When was the last time you saw a 20-something write a check? It's probably been a while.

People of all ages are paying most or all of their bills electronically, and hospital executives are taking notice. "There's a whole generation of consumers out there — and consumers are also patients — who want to do everything online," says Richard Nagengast, director of patient accounting at Northwestern Memorial Hospital in Chicago.

And not only do they want to read and pay their bill online, "they want to go from their computer to their mobile device, whatever they use," Nagengast says.

A Federal Reserve study found that as far back as 2009, just 22 percent of noncash payments were made with checks, down from 32 percent in 2006. That number should be even lower when preliminary results of the study are released later this year.

Health care, in general, has lagged other industries in its online bill payment offerings. The gap may be closing, though, as hospital executives recognize the benefits of offering comprehensive online billing and payment. Online-oriented patients will appreciate the easier access and information, while lessened paper-based billing and payment can cut into costs for the provider.

With additional younger people expected to join the insurance rolls as a result of the Affordable Care Act, and with insurance plans raising deductibles and co-payments, hospitals have additional incentives to make it easy for patients to pay their bills.

Northwestern is in the midst of transforming its online bill payment capabilities from one that essentially only provided the balance due and the ability to pay that balance into one that eventually will consolidate all billing from Northwestern-affiliated providers as well as the explanations of benefits from contracted insurers. To get started, Northwestern offers consolidated billing and insurer EOBs for the hospital.

"What's critical is [that] all the information you need is there," Nagengast says.

He adds that the online expansion, implemented using a cloud-based portal offered by Doxo, also gives it a leg up on its competition. "I think it will distinguish us as a provider," Nagengast says.

Northwestern is working on the effort with the Metropolitan Chicago Healthcare Council, which is assisting several other member hospitals with similar changes. "Billing and insurance claims processing for health care are complex," says Carl Pellettieri, principal for the MCHC-owned company, Impact. "The more hospitals that participate, the greater the benefit to the community."