How to deliver a great patient experience in the revenue cycle

At the Becker's Hospital Review 3rd Annual Health IT + Revenue Cycle Conference in Chicago on Sept. 21, 2017, a panel of healthcare industry experts came together to discuss delivering a great patient experience in the revenue cycle.

The panel included Senior Director of Revenue Cycle at Cleveland-based The MetroHealth System Donna Graham; Director of Revenue Cycle Management at Dallas Nephrology Associates Carolyn Rubin; Clinical Informatics/Patient Care Coordination Leader for Holdrege, Neb.-based Phelps Memorial Health Center Andrea Englund; and Vice President of Product Management and Patient Access at Change Healthcare David Dyke. Richard Laible, president of Laible Productions, moderated the panel.

Patient experience is becoming more important to keep patients returning to the health system. This is especially true when patients have potentially less expensive regional options. "It's really important to personalize the service for patients as to how they need to be treated as people," said Ms. Englund.

Ms. Graham reported significant consumerism and healthcare shopping in her market, particularly among self-pay patients, the uninsured working poor and independent white-collar consultants. "We ended up opening a self-serve portal on the web so that people could shop internally. We shifted from talking about patients to talking about customers. And we tried to get people enrolled in either Medicare or Medicaid with a 38-foot RV that goes in the community. We are trying to remove any barriers of the financial aspects in our community," she said.

Dallas Nephrology Associates is also spending more resources to enroll patients in health insurance programs and make sure they understand their bills. "We had to increase staff in areas of financial assistance to help patients find insurance. In the dialysis centers we take patients to the Social Security office. We have to change the way we look at the support and care from the financial standpoint, not just the medical standpoint," said Dr. Rubin.

Physicians are starting to discuss the cost of care with patients and setting expectations for payment. "We try in healthcare to dissect the clinical pathway from the healthcare pathway, and from the patient's perspective they are the same. There is no separation. The patient is the payer now and 30 to 40 percent of people who get healthcare through their employers have a high-deductible health plan," said Mr. Dyke.

Integrating a patient's financial responsibilities at the point of care can be challenging, especially for complex patients with multiple conditions or comorbidities. Dallas Nephrology Associates works with a social worker to connect with patients and help practice physicians understand what other tests and treatments their patients undergo. The practice also has a transitional care management team to help patients understand the different providers involved in their care and articulate expectations about who will send them bills. Patients can also ask the transitional care team questions about their bills after services are rendered. For example, many Medicare patients don't understand they need Part A and Part B coverage for facility and physician services and need guidance through enrollment.

Hospitals and health systems can also do a financial assessment early on for each patient and give the patient guidance on what to expect from upcoming bills to prevent unnecessary anxiety. Technology can help staff members estimate out-of-pocket costs for patients depending on their needs and insurance coverage.

Physicians may also need additional education about billing requirements and approvals, especially when policies and procedures change at the federal government or payer level. "They need to understand where the goal posts are so they can hit medical necessity targets or rules around the prior authorizations for each patient," said Mr. Dyke. "It's very different when variables change and having the tools to provide them with analytics to understand the specific nuance of two different people who need the same brand of healthcare, but have two different insurance carriers."

More articles on revenue cycle management:
3 best practices for hospital revenue cycle optimization
Treating patients as consumers—the key to improving revenue cycle health
10 hospitals seeking RCM talent

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