that equation is the already changing role that finance plays in keeping patients engaged.

"Engagement is a hot topic, but it's always focused on the clinical side, which is clearly important because providers are charged with an individual's physical well-being, but they also need to consider the financial well-being of their patients," says Ann Garnier, chief operating officer of CarePayment, a health care finance company. "Given the state of health care finance and consumers' shouldering of a large portion of their medical bills, more and more patients are feeling that they can't afford care, so they're delaying or skipping treatment. It's hard to have good clinical engagement if you're not paying attention to the financial side of the equation as well."

Garnier says that one of the key tenets of financial engagement is price transparency — providing a clear accounting of what the patient owes up front to help avoid that initial "sticker shock." For more on transparency, you should check out our June cover story by Lola Butcher. Also, the Healthcare Financial Management Association (along with several other high-profile partners) issued a report in April that provides guidance to hospitals on how to tackle the thorny subject.

The importance of improving the patient's experience with the financial side of health care is likely to grow as consumers with high-deductible health plans take on more of the cost of their treatment. An analysis by the American Medical Association estimated that patients are responsible for nearly one-fourth of the total cost of their medical bill. Focusing solely on the clinical side of the equation isn't going to cut it. "Patients can receive the best care in the world, but if they have a poor billing experience, that will change their overall rating of the provider from highly satisfied to highly dissatisfied," Garnier says.

Plus, providers should be getting to know their patients better, learning about the outside factors that affect patients' ability to manage both their health and their medical bills. In DeSoto Memorial Hospital's service area of Arcadia, Fla.,  a large population of "snow birds" typically migrates south for the winter, living on fixed incomes with little to no insurance. With concerns that many patients were avoiding care for fear of the bill, DeSoto has worked to reach out to the community to let patients know about the services they offer and the different ways that they might pay for those services, says CFO Dan Hogan.

And while usually it's the CFO driving financial initiatives, Garnier says all stakeholders should be involved in engaging patients around the monetary side.

"Traditionally, the revenue side of the provider organization rolls up to the CFO, but this should be a cross-functional initiative, reaching across the aisle to the clinical equivalent of the CFO to make sure that all stakeholders are engaged," Garnier said. "Ultimately, you need the buy-in of clinicians in order to make this work, because it's about a whole new shift in how they treat the patient."