Financial triage: Expanding care for pets, their people, and your practice

Every veterinary team in clinical practice has shared the distress of trying to help a sick pet whose owners cannot afford the cost of care. While money isn’t the only barrier to veterinary care, it is one of the key reasons that more than half of U.S. pet owners (52%) skipped veterinary visits in the past year, according to results from the PetSmart Charities-Gallup State of Pet Care Study. In addition, another survey found that nearly eight out of ten owners underestimate the cost of care for their pets.

“There really is a moral distress for the veterinary profession when they know they’ve got the tools to help, but are unable to provide care because of this financial barrier,” said Aimee St. Arnaud, founder of the Open Door Veterinary Collective, a nonprofit that mentors clinics on how to expand access to care for pets and still get paid for their services. “As the cost of care continues to rise, I think more people are looking for solutions.”

While new community models are improving access to veterinary care, you don’t have to wait for an industry-wide paradigm shift. There are tools you can use today to help bridge the cost-of-care gap and build client relationships without burning your hospital’s bottom line.

Providing a spectrum of payment care

“In the same way we offer spectrum of care from the medical perspective, we can also offer a spectrum of payment care,” said St. Arnaud, who is also a partner in two for-profit practices where they test financial tools to prove that patients can get the care they need and practices can still turn a profit.

That spectrum ranges from clients who can afford care that day, to those who can afford to pay for care over time, to pet owners who need subsidies. And people can be fluid about this, noted St. Arnaud. “We’re all seeing clients who used to do everything, and now are declining routine care.”

Veterinarians need three basic tools to financially triage pets and clients in need, she said.

• First: Offer an outside financial institution such as CareCredit, ScratchPay, or Cherry, that clients must apply for, and the clinic is not involved in the financing decision.
• Second: Make a clinic-based choice to offer a payment-over-time plan, such as VetBilling or Varidi. Generally, no one with a bank card is turned away from these plans.
• Third: Create an angel fund in which the clinic and/or client fundraises to meet the pet’s medical expenses.

Payment planning

Most veterinary hospitals are familiar with third-party credit programs, such as CareCredit or ScratchPay, which pay clinics directly (minus a service fee).

The pros are that these services can enable clients who can make payments over time to agree to care that day. The cons? It takes good credit scores to qualify and credit lines may have steep interest rates beyond the interest-free period.

Adding financing options with “soft” credit checks, such as Cherry, helps more clients get approved and offers more variety in pay-over-time plans. Cherry requires a down payment, but also approves larger sums ($35,000 or more) that can cover more extensive care.

Installment plans are another important option. While clinics can offer their own plans with promissory notes, post-dated checks, or credit cards, the onus of managing these payments falls on the hospital. Outside management services, such as VetBilling or Varidi, charge a service fee but handle all the billing.

While clinics may be wary of getting stuck with unpaid bills, the results from a six-year VetBilling study that analyzed more than 20,000 payment records found the plans have a 94% repayment rate. And the default rate was lower than amounts clinics would have “lost” by discounting services by 10-20 percent. Further, Varidi guarantees payment to the clinic even if the client defaults.

Clinics can start by offering payment plans to select clients, maybe just for dental procedures, suggested St. Arnaud. “If they try this for a few months, I think they will see the benefit,” she said.

Understanding angel funds

Many hospitals have angel funds—often in memory of a beloved pet—that can help defray costs for pets in need. They may be as simple as a donation jar on the reception counter, or clinics might hold fund drives, like the All Paws Animal Hospital in Wisconsin who got items from sponsors to fill goodie bags for donors.

To solicit tax-deductible donations, clinics need to create a nonprofit fund. However, starting a 501(c)3 takes time, money, and legal expertise. In addition to fundraising, it requires a board of directors, IRS approval, and filing quarterly tax documents.

Rather than go it alone, hundreds of clinics sign up with existing nonprofits, such as myBalto or the Veterinary Care Foundation, that administratively oversee the angel funds and help their fundraising efforts.

“Everything about myBalto is designed to make it easy for veterinary clinics to raise money and access funds quickly,” said Robert Parkins, an emergency veterinarian who started the foundation with his fintech-savvy brother. Hospitals are set up for fundraising success with a console of services, including a personalized website, vendor partnerships, and a GoFundMyPet crowdfunding platform that sends funds directly to the hospital. The foundation currently serves 170 hospitals in the U.S. and Canada.

“I can help more patients with myBalto in a week that I can do in an entire year of ER work,” said Parkins. “Clients feel supported, so it builds a better relationship between the owner and their veterinarian. And the team feels supported because they know they have options.”

The Veterinary Care Foundation, a Florida-based foundation started in 2007, uses a membership model for the angel funds of 950 hospitals, according to founder and president, Richard Heysek. Instead of transaction fees, veterinarians pay an annual fee (currently $480 per year). “It’s a wonderful, cost-effective solution to help end economic euthanasia,” he said.

Getting social

Crowdfunding sites like GoFundMe offer another fundraising venue. But pet owners have no obligation to pay veterinary bills with the money they raise. Pet-specific platforms, such as Free Animal Doctor and Furlanthropy, are nonprofits that verify the veterinary need and pay only the veterinary provider.

When hospitals create campaigns for pets in need they also build stronger bonds with clients when they see the extra mile their veterinarians go for their patients.

Becoming finance friendly is a team effort

Even with these tools, the biggest challenge to financial triage is training staff so they feel comfortable having conversations about money, said St. Arnaud. “You can’t wait until the end of the exam to find out the client cannot afford any care,” she said.

That conversation starts on the hospital website with a tab for “payment options” that includes more than links to CareCredit and pet insurance. “Those are great tools,” she said, “But less than five percent of pet owners have pet insurance and not everyone qualifies for new credit.”

The discussion continues when pet owners call to make an appointment and, again, when they arrive and fill out patient information. In the exam room, the spectrum of care process includes talking about treatment and payment options that meet clients where they are.

Of course, that conversation only works when practices have a system in place to provide payment alternatives and financial assistance—which is where the options mentioned above come into play.

“The goal is: before you’ve even given your treatment plan, you already know if clients need financial options, and you’ve already started to help them choose the right tool,” said St. Arnaud. “Starting with a single financial tool could be able to expand care by so much.”

 

Photo credit: SeventyFour/iStock via Getty Images Plus

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