Empathy and education: Revenue cycle strategies in a post-ACA world

In the era of the Affordable Care Act, communication between hospital and patient is essential, especially when it comes to revenue cycle management. Value-based reimbursement has directly linked reimbursement to patient experience, for instance, and the rise of high-deductible health plans means hospitals are interacting with patients more than ever to collect on accounts.

At the Becker's 2nd Annual CIO/HIT + Revenue Cycle Conference on July 28, a panel of experts discussed how changes in reimbursement have impacted revenue cycle management strategies. A touchstone for the conversation hit on early and often was the importance of the patient experience.

Here are three revenue cycle management strategies for the ACA era:

1. Educate the patient: There's no shortage of misconceptions and misinformation regarding healthcare in America. A patient who is well informed regarding how much he will pay for care is less likely to encounter billing issues down the road.

"It's complicated," said Richard Lyman, vice president of revenue cycle at Downers Grove, Ill.-based Advocate Health Care. "I would say in general about 83 percent of patients don't understand their health plan. We're in the role of coaching them through it and helping them understand it."

At Advocate, the health system has a digital strategy to reach out to patients and educate them about their financial options. Accepted insurance is listed plainly on the website for all the system's hospitals, financial counselors can be reached to help patients set up extended time payment plans and a plain language summary regarding potential financial assistance is available online in multiple languages.

2. Educate the staff: Ensuring staff are well informed about how to speak with patients regarding medical bills and making sure physicians understand the specific language that should be used when documenting a patient's condition to maximize reimbursement are critical to maintaining a thriving revenue cycle.

Rudy Braccili Jr., executive director of revenue cycle services at Boca Raton (Fla.) Regional Hospital, provides staff who meet with patients to use a specific script when advising a patient on how much a treatment might cost. He said, "It [the script] is simply this: 'I have no idea how much you are going to owe for this service. If you would like to know, only your insurance company can tell you. I can call them with you right now and we can find out.'" Mr. Braccili suggested this statement is essential due to the amount of patients who report being unaware of treatment costs.

Additionally, physicians at Boca Raton Regional are trained to use the proper language when documenting a patient's condition, according to Mr. Braccili, as reimbursements differ depending on the language used, i.e. the difference between obese and morbidly obese.

3. Learn empathy: In the age of the ACA, delivering quality care and ensuring patient satisfaction are essential for the fiscal health of a healthcare organization. The high volume of patients and seeing more acutely ill patients can leave healthcare workers emotionally drained and perhaps a little hardened.

Walter Groszewski, vice president of professional services with Birmingham Ala.-based SourceMed, a health IT solutions provider to outpatient facilities, described a philosophical shift toward empathy that should be embraced throughout a healthcare organization. Mr. Groszewski used a physician-centric metaphor to suggest a new way to think about patient interaction — the hospital room no longer belongs to the physician, it belongs to the patient. "It's a [different] philosophical approach. It sounds simple, but it really changes the way you think and the way you interact."

Mr. Groszewski also recommended the book Communication the Cleveland Clinic Way, which discusses strategies for communicating empathy.

More articles on revenue cycle management: 
5 key metrics to determine the health of a hospital billing department 
6 keys to achieving successful risk adjustment 
6 characteristics of consumer-friendly revenue cycles

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