Why patient access is a hospital's top branding issue

Many hospitals and health systems dedicate significant resources to marketing campaigns with little knowledge of how these initiatives affect their brand. But the most effective way for hospitals to improve public image may have little to do with mailers, billboards or commercials. Instead, it is this: improve the patient access experience.

                                     This article is sponsored by HEI Health

Instead of viewing patient access services, including scheduling, pre-registration, authorization and time of service collections as an expense, providers should view them as resources that can be leveraged to help achieve organizational goals. Organizations often view patient access departments as transactional, high-cost centers that connect patients with providers while generating bad debt and claims denials. Physicians often grow frustrated by the administrative burden and delays in care that poor patient access creates. Most importantly, these interactions can sour patients' opinions.

Patients are often troubled by calls from different people to simply set one appointment and the repetitive questions asked on each call. While system leaders may consider these complaints a cost of doing business, this negative experience reflects broadly on the organization in the eyes of the consumer. Unless every customer experience interaction is flawless, the negative experience will amplify and become the emotion patients immediately associate with an organization. A pound of excellent clinical branding can be destroyed with an ounce of administrative failure.

Multiple departments, including scheduling, finance and revenue cycle, compose the patient access experience. Because not one department owns this business imperative, it can result in a siloed and discontinuous process for patients. Complex payer requirements also require staff to spend their energy on a number of administrative tasks, leaving little room for attention to customer service. The turnover rates for scheduling, billing and revenue cycle staff are high, and it is difficult to build a sustainable team with the proper competencies to become a trusted customer service resource.

During the Becker's Hospital Review 4th Annual Health IT + Revenue Cycle Conference in Chicago, HEI Health hosted an executive roundtable Sept. 20 led by Marjorie Green, the company's co-founder and CEO. Ms. Green outlined the often underestimated importance of patient access, and explained how hospitals and health systems can reengineer these departments and leverage their functions in service of organizational goals.

"The world of healthcare is changing, and the old school approach to revenue cycle transactions and processes must adapt," said Ms. Green. "Revenue cycle, scheduling and billing departments have become important elements in managing and helping to sustain revenue, and we have to start tooling these departments not only from a process perspective but from a culture perspective."

Brian Unell, vice president of revenue cycle at Atlanta-based Piedmont Healthcare, shared how HEI Health was able to help his organization transition its hospital scheduling and pre-registration department from a cost-focused transactional function to a value-added investment that could become a strategic asset for the system. Mr. Unell and his team wanted to establish risk-based engagements with payers and improve denial rates within the revenue cycle department, and they also recognized the impact that revenue cycle has on patient experience.

The revenue cycle department is the first and last contact patients have with the hospital, and Piedmont noticed the striking influence the patient access experience had on consumers. However, system staff did not always work with customer experience on the forefront of their minds.

"People were just completing tasks — asking a 75-year-old grandmother if she was pregnant as part of the pre-work because they're just going down the list and checking boxes," said Mr. Unell. "No one was doing anything wrong. We just really needed people to take a step back and do some critical thinking."

HEI worked to create high performance work teams at Piedmont with cross functional roles that eliminated cumbersome silos. Through new vertical service lines, they reengineered processes and were able to eliminate repetitive questions. Using new precision measurement tools, team members were able to focus on their most important tasks and optimize their workflows according to their department's new goals. Visual work management tools also helped staff understand how they were progressing toward those goals, and what they needed to do to accomplish them.

With the help of HEI, Piedmont reduced overall call length for patients by 39 percent, improved service level by 27 percent, reduced denials by 19 percent, and greatly improved patient satisfaction. Scheduling is the front door to any organization, and unless leaders dedicate significant resources to improving it, patients will walk out that door and not look back.

"We kept most of the people that were doing the work but knew we needed to redo our processes," said Mr. Unell. "They needed to see things in a different way, and HEI helped us do that."

When one CFO in attendance asked if Piedmont was able to maintain its improvements and return on investment once HEI left, Mr. Unell emphasized that the company's approach not only helped Piedmont leaders roll out the new structure for the pre-service teams, but set the department up for sustained success in scheduling and pre-registration departments and any other departments to which they would like to apply reengineering principles.

"HEI helped provide the arms and legs and structure for this project, but let us know it needed to be led by us. They brought us the tools, technology and additional manpower we needed, because we couldn't have done this on our own, but they did train us," said Mr. Unell. "One of the most important things they left us with, that they taught all the leaders in this area, was the process behind their reengineering approach."

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