By David Shelton
Demand for patient access technology solutions is soaring. According to Market Research Future®, global spending in the segment will rise at a compound annual growth rate (CAGR) of 7.5 percent between 2019 and 2024.
Clearly, this trend indicates that hospitals and health systems are investing in technology to improve patient access staff productivity, boost profitability and enhance patient experience. Many, however, have learned the hard way that installing new technology tools is only half the battle. Even the most sophisticated patient access solutions can’t deliver tangible benefits when they’re simply bolted on to existing systems, processes and practices. To get a higher return from today’s patient access technology investments, hospitals must 1) integrate provider-specific data, 2) customize revenue cycle workflows for more efficiency and 3) train staff to optimize all available tools.
Requirement #1: Data integration
The patient financial experience is a key driver of overall patient satisfaction and hospital performance. Improving the experience can reduce the stress of care, drive loyalty and accelerate collections, but only if the information presented to patients is accurate, complete and relevant to each provider and patient.
Data integration is crucial. To be accurate, bill estimation tools must integrate providers’ managed care contracts, historical procedure charges, patient benefits and other data. Insurance eligibility tools must use intelligent data to ensure all payers in a provider’s account are connected to the major clearinghouses. Tools to determine patients’ propensity to pay and recommend appropriate payment plans must incorporate personal data such as credit standing, payment history and income.
A large portion of patient access time is spent determining whether prior authorization for services is needed. Prior authorization tools must be able to manage payer rules, integrate hospital-specific rules and automatically keep up with constantly changing procedure codes.
Requirement #2: Customized workflows
Sound patient access solutions bring traditionally disconnected functions including registration, insurance verification, bill estimation, payment planning and billing together in a seamless workflow. The key is to redesign existing practices and processes to optimize technology tools for productivity and profitability. As an example, in an effective workflow, registrars no longer go to multiple payer sites to verify insurance coverage. Instead, a pop-up window tells them in real time whether or not patients have active insurance and notifies them of any registration errors. Implemented holistically, solutions like these can enable staff to treat patients as unique individuals, explain their financial obligations and find payment plans that meet their specific needs.
Requirement #3: Ongoing training and development
The importance of patient access staff to patient satisfaction and hospital profitability can’t be overstated. Registrars are expected to capture all patient information correctly while solving complex problems, complying with regulations and communicating critical information to patients. In many healthcare organizations, registration positions are among the lowest paid in the business office, yet their work is the most scrutinized because of its impact on cash flow. High turnover compounds these challenges for hospitals. In 2016, the Healthcare Financial Management Association said employee turnover in hospital patient access departments averaged 19 percent, with some hospitals reporting up to 40 percent.
Training can strongly influence the success or failure of patient access technology solutions. While it should be included in every implementation plan, it is often overlooked. With time and resources stretched thin, hospitals struggle to provide consistent training themselves, so they settle for a quick orientation and rely on strong staff members to carry the message forward. A better approach is for the technology provider to help build high-performance patient access teams through ongoing training, best practices and onsite expertise.
A comprehensive strategy starts with in-depth training on what the new tools do, why they’re needed and how they fit into the overall revenue cycle workflow. “Rounding” should come next, where trainers spend time with employees in all patient access departments on all shifts so they can benchmark performance and give feedback to managers on staff strengths and challenges.
Importantly, technology training should not be considered a one-time event. A solid strategy includes detailed procedure documentation; monthly reports on how staff members interact with tools, which can guide staff management; and ongoing tracking of tickets opened, which can identify trouble spots. Daily or weekly onsite support from the technology provider can help sustain success through one-on-one coaching, live refresher classes, monitoring staff outcomes and recommending corrective actions. Ideally, the hospital or solutions provider can also offer ongoing training via webinars and online tutorials.
Bottom line benefits
Hospitals and health systems have seen the value of patient access technology to improve staff productivity, patient experience and profitability. Those who combine technology tools with streamlined workflows and best practice training significantly increase the potential for greater patient satisfaction, staff performance and overall return on investment.
David Shelton serves as Chief Executive Officer for PatientMatters. He has served in senior healthcare management for more than 15 years, with experience in operations, technology development, and manufacturing. His expertise includes delivering business growth, streamlining operational management, and generating profitability for PatientMatters and its healthcare clients.