During the COVID-19 pandemic, national and state health departments needed timely and accurate patient data to communicate quickly with citizens and make decisions about the local public health response. With support from Experian Health, the Council of State and Territorial Epidemiologists (CSTE) utilized Universal Identity Manager to provide members with reliable and accessible data tools to help slow the spread of disease. Here’s how the Tennessee Department of Health (TDH) used those resources to improve contact tracing and patient outreach amid mass relocations. According to Pew Research Center, more than a fifth of US adults changed their residence in 2020 because of the pandemic, or knew someone who did. In Tennessee, Epidemiologist and COVID-19 Team Lead David Fields identified mass relocation as a major obstacle to patient outreach during the pandemic. Job losses caused residential displacement, meaning that a patient’s health record didn’t always show the most current address. Because of the nature of their work, migrant farmworkers often have fluid living situations. This means that they rarely have a continuous home address and will share the same address or phone number with others, which hinders effective communication. And the private laboratories that expanded into COVID-19 testing often relied on stale contact data. These are some of the primary challenges that confronted the team in Tennessee working to verify data they were receiving. Experian Health helped TDH close the gaps in patient records using the Universal Identity Manager (UIM) platform. With UIM, records are matched using a unique patient identifier that combines industry-leading demographic information with the highest quality reference data to create the Experian Single Best Record. This accurately identifies separate records that belong to one person, creating a “golden thread” that follows the patient throughout their healthcare journey. TDH was fielding around 150 demographic data requests from community health departments per day. Before the pandemic, David’s team responded to these requests using proprietary and third-party databases that aggregated data held in public records. UIM complemented this approach with faster records matching, which allowed the team to provide quicker and more reliable patient contact information. In particular, UIM supported more efficient contact tracing during mass relocations by providing accurate phone numbers for citizens with positive COVID-19 test results and data for "hard-to-contact" cases. This solution also helped TDH create statistical analyses for the spread of COVID in the local populace by providing demographic data – such as gender and race. Find out more about how Universal Identity Manager accurately matches and protects patient data across multiple data sources, to create a single, longitudinal view of each patient and real-time insights to improve public health decision making and patient outreach.

The Appropriate Use Criteria (AUC) program is due to come into full effect in January 2023. Here’s how healthcare providers can learn, test, and prepare.

Discover how improving the patient experience and journey can improve revenue cycle management (RCM) in healthcare.

Experian Health and PYMNTS recently collaborated to release a new report, "Accessing Healthcare: Easing Digital Frictions In The Patient Journey." Getting care through digital channels became a norm during the pandemic, and will continue post-pandemic. Digital-savvy consumers have come to expect seamless experiences; however, there are a few gaps that healthcare providers must continue to address. This report examines how consumers use digital healthcare channels, their pain points and how providers can address gaps to improve patient care and satisfaction. Check out some of the highlights below: To learn more about how consumers access healthcare services via digital methods, download the full report.

Inflation is giving the cost of healthcare a run for its money. The Consumer Price Index rose by 8.3% year-over-year in August 2022, compared to a rise of just 2.9% in the Health Care Price Index. However, slower price increases do not necessarily mean healthcare will get an easier ride than other businesses. Healthcare contracts are agreed in advance with government and commercial payers, so any effects of inflation could simply be delayed. How should providers factor such economic unpredictability into their revenue cycle management strategies? Healthcare is usually more resistant to wider economic shocks than other service sectors, so rising inflation doesn’t necessarily mean there’s an urgent need to change course. Providers are always working to maintain a healthy revenue cycle and will continue to do so now. That said, the lingering financial effects of the pandemic, staffing shortages and increasing operational costs mean that provider cash flow is sensitive to any added pressure. While there’s currently no sign that patient collections have been significantly affected by inflation yet, patients may assume that health costs will increase too, along with everything else. This might lead them to delay elective care, which could affect providers’ bottom lines. As non-COVID patient traffic slowly returns and state and federal aid ends, rising inflation presents an additional hurdle to providers’ financial health. Providers will need to tighten their patient collections process and safeguard their bottom line. Download the white paper to learn how inflation is impacting healthcare and get strategies to optimize collections and avoid revenue loss. Providers that want to bolster their revenue cycle against the potential impact of inflation should focus on increasing workforce efficiency to manage costs and mitigate the risk of deferred care, to maintain a steady inward cash flow. They’ll also want to be prepared for any potential shift in patient payment reliability that could occur if inflation persists. Automated solutions and self-service digital tools can help to solve these issues. Minimize workforce inefficiency with automation and self-service solutions Questions to consider: How can digital technology and automation improve efficiency and ease pressure on staff? Where can patient self-service solutions help reduce the need for staff input? Inflation is likely to hit providers hardest in relation to payroll expenses. Staffing shortages lead to increased costs as providers raise salaries to attract and retain new staff, pay overtime costs, and hire more temporary workers. Reduced purchasing power will only exacerbate these challenges. Automation and digital tools can help address staffing shortages and keep a lid on payroll costs by increasing efficiency in existing workflows. For example, digital technology can allow patients to take care of many administrative tasks themselves, thus reducing the demand for staff input. Online self-scheduling and registration allow patients to book appointments and fill out pre-service paperwork without taking up valuable staff time. These tools leverage data and automation to pre-fill patient information, which reduces the risk of costly errors and saves time for patients and staff. Further along in the patient journey, automated collections can eliminate much of the manual work that puts pressure on understaffed teams, while increasing the likelihood and speed of payment. Collections Optimization Manager helps increase workforce productivity to make better use of staff time and avoid unnecessary revenue loss. Advanced analytics are used to prioritize accounts by payment probability, which will be increasingly useful should ongoing inflation increase the risk of patient bills going unpaid. Consumer data helps identify the most appropriate communications method for each segment, so the right message can be sent at the right time to boost the chances of collecting a greater percentage of money owed. Automation also helps reduce staff costs to collect, while bumping up the amount of money that comes in the door. As hospital operations become more expensive on the whole, maximizing efficiency in collections is increasingly important. Maximize revenue by removing friction for patients worried about the cost of care Questions to consider: How can providers help patients better understand their bills? How can digital technology make it easier for patients to access and pay for care? The second step is to make sure that dollars keep coming in the door. Managing household bills can be challenging for patients, and there’s no suggestion that the rise in inflation during 2021 has added any new pressure to patients’ ability to pay for healthcare. Experian Health’s clients also continue to see very low levels of delinquency. However, despite pay raises, many consumers are worried that price inflation will overtake any increase in household income, especially as energy and food prices go up. They may decide to cancel or postpone elective care until they’re sure of their financial situation or move their medical bills to the bottom of their priority list. In reality, costs for patients haven’t increased, because of the delayed effect of inflation in healthcare. That’s why it would make more sense for patients to seek elective care sooner rather than later. Given reports of pricing concerns, providers should consider ways to reassure patients about their financial obligations and make sure they don’t miss out on the care they need. Here are some ways that providers can support their patients: Providers can help patients get a better understanding of their medical bills and payment options, by incorporating solutions that offer greater price transparency. Upfront patient estimates delivered directly to their mobile device, with links to appropriate payment plans and payment methods, can help them plan with confidence. This will help to reassure patients that prices have not increased drastically due to inflation, so they are dissuaded from deferring care. Finding missing or forgotten insurance coverage is another strategy to give patients certainty around how their bills will be covered. A tool such as Coverage Discovery can run repeated and automated checks for previously unknown government and commercial coverage, using multiple data sources. Self-service patient access and patient payment tools can help to reduce friction during scheduling, registration and billing, so patients see fewer reasons to postpone care. Liz Serie, Senior Director of Product Management at Experian Health, says, “Automation and patient self-service features can help address the risk of patients choosing to put off visiting their doctor or getting a procedure they need. Many patient access and patient payment activities that would normally require staff attention can be easily pivoted to an innovative patient-facing experience. This will reduce friction for patients and help providers manage staffing shortages and cost pressures.” “Automation and patient self-service features can help address the risk of patients choosing to put off visiting their doctor or getting a procedure they need. Many patient access and patient payment activities that would normally require staff attention can be easily pivoted to an innovative patient-facing experience. This will reduce friction for patients and help providers manage staffing shortages and cost pressures.” – Liz Serie, Senior Director of Product Management Find out more about how Experian Health’s digital tools and solutions can help healthcare organizations create a financial safety net and protect their revenue cycle against the possible impact of inflation.

Discover six ways providers can make healthcare payments easier and faster in 2022 with patient-centered payments solutions.

Solving the patient identity problem and ensuring that each patient record is accurate and airtight is a top priority. Healthcare providers want to be 100% confident in answering “yes” to the following questions: Is the patient who they say they are? Is the right medication being administered to the right person? Is the correct bill being sent to the patient’s current address? By validating patient identities, providers can secure patient trust, deliver high-quality care, and avoid losing revenue to identity errors and fraud. Unfortunately, patient identity management is only becoming more complex. While telehealth and remote patient access are opening healthcare’s digital front door to meet changing consumer needs and expectations, a mountain of sensitive patient data is piling up. This data is a gold mine for fraudsters who steal and sell patients’ personal information or use it to access services and prescriptions without paying. It’s distressing for patients and creates a major financial and administrative burden for healthcare staff. A nationwide patient identification system may still be some way off. However, providers can optimize patient matching in their own health systems by working to reduce vulnerabilities and adopting cutting-edge interoperable patient matching technology. Better patient matching means better patient care and protected profits The human cost of incorrect, incomplete or outdated patient medical records is significant. Patients could be given the wrong medication or diagnostic procedures. Allergy information can be missed. Patient test results can be mislabeled or mixed up. In Experian Health’s State of Patient Access 2.0 survey, almost half of providers said inaccurate and incomplete patient data was an obstacle to proactive follow-up, which could cause gaps in care and avoidable complications – which are critical to value-based care compensation. Duplicate and mismatched patient records also create massive inefficiencies that can threaten an organization’s financial health too. With telehealth claim lines climbing by 2817% between December 2019 and December 2020, reliably authenticating patient identities in both existing and new services will be critical to future financial performance. Resolve, protect and enrich patient identities with universal identifiers Having the right technology to resolve and secure a patient’s information when they log on to patient portals and telehealth systems is the first step. Automating patient enrollment with Experian Health’s PreciseID® ensures the patient is who they say they are. This solution utilizes best practices in identity-proofing, fraud management and device recognition. But this system only works if the records being matched are accurate. A universal patient identifier provides a single, accurate, 360° view of each patient throughout their healthcare journey. An interoperable format allows systems to talk to each other and protects against duplicates, errors, inefficiencies and fraudulent activity. Universal identifiers aren’t available nationwide yet, though there has been some encouraging movement. Congress is working to remove the ban on funding for such measures, while the Centers for Medicare and Medicaid Services are taking steps to promote data standardization. For health systems that want to maintain a golden record for each patient within the bounds of their own operations, Experian Health’s Universal Patient Identifier allows staff to connect, verify and protect patient information. Choosing the right patient matching technology Traditional matching technology relies on demographic data and uses deterministic or probabilistic methods to link records with identical identification information. However, relying on a single source of data means that previous errors are inherited by new versions of a patient’s record. Demographic data isn’t unique to individual patients, which can lead to mismatched records and create extra manual work to fix. Experian Health uses referential matching technology to build a complete view of patients from reliable health, credit, and consumer data sources. The universal patient identifier connects disparate datasets and instantly updates the master index of patient records with new data points. Referential matching can only ever be as good as the data that is being matched and Experian is a global leader in data accuracy, across numerous sources, and is continually updated. Victoria Dames, VP of Product Management at Experian Health, says, "With Experian’s reference data, we’re able to create a longitudinal record of each individual and reconcile their data as they change names, addresses and see different providers. You need to know that it’s the same person, especially with the pandemic acting as a catalyst for digital technologies such as telehealth. It also helps organizations bring data together and ensure data integrity through mergers and acquisitions. Dealing with large volumes of data is a big hill to climb, but with the right technologies it can be that much faster.” As telehealth and digital patient access services gain traction, solving the patient identity problem becomes increasingly urgent. Universal Identity Manager combines industry-leading consumer demographic information with the highest quality reference data and powerful unique patient identifiers to create a single view of each patient. With better patient identity management, providers can protect against errors and fraud, and reassure patients that their personal information is safe. Find out more about Experian Health’s identity management solutions.

QR code technology has opened the door to new cybersecurity risks. Providers must remain vigilant with protecting patient identities.

Discover how Novant Health partnered with Experian Health and used Collections Optimization Manager to automate their collections process.

In the decade since the Affordable Care Act sparked the transition toward value-based care and pay-for-performance care models, clinical services have been transformed by advances in diagnostics, medical devices and digital technology. However, despite a commitment to improving care quality and patient experiences, the healthcare industry still struggles to influence the factors that have the greatest impact on patient outcomes – the social determinants of health (SDOH). It’s now well-established that clinical factors have a relatively small impact on a person’s health-related quality of life. As little as 20% of the factors that influence health outcomes are attributable to clinical care. The remaining 80% includes social, economic and environmental factors – such as access to safe and clean housing, healthy food, education and transportation. Healthcare providers cannot be expected to solve these challenges alone. That said, providers will benefit from developing plans and investing in systems that foster awareness of the social determinants of health that impact their communities. This will help enable the delivery of the proactive and coordinated services patients need to live healthier lives. The pandemic intensified many of the socio-economic barriers patients face when accessing care, medication, housing and food. It forced sudden changes to the way care was delivered, making it harder for healthcare organizations to sustain high-quality services. When overwhelmed hospitals just needed to get through the day, value-based care took a hit. To support underserved communities, healthcare organizations need reliable insights into their patients’ evolving life circumstances and socio-economic challenges. SDOH data can help providers identify the right strategies to serve their patient population in the most effective way. SDOH should be at the heart of patient-centric services. Healthcare organizations that prioritize the use of SDOH data are strengthening their ability to deliver value-based care. How has the pandemic affected SDOH and value-based care? Value-based care and pay-for-performance models were gaining traction just before the pandemic, and many providers were agile enough to respond quickly to the pandemic with telehealth and other remote services. But against a tsunami of COVID-19 cases, tests and vaccination programs, reimbursement models based on quality measures such as effectiveness, efficiency and timeliness proved fragile in the midst of an emergency. As is often the case, the worst effects of the pandemic were felt most acutely by marginalized and economically vulnerable groups. For example, groups with less stable employment were less likely to have access to sick leave or remote working opportunities, putting them at greater risk of catching the virus. Many community programs were put on hold, with consequences for the individuals who relied on them for food, support, and company. Insights on the social determinants of health can help providers segment vulnerable populations that need extra assistance to take control of their health. Once these populations are identified at the patient level with insights driving one’s unique SDOH risks, providers can develop strategies to ensure the right help is given at the right time. They can offer targeted outreach to ensure patients are able to adhere to care plans and access health checks, even take their medication as prescribed. This can reduce the risk of readmission, minimize hospitalizations, and keep healthcare costs down for both patients and providers. To supplement reliance on expensive and time-consuming patient surveys (that often leave out the “why” of a patient’s circumstances), Experian Health’s SDOH solutions combine analytical expertise, machine learning and proprietary data to generate actionable recommendations on the best way to address barriers to care, medication, housing and food. Combine SDOH and consumer data to personalize patient outreach The key to successful value-based and pay-for-performance care models is treating the patient, not just the disease. Data on SDOH allows providers to offer a more personalized healthcare experience, which is even more powerful when combined with consumer data. ConsumerView pools data on patient interests, psychographics, behavioral insights and broader lifestyle insights to give providers a 360-degree view of their patients. With this data, providers can offer relevant and timely advice to help patients overcome potential obstacles to attending appointments and complying with their care plan, such as information about transportation or childcare. It can be used to personalize healthcare communications too. Rather than blasting patients with one-size-fits-all healthcare information, communications can be tailored to patients’ preferred time and format, so they’re most likely to engage with the message. Making value-based care a reality starts with knowing who your patients are and what’s stopping them from getting the care they need. Find out how Experian Health’s Social Determinants of Health turn-key solutions can give your organization the insights needed to develop resilient and responsive models of care. With these tools, your organization can lay the groundwork to improve patient outcomes, regardless of the challenges that lie ahead.

Patient identity management remains a major challenge for healthcare providers. Learn how to unlock the power of data to deliver better care.

Patients want digital healthcare tools for easy access to care. Discover 4 ways to open your healthcare organization’s digital front door.