6 characteristics of consumer-friendly revenue cycles

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With clinical outcomes and patient satisfaction bearing equal weight in determining hospitals' prospective reimbursement, what happens to patients in the billing department or at the registration desk is just as important as what happens to them in the operating room.

Karen Shaffer-Platt, corporate vice president of revenue cycle and patient concierge services at UPMC in Pittsburgh, and John Holyoak, director of product management for RelayHealth Financial, discussed revenue cycle strategies hospitals can deploy to improve patient experience during a panel on July 27 at the Becker's Hospital Review 2nd Annual CIO/HIT + Revenue Cycle Conference in Chicago.

From patient portals to customer relationship management software, here are six strategies to drive patient satisfaction.

1. Complete registration prior to arrival. Both panelists said it's important for hospitals to complete the laundry list of pre-registration, registration, eligibility and verification services prior to the patient's arrival. "It's about moving the revenue cycle as far left as it can go," to prevent patients from feeling overwhelmed at the point-of-service, said Mr. Holyoak. Moreover, digital forms and pre-service phone calls can streamline, simplify and save time for registration staff while reducing hospitals' overhead costs. A proactive registration strategy can help patients feel more comfortable and prepared when they arrive for service.

2. Evaluate resource use. As demands and needs shift in the healthcare market, revenue cycle leaders should consider where and how they invest department resources. At UPMC, Ms. Shaffer-Platt found the point-of-arrival department absorbed more funds and employees than it needed to function effectively. By downsizing her point-of-arrival staff, she was able to reassign labor and capital to areas of the revenue cycle in need of attention, such as financial counseling, insurance counseling, emergency arrival or data analytics departments.

3. Don't collect at point-of-service; collect beforehand. "Today, healthcare costs the same amount as a mortgage or car payment," said Mr. Holyoak. Due to the serious financial investment  medical services require, payment for elective services should be confirmed prior to the patient's scheduled appointment. On the day of service, patients' only concerns should be clinical in nature and focused on their recovery rather than their looming financial responsibility, said Mr. Holyoak. Hospitals can offer a number of financing options to patients who can't pay upfront, such as installment plans, loan programs, financial aid services and charity care funding. 

4. Reform employee criteria and hiring practices for front-end staff. The role of point-of-service staff has changed significantly during the past decade. Modern technology has automated mundane, labor-intensive tasks traditionally assigned to registration staff. At the same time, health insurance markets created under the Affordable Care Act have granted millions of Americans access to healthcare coverage for the first time. To manage new expectations and demands, hospitals' point-of-service workforce requires a skill set and level of expertise hospitals cannot attract or sustain with hourly compensation and unorganized training, both panelists agreed. To provide exceptional customer service, hospitals must invest in attracting and training a workforce capable of educating consumers about complex healthcare topics with compassion and understanding. "The real challenge for revenue cycle leaders...is to remodel the system to look like financial counselors and not debt collectors," said Ms. Shaffer-Platt.

5. Implement and utilize powerful information database tools. Patients are often asked to provide the same medical information — insurance member ID, Social Security number, driver's license — at multiple points during a single episode of care. This wastes hospital resources and employee's time and can lower patient satisfaction by testing their patience. To improve efficiency, Ms. Shaffer-Platt recommends hospitals appropriate and leverage the same software other service industries use to deliver exceptional customer service.Particularly, she suggests implementing customer relationship management software. Deployed in a healthcare setting, this software enables staff to store and access patient information across the enterprise, track patient utilization and activity and can notify physicians if a patient checks in at a different health system.

6. Reconsider the patient portal. Patients who are relatively healthy will go long periods of time without returning to a healthcare facility. Ms. Shaffer-Platt and her revenue cycle team at UPMC redesigned their patient portal to better engage infrequent fliers in the financial and clinical aspects of care. "At UPMC, we appropriated a number of buzzwords from the banking industry and created a 'virtual wallet' for healthcare," said Ms. Shaffer-Platt. The application allows patients to store and log health information, pay medical bills and schedule appointments from their smart phone or computer.

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