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Improving the Revenue Cycle with Innovative Patient Engagement Technologies
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Transcript of Improving the Revenue Cycle with Innovative Patient Engagement Technologies
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Improving the Revenue Cycle with Innovative Patient Engagement Technologies July 30, 2014
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Learning Objectives
Explore the role of technology
used for patient engagement
to address the challenges of
revenue cycle management
1
Understand best practices
that improve collections and
the patient experience
through financial patient
engagement
3
Outline a strategy for
accelerating revenue
opportunities with every
patient at check-in and across
the care continuum
2
Discuss tips for implementing
process and culture to help
ensure success 4
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Reform & Revenue Cycle
MORE PATIENTS
• 8 million signed up in
Marketplace
• 5 million enrolled in plans
that meet ACA standards
outside the Marketplace
• 3 million more people
enrolled in Medicaid and
CHIP as of February,
compared to before the
Marketplaces opened
MORE &
POTENTIALLY
RISING PATIENT
PAYMENTS
• Patient financial
responsibility is projected
to be 30%-40% (The
Ryder Group, January
2014)
NEED FOR NEW
STRATEGIES AND
PROCESSES TO
HELP… • Balance staff workload
through efficiencies that lead
to higher employee
satisfaction
• Drive collections earlier in the
revenue cycle
• Facilitate higher overall
collections-all while
increasing patient satisfaction
in a more consumer-driven
environment
Source: Department of Health & Human Services. Press Release. May 2014. http://www.hhs.gov/news/press/2014pres/05/20140501a.html
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Cost of Revenue Cycle Inefficiency
8%
First-past denial
rate (1)
40%-50%
Of claims denials
due to
demographics (2)
$25-40
To rework 1
claim (3) (4)
35%
Of copay and
collections
missed (1)
$40/day
Savings from
printing and
handling of paper
formsSources: (1) MGMA. Performers and Practices of Successful Medical Groups - 2012; Primary Care Single Specialties. 2012. (2) Health Directions. Improving the Physician Revenue Cycle Through KPIs. 2012. (3) Moore, P. “Fix your denial problems,” Physician Practice, April 2004. (4) Cost to appeal denial, analysis by Susanne Madden, The Verden Group.
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Past Solutions
Patient Portal Project 227%
growth by
2017 (Frost and Sullivan,
2013
50% of U.S.
hospitals and 40%
office-based
physicians have a
portal through
their electronic
health record
(EHR) or practice
management
system.
Despite offering
patient payment
solutions and cost
transparency
capabilities, portal
adoption remains
lower than
expected due to
cost,
interoperability or
workflow issues
and limited
functionality
TAKEAWAY
Practices are seeking
alternative options to
engage patients
Source: Frost & Sullivan. U.S. Patient Portal Market for Hospitals and Physicians: Overview and Outlook, 2012–2017. February, 2013.
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What Can Providers Do to Improve?
Create Efficiency
& Capacity 1
Increase Capabilities
to Maximize
Reimbursement 3
Create
Access 2
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Framework for Optimizing ROI Opportunities
Data Accuracy Real-time
collections
Electronic
consents /
signatures
Patient
Experience
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Innovations Driving the Framework
Point-of-Care Kiosk Pre-/Post-Care Mobile Access
Patient Services Command Center
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Electronic Check-In
• Improve efficiency
• Close gaps-in-care
• Promote adherence
• Enhance the patient experience
Point-of-Care: Visit Maximization & Clinical and Administrative Efficiencies
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Patient / Practice Impact Using Kiosks
Shortened wait times (25% first visit, 75% subsequent)
(Newark Beth Israel Medical Center, NJ,
InformationWeek)
Nearly all copayments (97%) collected at time of service
(Elmhurst Clinic, IL, Healthcare Finance News)
Reduced expenses associated with paper statements
(HealthLeaders Media)
Can support practice portal strategy (Gartner)
May be leveraged as tool to educate patients about
other services (e.g. LASIK in ophthalmology practices,
patient portal, patient education)
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ROI: Data Accuracy
Source: (1) The economy-busting revenue cycle. HealthLeadersMedia. 2009. http://www.healthleadersmedia.com/content/234307.pdf (2) MGMA Connection. Building Success: Strong Financial Management Fuels Patient-Centered Practice. February 2014. (3) AMA. Appeal that Claim. http://www.ama-assn.org/ama/pub/advocacy/topics/administrative-simplification-initiatives/appeal-your-claim.page
Improves clean claim rates by
• Demographics Update
• >50% recent claims denied by payers are a direct result of patient access
errors (1)
• Better up-front processes may cut denials by up to 80% (1)
• Insurance Verification
• Net revenues lost to third-party claim discrepancies average 3%–5% (2)
Bottom line:
Denied, rejected, resubmitted and underpaid claims can cost a practice up
to$100k per month (3)
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ROI: Real-Time Collections
Source: (1) "Surviving the Deductible Reset in 2012: How to Collect Deductibles and Improve Self Pay Collections." Kareo.com. January 9, 2012.
http://www.kareo.com/gettingpaid/2012/01/lets-collect-deductibles-in-2012-tips-for-improving-self-pay-collections/ (2) "Examining The Newly Covered Under The Affordable Care Act." Health Affairs Blog. October 2012. http://healthaffairs.org/blog/2012/10/30/examining-
the-newly-covered-under-the-affordable-care-act/ (3) MGMA. Performers and Practices of Successful Medical Groups - 2012; Primary Care Single Specialties. 2012.
Copays and outstanding balances
• 5-15% increase in collections (PatientPoint)
• Likelihood of collecting payment drops to ~40% once patient leaves the
practice (1)
• Even more important now due to increase in covered lives, private
exchange plans and high deductible plans (2) (3)
• Staff does not have to follow up after the appointment or send additional
paper statements
• Employees will have fewer discussions with patients about fees and
outstanding balances
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ROI: Electronic Consents / Signatures
Source: (1) Touchscreen Check-In: Kiosks Speed Hospital Registration. California Healthcare Foundation. March 2009. http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/T/PDF%20TouchscreenCheckInKiosks.pdf
Automates an entirely paper-based process
Electronic consent forms also save staff time
• Up to a 50% reduction in time spent scanning and filing the completed
forms (1)
• Digitizing forms saves an average of 3 pages per visit (PatientPoint). One
PatientPoint customer saved 13 pages per visit, totaling nearly 3 million
pages and a projected savings of $1.2M over a 12-month period.
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ROI: Patient Experience
Source: (1) Touchscreen Check-In: Kiosks Speed Hospital Registration. California Health Care Foundation. March 2009. http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/T/PDF%20TouchscreenCheckInKiosks.pdf
Overall patient satisfaction from
• Reduced check-in and wait times
• Improved data accuracy
• Increased autonomy and privacy for the patient
75% of members felt that checking in through the kiosk is faster than checking in
through a receptionist (1)
90% of members who used a kiosk to check in were able to do so successfully
without assistance (1)
90% felt comfortable with the level of privacy offered by the kiosk (1)
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Innovations in Mobile Patient Access at the Point of Care
Introduce significant
opportunities to
improve the patient
experience and
streamline practice
operations regardless
of care setting by:
AUTOMATED
SCHEDULING
OF
PATIENTS
PRE-REGISTRATIO
N OF
PATIENTS
MOBILE
BILL PAY
1 2 3
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Greater Opportunity with Mobile Patient Access Technology
Source: http://www.himss.org/files/HIMSSorg/content/files/DieboldHCSelfServicePositionPaper.pdf
INCREASE PATIENT
SATISFACTION
• Present only the details necessary for that
user-specific encounter
• Reduce check-in and wait times
• Improve data accuracy
• Increase autonomy and privacy for the
patient
STREAMLINE PRACTICE
OPERATIONS
• Systemize data input and information
workflow for greater accuracy
• Realize cost savings and greater efficiency
by offering self-service options
• Increase throughput by expanding customer
service options
• Reduce wait times for patients who require
personal attention
• Collect payment upfront instead of billing
later, enabling staff reallocation
• Increase staff productivity
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CareSpot Case Study
Profile: CareSpot-operated
centers provide a wide range
of healthcare services such as
urgent care, health checks,
and occupational health
services.
56 urgent care
centers across
Tennessee, Texas,
Kansas, Missouri
and Florida
Online and mobile scheduling
tools at CareSpot.com allow
patients to find a convenient
location, book appointments
and save a spot in line.
Two-phase project
PHASE 1
Patient Portal
PHASE 2
Electronic
Check-in
Tablet
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CareSpot Phase 1
INITIATIVE SOLUTION RESULT
Establish and brand a
unique, innovative
consumer experience at
each center
Introduce online and mobile
patient portal fully integrated
with NextGen practice
management platform in all
CareSpot centers
30% increase in scheduled
appointments by patients through
the online and mobile patient portal
• Fills otherwise open
appointments
• Allows patients to find the
closest and most convenient
location, compare wait times,
“save a spot” for same-day visits,
schedule future appointments,
and complete most pre-
registration forms online to
reduce time spent at a center
Up to 90% utilization in first 3
months of go-live
3-5 minutes staff time savings
per patient
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CareSpot Case Study
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MCH Results
Miami Children’s Hospital
(MCH) has over 650 physicians
providing all-inclusive pediatric
medical care to patients from
birth to adolescence. MCH
features more than 40 pediatric
specialties and subspecialties
and includes Florida’s only
freestanding pediatric trauma
center.
ELIMINATED
13 PAPER
FORMS
per check-in,
totaling nearly 3
million pages
A
PROJECTED
SAVINGS OF
$1.2M OVER
A 12-MONTH
PERIOD
INCREASED
STAFF
EFFICIENCY
1 2 3
As a result of electronic check-in, MCH:
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OIM Results
Orlando Internal Medicine
(OIM) has four board-certified
general internists and three
nurse practitioners serving as
primary care providers to adults
in the Orlando Metrowest area.
EXPERIENCED
A MORE
EFFICIENT
PREVENTIVE
SCREENING
PROCESS
REDUCED
POST-CARE
BILLING TIME
AND COSTS
IMPLEMENTED
MEDICATION
ADHERENCE
PROGRAMS
1 2 3
As a result of the credit card payment feature during electronic check-
ins, used for nearly 90% of all tablet-based check-ins in 2013, OIM:
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FPG Results
The Family Physicians Group
(FPG) has more than 20
patient-centered medical home
offices around Florida. FPG
offers comprehensive services
to patients, ranging from
disease management and
diagnostics/procedures to
behavioral health and
pharmacy services.
VALIDATED
PATIENT
DEMOGRAPHICS
AND INSURANCE
INFORMATION AT
TIME OF CHECK-
IN
RECOGNIZED a
36% REDUCTION
IN REJECTED
CLAIMS DUE TO
INVALID OR
INCORRECT
PATIENT AND/OR
INSURANCE
INFORMATION
USED THE
SPANISH-
TRANSLATION
FEATURE TO
SERVE 30% OF
ITS PATIENT
POPULATION
1 2 3
As a result of 52 physicians using electronic check-in, FPG:
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Connect with Noel & PatientPoint
www.linkedin.com/pub/noel-khirsukhani-mba/7/816/b14
www.PatientPoint.com
www.PatientPoint.com
/blog
/PatientPoint /Company/
PatientPoint