Under the fee-for-service model, healthcare organizations typically used revenue cycle management systems to recoup, protect and drive revenue. However, as traditional fee-for-service care transitions to fee-for-value, many hospitals and health systems are looking to customer relationship management platforms to achieve financial success.
During a Sept. 27 webinar sponsored by Evariant and hosted by Becker's Hospital Review, Rob Grant, cofounder and executive vice president of Evariant, discussed the many ways a CRM platform can help hospitals and health systems increase revenue and market share despite the challenges that accompany the shift to value-based care.
With this transition, healthcare organizations are losing predictable revenue streams as they try to keep patients out of the hospital. This shift is occurring as rapid consolidation fuels hyper-competition in the industry and hospitals and health systems struggle with erosion of the payer mix caused, in part, by baby boomers rapidly switching to Medicare and the increasing popularity of high-deductible health plans. These forces, combined with a greater focus on consumerism and challenges presented by physician alignment, create the "perfect storm," said Mr. Grant.
To protect current revenue and simultaneously compete with other hospitals to build market share and increase revenue, many healthcare organizations are implementing CRM platforms. Although RCM tools have been used by hospitals and health systems for many years, CRM should be considered as a solution for value-based care, according to Mr. Grant.
By pulling data from various solutions, including RCM systems, Evariant's CRM platform goes beyond the point of service to help identify trends in the market and provide a 360-degree view of patients.
Patient acquisition and retention
Mr. Grant said acquiring and retaining patients is one of the largest goals of CRM.
To help hospitals and health systems acquire new patients, the Evariant platform performs an analysis that uses predictive modeling, patient and consumer segmentation and other processes to determine an organization's target market. The platform then deploys engagement programs using email, direct mail, web forms and other means to reach the target audience. The CRM platform includes a cloud-based system to track and store interactions hospitals and health systems have with their target audience. It also has the capability to manage all inquiries that the patient engagement programs produce.
The last step in the process is to measure results. Using reporting and analytics, the CRM platform allows hospitals and health systems to measure the return on investment of their efforts and the net revenue the campaign brought in.
"From running all of our campaigns, we've figured out how to best communicate with patients," said Mr. Grant. "Overall…[the CRM platform] leads to better customer satisfaction and better retention of patients."
Mr. Grant noted the success realized by a large academic medical center in the eastern U.S. after it implemented Evariant's platform. The hospital is in a hyper-competitive market and national provider groups from outside the area were encroaching on the hospital's turf. The hospital wanted to be more efficient in reaching target markets and also wanted to improve patient experience to boost brand loyalty.
Using the CRM platform, the hospital conducted 100 multi-channel, segmented campaigns over a four-year period. The campaigns generated $1.2 billion in net patient revenue and 1,500 new patients.
Physician alignment
The second component of CRM is physician alignment. Mr. Grant said it's critical for hospitals and health systems to drive profitable relationships with physicians, but understanding those relationships is complex.
Using data-driven analytics, Evariant's CRM platform tracks new and existing physician relationships and assesses physician loyalty by tracking where they refer patients. Using this information, hospitals and health systems can identify business development opportunities, implement improved workflow and accountability tools, and increase provider loyalty by documenting and addressing drivers of dissatisfaction.
Mr. Grant discussed how an academic medical center in the Midwest used Evariant's CRM platform to improve physician alignment. The hospital has an excellent reputation but realized that was not enough to maintain and grow its patient base. The hospital used the CRM platform to launch a physician outreach program with a clearly defined strategy to grow referral relationships. In the first year, the hospital realized more than approximately $6.5 million in net new patient revenue for one service line.
Putting the components together
With the challenges facing healthcare organizations today, such as the shift to value-based care, consumerism and rapid consolidation, it's vital for hospitals and health systems to find ways to grow revenue and market share. A CRM platform provides the tools and insights to assist hospitals and health systems in achieving these goals by helping them acquire new patients and keep them in-network.
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