Tag: Big Data

Patchy patient data has plagued the healthcare industry for decades, but the pandemic opened the door to a whole new set of identity management challenges. As patients rushed to register for patient portals and book vaccines, many unwittingly created multiple accounts, having forgotten they’d already signed up. Fluctuating unemployment levels meant many individuals were forced to jump health plans, which meant their records were moved between various organizations. As a result, data errors crept in, and identity updates were omitted. Incomplete and inaccurate patient identification data leads to suboptimal clinical decision-making, poor patient experiences, and higher costs for patients and providers. A 2020 study found that one in five patients had spotted an error in their electronic health record (EHR). Many clinicians have also witnessed medical errors that stem from patient misidentification. Hospitals lose millions of dollars every year in denied claims arising from identity errors, which can easily be avoided with a standardized approach to identity management. In a recent survey conducted by Experian Health, we found that identity management emerged as a major challenge for healthcare providers. Almost half of the respondents said that having inaccurate and incomplete patient data hindered follow-up contacts and patient outreach. It matters to patients too – a 2020 survey for the Pew Charitable Trusts found that four in ten were more supportive of data-sharing efforts among providers because of the pandemic, and twice as many were open to the idea of biometric identity verification. "Patients still welcome proactive outreach by providers, but more say their providers fail to do this, and 45% of providers say inaccurate or incomplete patient data gets in the way." - Experian Health's State of Patient Access, June 2021 Providers know that a 360-view of their patients is essential for improving patient outcomes and delivering positive patient experiences; however, duplicate and incomplete data continues to thwart their efforts. With a unique patient identifier (UPI) and a robust identity verification solution, providers can achieve single, accurate, and current records, and solve for these data standardization challenges. Data standardization creates a single source of truth for each patient Despite bipartisan recognition of the need for a national standard for patient identities, statutory barriers have hampered the adoption of a nationwide UPI. In the absence of a national approach, providers must take the lead to ensure high-quality patient records and prevent duplication, gaps and errors. The first step towards data standardization is identifying the type of patient information your organization needs. What data must be collected from patients? Which form fields are required and which are optional? How should data fields be formatted when updating patient records? Standardizing data collection and ensuring content and format consistency will help create reliable records for every individual patient. Next, a Universal Identity Manager (UIM) can hold and protect that single view of each patient, creating a standardized approach when new data is added. The software assigns a unique identifier to each patient, which follows them throughout their entire healthcare journey. By drawing on referential and probabilistic matching techniques with Experian data and patient rosters, the UIM uses the unique identifier to accurately match the patient’s identification and medical history, to help both clinical and non-clinical staff offer optimal care and support. Confirming the patient is who they say they are Having an accurate picture of each patient is only the first step. Next, providers must feel confident that each record can be correctly matched to the individual who is trying to log on to the portal or sitting in the waiting room. A complete and current record is useless if clinicians are matching it to the wrong person. To solve patient matching challenges, most healthcare organizations assign employees or contractors to fix and clean up data records. Without a software-driven identity management engine, these teams are forced to rely on manual processes, which are time-consuming, costly, and still vulnerable to errors. Alongside the consistent approach to content and format mentioned above, providers should have a reliable way of checking and amending the patient’s records at every touchpoint in the healthcare journey, using cutting-edge identity proofing techniques, risk-based authentication, and knowledge-based questions. A tool like Identity Verification can easily identify every patient and help maintain a clean and accurate patient database. Each patient’s demographic data can be validated and corrected during pre-registration, so providers know that the person is who they say there. This is even more crucial as the pandemic leads more patients to opt for remote and virtual services alongside in-person care. Future-proofing patient identities as the pandemic prompts long-term change Since March 2020, many Americans have gone through major life changes. Whether it’s the loss of a loved one or loss of a job, a change of address or a change in attitude towards their health, patients’ lives are changing. The healthcare system must adapt to follow suit. Many more players are involved in delivering healthcare, with digital apps and tools growing in popularity. These developments mean more patient data is being generated and shared, and by more diverse and distributed sources. A robust identity verification system built on standardized data can help smooth out the bumps in patient records and offer better patient experiences and improved health outcomes. Providers don’t need to completely overhaul their records system, but by investing in incremental changes to improve the quality and governance of their data, they can accelerate the move towards data standardization. Talk to Experian Health about how our proven tools can help your organization deliver better patient data quality today, and build a universal identity management system fit for the future.

Editor's note: This blog post was updated on October 2, 2023.  In today's rapidly evolving healthcare landscape, the need for a standardized approach to patient matching and identification has become crucial. Not having a unique patient identifier (UPI) not only poses challenges to managing patient data but also hampers interoperability between healthcare organizations. A unique patient identifier (UPI) is a method for standardizing patient identification. Individuals are assigned a unique code, and that code, rather than a Social Security Number, name, or address, is what is used by healthcare organizations to identify and manage patient information. A standardized code like this not only protects sensitive health information but supports the exchange of data between healthcare organizations and states as it is a number and format easily read and recognized by all. Advocates for a coordinated approach to patient matching are continuing to make the case for a national unique patient identifier (UPI). In April 2023, healthcare organizations wrote to legislators urging them to reject language in the 2024 Health and Human Services appropriations bill that prohibits the use of federal funding for a national UPI standard. More than 150 healthcare and medical organizations signed the letter, including Experian Health. The coalition argues that a standardized approach to patient matching could save lives, avoid medical errors, reduce unnecessary costs and greatly improve operational efficiency. While federal funding currently remains off-limits, the industry is poised to move forward to develop a national patient identity solution that is cost-effective, scalable, secure and one that protects patient privacy. Let's explore how a UPI can revolutionize the healthcare industry and create a truly connected ecosystem. How a unique patient identifier is used in healthcare UPIs give providers and payers a way to link records for the same patient or member, so they have one complete record. Without a UPI, a provider may inadvertently create a duplicate patient record because a slight variation in the patient's name or address means their original record isn't accurately matched to them. A 2022 survey by Patient ID Now found that 6 in 10 healthcare organizations had estimated duplication rates of 4-8%, while 16% of organizations had more than 15 patients with the same name.  If there's more than one record for a patient, providers may miss important medical information that's not carried through to the version of the record they're looking at. Unreliable records can also lead to misidentification, where patients with a similar name may have their records incorrectly matched. According to the ECRI Institute, misidentification is one of the top ten threats to patient safety. Patients could be given the wrong treatment or medication, with life-altering or fatal consequences.  While patient safety is the top concern for providers, efficiency is another driver of attempts to improve records management. Organizations report spending $1.3 million per year on patient identity resolution, as resources must be redirected to figuring out who patients are and fixing errors. Being able to correctly link records for a complete view of an individual's identity can help circumvent these challenges.  A unique patient identifier is the key to interoperability Managing patient data across the entire healthcare ecosystem is a long-standing challenge. Many organizations rely on master patient indexes to match patients using demographic data. But these single-source databases are rife with gaps, overlaps, and outdated patient information. They can't keep up with simple name and address changes or easily identify and fix data entry errors.   A more effective solution involves combining data sets to create complete identities and profiles, where every piece of new data is instantly updated and verified. Experian Health uses referential matching technology to achieve a fuller picture of each patient's identity. The UPI then acts as a golden thread, linking each patient record correctly within and between systems.  For example, if a provider has a patient in their EHR twice under two spellings of the patient's name, a UPI would link those two profiles, creating a singular view of the patient. If a pharmacy has a patient listed under a birth name but the doctor has them listed under their married name, a UPI can ensure both systems match the patient correctly.  When combined with other patient engagement solutions, data and identity management tools  create the infrastructure needed for healthcare to truly become one cohesive, patient- and member-centric network.  It is important to note that the UPI is not a patient-facing number and is not known to the patient or provider. It does not collect or share any clinical claims or diagnostic information; its purpose is simply to link records together giving providers and payers a complete view of someone's identity.  Improving the patient experience with a unique patient identifier  Healthcare consumers are increasingly seeking digital-first, efficient processes, and they're sensitive to the need for robust data security. Healthcare organizations must demonstrate their ability to manage patient data properly from the patient's first interaction. If data management is inefficient, patients will find themselves being forced to fill out forms they've already filled out multiple times or undergo duplicate tests as they travel between facilities. Patients with similar names may be confused if they're shown someone else's details during the identification process.  In an ecosystem built around a strong healthcare network, these discrepancies can be avoided. The patient's unique identifier remains consistent across every healthcare facility they visit – including physicians' offices, hospitals, pharmacies, specialists and long-term care facilities – so all providers know exactly who they are.   While patients welcome a more convenient, coordinated experience, they'll also be reassured by the reduced risk of medical errors that comes with a well-connected healthcare network.   Efforts to improve patient identity resolution in healthcare  While there may not be a national UPI yet, the industry is trying to find workaround solutions. The Centers for Medicare & Medicaid replaced Social Security Numbers with Medicare Beneficiary Numbers as the primary means of identifying Medicare beneficiaries. But while this addresses the risk of data breaches, it doesn't resolve the interoperability challenge.   Another initiative is Project US@ (Project USA), run by the Office of the National Coordinator for Health Information Technology (ONC). This aims to create a consistent healthcare industry-wide specification for representing patient addresses, to improve address accuracy. This would ensure that, for example, the same street name written as “road” and “Rd.” is not mistakenly viewed as two different addresses by the software.   To support efforts to integrate disparate software solutions, Experian Health announced in 2019 that every person in the United States had successfully been assigned a unique UPI, powered by Experian Health Universal Identity Manager (UIM) and NCPDP Standards™ (the “UPI”).  Combining Experian's expansive data assets and innovative UIM technology along with NCPDP standards, each person who has received medical care or used a pharmacy has been assigned a UPI. As new patients enter the healthcare ecosystem, this number will continue to grow.  Dave Roberts, VP of Platform Products at Experian Health, says that “the technological foundation is already in place for data interoperability through the creation of UPIs that are maintained in a master person index. These solutions are vendor-neutral, meaning data can flow freely between disparate electronic health systems, regardless of size or location.” Utilizing Experian Health's Patient Identity Solutions The implementation of unique patient identifiers holds immense potential for creating a connected healthcare ecosystem. By standardizing patient identification and enhancing data management, a unique patient identifier can improve patient safety, reduce costs, and streamline processes across the entire healthcare industry. Find out more about how Experian Health's patient identity solutions serve as stepping stones towards a more efficient and patient-centric healthcare network.

  Recently I had the opportunity to present at a regional chapter of the National Association of Healthcare Access Management about the growing need for business intelligence to improve patient access functions, as well as revenue. In speaking with attendees, it became clear that automating the patient access workflow with real-time data can create a more efficient and accurate process. Here’s how. As the responsibility for paying healthcare bills increasingly falls to patients themselves, patient access can make or break the revenue cycle. From registration and verifying insurance details, to scheduling appointments and collecting cash payments—this is the front line for the financial side of the patient experience. When you consider that half of denied claims occur earlier in the revenue cycle at the point of registration, improving those early-stage patient access processes is the obvious place for providers to look when seeking to minimize lost revenue. Revenue loss in patient access is mostly due to errors in patient identification, inadequate data analytics and inefficient workflows. If front and back office teams were better connected and able to work together quickly to communicate and resolve issues, many of these errors could be prevented. Without reliable tools and workflows to support this, those teams often must resort to manual fixes for any errors that arise. Unfortunately, this takes time and effort, blocking opportunities to find new ways to improve decision making and business performance. Healthcare is becoming more competitive. Providers must work to leverage the right data in the right way to safeguard profits and offer a better patient experience. That said, where should you start? Doing more with less requires the right data insights There are two sides to the solution: first, you need to be sure your data is accurate from the start. Around a third of denied claims are caused by inaccurate patient identification, while 12% of patient records are duplicates. Cleaning up your data with high-quality demographic data can help eliminate preventable denials. Secondly, you need to be able to draw insights from your data to help make smarter decisions in the future. Let’s say you notice a spike in late payments from a certain population. Why is that? Looking at historical data on patient and payer behavior can point to emerging trends and help you figure out where to focus your efforts in response. Or perhaps you’ve recently added a new function to your patient portal. Analytics can help you see if and how patients are using it and evaluate its overall performance. Once you have your data and analytics in place, you can start to use it to make improvements. Automating the patient access workflow with real-time data can create a more efficient and accurate process. It will also help link front and back office staff with shared systems that minimize errors and wasted staff time. 3 ways to use data analytics to streamline patient access For providers looking to streamline their early revenue cycle processes using the power of data, three areas to focus on are: Creating a better patient experience Increasing numbers of self-pay patients means patient loyalty is a growing priority for providers. Creating a positive, straightforward patient financial experience is essential for hospitals and health systems looking to reduce the stress and anxiety many patients feel when dealing with healthcare bills. Using data insights to identify the sticky parts in your patient access processes can help you spot opportunities to improve the consumer experience. For example, are patients receiving duplicate communications because the system is failing to update demographic information? Are there bottlenecks or backlogs that are creating stressful delays for patients? A business intelligence tool such as Revenue Cycle Analytics can help you pinpoint the root cause of delays and errors so you can work to fix them—and level-up your patient experience. When Martin Luther King Jr. Community Hospital (MLKCH) realized patient registration in their busy Emergency Room was a bottleneck and source for claim denials, they implemented an automated platform to streamline their registration process and improve the data being captured at the point of registration. Lori Westman, patient access manager at MLKCH says: “We get fewer denials because we’re getting true verification data, and our patient volumes continue to increase. So the fact that we can take off two to three minutes, at least, on half of our registrations is speeding up the work for the team, and the turnaround time is much better for the patients.” Uncovering potential revenue loss Analytics can show you exactly where your revenue cycle is losing money. Using appropriate benchmarks and custom KPIs, you can analyze accounts across the entire cycle to make sure your existing revenue cycle solutions are performing optimally and identify new opportunities for improvement. By gathering together multiple data streams into a single dashboard, you’ll get an at-a-glance view of your revenue cycle performance, so you can drill down to the root cause of denials. This also helps link up your front and back office staff. Rather than working retrospectively to address issues as they happen, your back office team can use insights from whole system data reporting and analytics to give front office staff immediate feedback on where denials are occurring. Monitoring payer rules and performance With American hospitals footing the bill for more than $620 billion in uncompensated care over the last two decades, it’s vital to verify a patient’s insurance options as soon as they set foot in the hospital. With up to date information on payer rules and a robust process for finding missing coverage, you can avoid protracted negotiations with payers and focus on denials, rejections and exceptions. A payer dashboard can also help you assess how payers are performing against one another, so your discussions around timely payments will be based in fact. By analyzing performance around pre-service, point of service and post-service, you’ll be better placed to work more closely with payers to minimize the risk of both late payments and denied claims. Learn more about how data analytics and an automated patient access workflow can help eliminate costly denied claims, boost revenue cycle performance and improve the patient financial experience. Steven Thiltgen is Director of Analytics Consulting for Experian Health

  When a doctor pulls up a patient’s record, it should be a safe assumption that the information on the screen relates to the patient sitting in front of them. It should contain every detail of the patient’s medical history, along with their current address and accurate personal information. It certainly shouldn’t contain anyone else’s data! Yet all too often, patient records are plagued with inaccuracies. Around 30% of patient data in electronic health records is incomplete or inaccurate, and up to half of records are not linked to the correct patient. The ONC estimates that around a fifth of patients may not be matched to their entire medical record within an organization, while more than a half of records shared between organizations contain errors. Despite all of modern medicine’s ground-breaking achievements and our increasingly digitized world, the ability to share information between different payers and providers in a reliable and secure way remains frustratingly out of reach. Could a universal patient identifier unlock interoperability? Imagine a healthcare ecosystem where administrators and clinicians can safely exchange information without worrying about whether it’s inaccurate, incomplete, or incompatible with each other’s systems. Interoperability could make life easier for healthcare staff and patients alike. While regulations such as the Affordable Care Act introduced many carrots and sticks to drive up adoption of electronic medical records to support interoperability, they also revealed a critical gap in healthcare: the need for a universal patient identifier (UPI). This is an identifier that would help manage patient identification across the whole healthcare ecosystem. A UPI would allow providers and payers to follow patients throughout all their major medical and life events and be sure that the information they hold for their member or patient is 100% accurate, current and complete. Instead, the absence of a UPI, compounded by the sheer volume and fluidity of patient data, has created significant issues downstream. Billing errors, unnecessary treatment and testing, HIPAA breaches, prescriptions filled for the wrong patients and many other issues all play a role in the growing number of preventable medical errors (estimated to be the third leading cause of death in the US). Striving for truly interoperable patient information should be a priority across the entire healthcare industry. Still, while federal funding for a UPI is currently being considered by Congress, we’re seeing more and more industry-led responses to help improve patient identity management. 5 benefits of using a universal patient identifier for interoperability Improve patient safety How can physicians be sure they’re recommending the right treatment for a patient, when there could be a vital piece of information missing from their medical history or allergy list? How can a pharmacist feel confident handing over a prescription, when there’s a chance the patient in front of them isn’t the same patient named on the script? A UPI can help avoid ‘wrong patient’ events and allow providers to share information to spot trends in recurring errors so that action can be taken to prevent them in future. Lower healthcare costs The West Health Institute found that that medical device interoperability could save the U.S. healthcare system more than $30 billion per year. For individual providers, UPIs could improve productivity by reducing the amount of time clinicians and hospital staff spend trying to sort out inaccurate records. And with nearly a third of claims denied as a result of patient misidentification, this could mean savings in the region of $17.4 million for the average hospital. A better patient experience Patients are right to be frustrated when their physician doesn’t have up-to-date records about them, or their provider sends appointment reminders to an old address. Expecting patients to fill out multiple forms (often multiple times) is inefficient and hardly contributes to a positive patient experience. A tool such as Universal Identity Manager can help providers exchange timely data, eliminate duplicate records and coordinate care, so the patient is supported throughout their healthcare journey. Stronger privacy Electronic records linked with a UPI allow healthcare organizations to phase out manual processes—which is not only more efficient, but also helps minimize the risk of patient data falling into the wrong hands. It’s much easier to keep the data secure when it’s contained in a single record, compared to multiple versions of a record filled with scribbled notes and random updates that could easily end up attached to the wrong record. Experian Health’s Precise ID gives healthcare organizations a HIPAA-compliant way to authenticate patients and reduce the risk of a data breach during enrollment. Better data to tackle the social determinants of health As consumer data opens up new opportunities to improve population health, a network of shared data will be essential for identifying trends in the social and economic factors that affect medical outcomes. Interoperable data sets and technologies can enhance the way public health data is collected and used, for better patient outcomes and population health. Interoperability currently remains a challenge, but the tools exist to improve the way information is shared and used across the healthcare ecosystem. By integrating clinical data into the patient access workflow, you can increase productivity, reduce costs, and ultimately improve the patient experience. Contact our team to find out how this could help your organization achieve more efficient, accurate and actionable data sharing.  

The healthcare industry is starting to embrace the use of consumer data to help achieve better treatment outcomes, engage patients in meaningful ways, market to health consumers, and identify social determinants of health among their patient population. As consumers now spend an estimated $3.5 trillion annually on healthcare in the U.S. (approximately $10,348 per consumer), they expect the healthcare industry to create modern and innovative experiences for their care journey. Those experiences can only be created through data-driven insights. When it comes to the world of data, where can we start? What if we could use health data and other variables like socioeconomics to predict missed appointments, noncompliance with medications, and patient trajectory over time? By learning how to apply data analytics to practice management workflows, we will improve the delivery of patient care by zeroing in on the best in social determinants of health. Data insights can also forge stronger customer and patient relationships, foster brand loyalty, and drive decisions around how to interact with consumers in ways that consider their lifestyles, attitudes and preferences. Those insights help deliver tailored messages to patients that are relevant to every stage of their journey. And what about applying credit data to create a personalized, nearly invisible, payment experience for patients? As patients express that paying their bill is a top pain point in their health journey, we look to use the right data insights to fuel collection strategies by offering patients financial assistance and payment plans at the point of service to ensure a positive patient financial experience. The right data can transform patient and consumer experiences in healthcare. However, it’s important to have access to clean, original-source data, as well as analytics to gain insights that drive decisions and achieve results. Household data, marketing data, credit data and of course healthcare data can all offer a more complete view of today’s healthcare consumer. If you are attending HIMSS19, join us in booth 2033 to hear one of our presentations on using data in the patient experience to earn CE credits.  

No two healthcare organizations are the same. Each has varied workflows that optimize efficacy and overall care for patients. That’s why healthcare software solutions should never be considered one-size-fits-all approaches. It isn’t fair, or terribly productive, to force healthcare organizations to adapt to new software. Rather, the healthcare software should adapt to them. At Experian Health, we’ll never supply a software product and then expect you to adjust workflows to suit it. Instead, we embed ourselves into your company to ensure we deeply understand your productivity needs and the reasons behind them. Only then can we tailor the solution we provide around you. It’s never too early to get it right The conversation about customizing your healthcare organization's solution begins before you even sign up. As soon as a solution interests you, we’ll start looking at how to tailor it to your unique needs. We’ll hold a meeting that includes subject matter experts and implementation leadership groups to uncover your greatest usability needs. Then, we’ll document those needs to better prepare whoever runs your project and ensure he or she has all the necessary information upfront. Then, gears start moving during the sales process. After choosing a solution, our team of experts works with members from every department in your organization to iron out the appropriate design and functionality details. We believe the people who will be using and relying on the solution every day should have a significant say in these details. However, we’ll do all the legwork of actually building and implementing the solution itself. By the time we’re ready to run internal tests to make sure the software works, members of every department will already know what to expect. Consequently, when they run user acceptance tests to check whether the solution fits into their workflows, they can accurately measure the solution’s performance against their input into its design. Afterward, we can iron out any hiccups they run into before initiating the organizationwide training and “go live” steps of the process. It’s never too late to make adjustments Our deep involvement in customizing your solution also begins before you select it, and it continues long after it's successfully implemented. We don’t go away just because we marked you as “live.” Instead, we understand that the healthcare industry is in constant flux and you might experience operational changes that warrant additional tinkering and tailoring to our solutions. We’ll stick around for a couple of days after going live, and we’ll stay available forever after, just in case. For example, if you purchase a new physician group six months after going live, you’ll face quite an uphill battle onboarding them all into your software system and, in turn, getting them up to speed. Because the group is new, you might face opposition to bringing on any change in general. In this case, you could use help facilitating the training and the adoption of your system into this new group, and that's where we step in. Additionally, what if this implementation requires a work queue structure that’s vastly different from yours? If the new group operates in a different area of the state, they might also have unique rules for some of their payers. These rules have to be incorporated into their system to accommodate the patient population. None of this, though, should fall solely on your shoulders. We can worry about the system's features so you can focus on the operational change management aspect. For our clients, we’re always on call. This devoted availability could range from six months or even six years. Whatever the situation, we know that you’ll eventually face circumstances that your software wasn’t originally designed to address. Instead of feeling stuck and frustrated, clients can find comfort in knowing we are here for every step of the process. And beyond tailoring your solution before implementing it, we also offer continued customization to help you tackle new circumstances without compromising workflow. Overall, here at Experian Health, we understand the pressures facing healthcare organizations today, and we are eager to be partners with you in securing the best solution for you needs and guiding you through the challenges ahead.

Remember those commercials for the hamburger chain in the mid-1980’s? An elderly lady angrily shouted, “Where’s the beef?” in response to seeing a tiny burger on a large, fluffy bun. If that same creative concept were applied to healthcare today, perhaps the lady would proclaim, “Where’s the data?” when looking at the revenue cycle. While healthcare as a whole is moving toward using clinical data and analytics to enhance patient care, most organizations aren’t realizing the true potential of financial data to drive revenue cycle performance. So where does that potential lie? Quite simply, it lies in the vast amounts of financial data that healthcare organizations can access, yet do so ineffectively. By leveraging this existing data more appropriately, organizations can build and sustain margins while improving performance and enhancing the patient experience. Consider these three areas of opportunity to use data to drive the revenue cycle. Patient Access Correctly capturing and analyzing patient data at the initial point of contact allows an organization to reap large rewards, both clinically and financially. For example, correct patient identification reduces the risks of fraud and identity theft and ensures that medical records are being provided for the right patient, thus preserving patient safety. In addition, using data to provide accurate estimates of the patient’s payment responsibility up front and developing customized payment plans can elevate patient satisfaction as well as propensity to pay, allowing the healthcare organization to enhance collections and reduce bad debt. Claims and Contract Management Another area of opportunity is in payer contracts and claims. During contract negotiations, data and analytics help identify new service line opportunities for enhanced financial performance. Claims are more accurate and efficient when analytical tools review them before submission, comparing them with contract requirements and kicking out those with errors or ones that require further information. Consider the example of a healthcare organization that improved its recovery rate on denials by almost 50 percent by leveraging data to compare the amount received for the claim with the contracted amount. Collections Data and analytics also can be used to improve internal collections efficiency and profitability. Organizations can use data to segment accounts that share demographic and financial profiles, rather than simply looking at balance amounts and number of days open. This allows collections staff to prioritize work based on a patient’s likelihood to pay, which improves both collections and the patient experience. For example, a patient scoring in the “most likely to pay” segment may not need a call until day 75, while someone in a lower segment may need additional calls and help setting up a payment plan within the first month. Segmenting in this way not only increases the likelihood of successful payment, it preserves patient satisfaction at the same time. Realize your revenue cycle’s true potential by leveraging financial information to enhance performance. Moreover, marry these activities with efforts to use clinical data to improve care, and you can realize a comprehensive approach to elevating overall quality and performance. You’ll no longer need to ask, “where’s the data?” Learn more about leveraging data and analytics to drive the revenue cycle with this white paper: The new revenue cycle imperative: A data-driven approach to minimizing risk and optimizing performance.

There’s a knock on the door, and it’s “big data.” The promise of Big Data is redefining patient care, becoming the norm in clinical settings as it drives clinical pathways and care decisions. But it’s now time to broaden healthcare’s perception of Big Data to show how healthcare organizations can open the door to other possibilities where it can have a dramatic impact on financial performance. The key opportunity centers on making sedentary data within your organization’s four walls actionable, especially when combined with other valuable data such as credit information, to improve financial performance, patient safety and patient satisfaction. Although there are many benefits to leveraging data in this way, there are three that rise to the top. Who knew the revenue cycle and patient access would be a first line of defense for patient care? A significant, yet often underappreciated benefit of a data-driven revenue cycle is improved patient safety. Identity theft and fraud are decreased by properly identifying the patient at the outset of the healthcare experience. This proactive approach can also ensure healthcare organizations treat the correct patient and avoid the risks associated with misidentification. It’s all about upfront payment whenever possible. The back end of the revenue cycle is shifting to the front — while nothing new, it’s an increasing reality dependent on important data points. Verifying benefits, eligibility and propensity to pay before the patient arrives or in real time at registration not only improves patient-provider interactions, it also allows the registrar, and other patient access professionals, to better understand the patient’s unique financial situation and engage in appropriate and tailored financial counseling discussions. While some processes remain on the back end, it’s really about having a clear understanding of the patient’s financial picture upfront. Collecting with compassion, and for the bottom line. Finally, collections become less about randomly tracking down payments and more about compassionate customer service and targeted process improvement by scoring and segmenting patient accounts. Data and analytics improve collections efficiency and profitability by streamlining processes and proactively assessing and responding to each patient’s unique situation, whether providing a customized payment plan or identifying charity care for a patient in need. And, robust data points on collections agency performance provide insight into which agencies are delivering the most return on which accounts, as well as where agency consolidation or internal support will yield stronger collections results. Big data has transformed clinical care. Now, it’s time to apply the same data-driven approach to mitigate financial risk and enhance the bottom line. Isn’t it time to answer that knock on your revenue cycle door?