Patient expectations of their healthcare providers have changed. Today, patients expect providers to offer the same convenience as their favorite e-commerce site, with intuitive self-service options that put them in the driver's seat. It's a brave new world for healthcare providers, who know the patient experience is about more than providing quality care—it's also about opening a digital front door with patient access technology. What do patients want from their healthcare providers? Experian Health's State of Patient Access 2023 survey shed light on what healthcare customers want: 76% want online scheduling from their favorite mobile device. 72% want an online payment option that is mobile-friendly. 56% want more (not fewer) digital options for managing their health. Outdated manual workflows do more than bog down backend healthcare teams; there's evidence this also frustrates patients. One study showed that 85% of patients believe technology can improve communication with their providers. Beyond the convenience of self-scheduling and improved communication, there is also evidence that patient access technology improves patient safety. Most people hate paperwork, and patients are no exception. Providers can digitize many of these manual tasks. Streamlining the patient access experience online could include: Online self-service appointment scheduling. Pre-registration via a patient portal. Real-time insurance eligibility verification. Automated, accurate out-of-pocket estimates. Text and email reminders to reduce no-shows. Online bill payments with personalized payment plans. Today's patients have grown accustomed to the immediacy of online shopping thanks to vendors like Amazon. That expectation transfers to healthcare, where administrative and financial tasks can be repetitious and frustrating. Technology can improve engagement with healthcare consumers, from patient intake to bill payment, while lowering the administrative burden on medical staff. How can patient access technology make healthcare convenient? Digital technology can transform the healthcare experience into a more accessible and patient-centric model. For example, 24/7 online scheduling lets patients book appointments at their convenience from their favorite online device without lengthy phone calls or complex scheduling processes. These solutions reduce wait times and patient frustration. Providers benefit from improved call center efficiency, lower no-show rates, and higher patient satisfaction. Digital patient portals are an easy conduit to better communication and faster access to healthcare information. Patients can fill out forms, get price estimates, check test results, and update insurance details. Providers benefit from more accurate patient data, not to mention more satisfied patients. Mobile-friendly tools enable on-the-go access to patient health information. From viewing test results to communicating with healthcare providers, mobile apps empower patients to actively engage in their healthcare journey. Secure messaging platforms enable patients to interact with healthcare providers by email and text, when they want, on their chosen device. Patient access technology also streamlines labor-intensive administrative processes with digital registration systems. Patients experience reduced wait times, as these technologies expedite check-in, contributing to a more efficient and hassle-free healthcare experience. Ultimately, these tools make life for patients and providers easier. Manual healthcare workflows cause bottlenecks and mistakes that lead to increasing claims denials. Patient access technology automates many labor-intensive tasks for patients and providers, including prior authorizations, which, if declined, can delay care and negatively affect patient outcomes. Tools like Experian Health's Patient Access Curator can check patient coverage within just a few seconds, speeding up reimbursement workflows from registration through payment. The software is particularly helpful for self-pay patients, helping providers identify a clear path towards financial accountability at the beginning of the encounter. Can automation improve patient engagement? Automation technology does more than improve human workflows in the complex service delivery world. These tools engage patients across their healthcare journey, a crucial component of effective, patient-centered care. Patient engagement refers to the active involvement of individuals in their healthcare journey, and automation can play a pivotal role in facilitating this process. Patient data allows technology to personalize each encounter. Automated systems can deliver timely and tailored messages to patients, reminding them of appointments, medication schedules, and preventive care. Automated patient access technology lets patients know that their chosen healthcare provider is looking out for their well-being. These solutions help patients stay informed and create accountability for adhering to treatment plans. Behind the scenes, sophisticated analytics provide valuable insights into the health of various patient populations. Healthcare providers make data-driven decisions that can guide any intervention before issues escalate. Automation can streamline administrative tasks, allowing healthcare providers to focus more on direct patient care. Digital platforms handle appointment scheduling, prescription refills, and routine inquiries, reducing the burden on healthcare staff and patients. Automating routine processes allows healthcare professionals to spend more time on meaningful patient interactions that build stronger long-term relationships. Improve patient access technology and improve patient experiences A recent Accenture study shows healthcare consumers are willing to switch providers if their needs and preferences are not met. Millennial and Gen Z populations are six times more likely to switch providers. The study also showed patient access was the top factor when choosing to stay or leave their healthcare provider. The increasing level of consumerism in healthcare should be incentive to change for any provider with legacy technology and outdated administrative processes. Experian Health’s automated patient access solutions improve the patient's experience at each point in their encounter with their provider. To find out more, speak to the Experian Health team.
As 2023 draws to a close, revenue cycle leaders are in planning mode, reviewing financial performance, and gearing up for resource allocation negotiations in the new year. What should they be prioritizing? Three of Experian Health's senior executives share their healthcare predictions for 2024 based on the latest healthcare trends, and the steps providers can take to maximize reimbursements in the year ahead. Healthcare prediction #1: “Staffing shortages will persist, driving demand for technology-based solutions over traditional HR tactics” According to Jason Considine, Chief Commercial Officer, the healthcare staffing shortage is unlikely to let up any time soon: “In our recent survey, we found that 100% of respondents are seeing ongoing shortages affect revenue cycle management and patient engagement. There's an urgent need to address the problem, but too many providers are relying on traditional recruitment approaches that won't give them the longer-term resilience they need. Heading into 2024, providers should leverage technology and data to alleviate the burdens on front and back-end operations, and drastically improve efficiencies. This will better protect providers from the talent pipeline fluctuations that cause major disruptions.” This healthcare prediction for 2024 is based on Experian Health's staffing survey that was relased in 2023. Participants in the survey agreed that the staffing crisis would continue, expressing concerns about its impact on revenue and patient engagement. For many, the culprit is high turnover rates. More than four in ten said turnover in their administrative teams exceeds 25%. Given the difficulties in finding skilled candidates and addressing staff burnout, it seems clear that traditional HR-based strategies will fall short. Despite this, salary increases, cross-training and incentives remain go-to responses. Responding to the survey findings, Considine says, “It's time to look at the many areas where automation – and even artificial intelligence – can stabilize, improve and optimize understaffed functions.” One use case for artificial intelligence is in claims management. Experian Health's AI Advantage™ solution uses historical and real-time claims data to identify claims that may be at risk of being denied. This allows staff to zero in on those claims and ensure all information is correct and complete before submission. It integrates seamlessly with ClaimSource® to augment the claims workflow, so staff can focus on claims and denials with the highest likelihood of payment. As well as alleviating pressure on staff, it reduces costs and maximizes reimbursements, helping providers to protect margins during uncertain times. See how AI Advantage helps healthcare organizations reduce and prevent claims denials. Prediction 2: “Patients' changing digital expectations will prompt more providers to adapt (and those that don't will risk losing market share)” Clarissa Riggins, Chief Product Officer, says that patients are increasingly likely to expect a better “digital front door” experience, and will start to look elsewhere care if they encounter too much friction: “Patients have increasingly high expectations for easy and efficient tech-enabled solutions when it comes to accessing healthcare services. They seek convenient self-scheduling options, accurate cost estimates, and the ability to pre-register through their smartphones. We're seeing a continuing trend in the number of patients who say they'd switch providers if the digital front door isn't open.” That healthcare trend was evident in Experian Health's State of Patient Access 2023 survey, which showed that 56% of patients who had seen a deterioration in the patient access experience would switch providers because of it. Demand for more digital options can be tracked back to the “Amazon effect” and the rise of online retail environments that give consumers convenience and choice at the tap of a button. Indeed, healthcare providers stepped up during the pandemic to deliver flexible, contactless care, so patients have seen that it's possible. With digital transactions now well-established, patients will find it surprising to be asked to fill out paper forms at the registration desk or have limited online payment options in 2024. Riggins says providers must update their technology or risk being left behind. “Clients who are making the switch to digital patient access offerings tell us they don't want to look stuck in the 90s. They want a more contemporary patient experience that's smoother and more efficient for both patients and staff.” To open the digital front door and kepe up with healthcare predictions in 2024, Riggins recommends prioritizing self-service and digital options for patient registration, scheduling and billing inquiries. Prediction #3: “More patients are struggling financially, so providers will need to do more – and sooner – to help them manage bills” Victoria Dames, Vice President of Product Management, says that with household finances under pressure, patients will remain anxious about the cost of care: “The earlier providers can give patients clarity, the better for all involved. Creating a convenient and transparent patient collections experience should begin during patient onboarding, so patients can start to plan. With integrated patient access software, providers can deliver a more compassionate and efficient collections process, which supports patients while accelerating the revenue cycle. They don't have to choose between prioritizing revenue and patient experience – patient access technology delivers on both.” Recent Experian data suggests that many Americans are not confident in their financial literacy. This does not bode well for their ability to navigate the increasingly complex processes involved in healthcare billing. The troubling health consequences are already evident: a 2023 Gallup poll revealed that record numbers of patients were putting off medical care because they were worried about the cost. Anything providers can do to simplify the payment process is going to improve access to care and minimize bad debt, as noted in Dames' healthcare predictions for 2024. Dames says the collections effort should be viewed as an ongoing interaction with patients, beginning in patient access: “Patient access is where providers begin collecting data, confirming insurance eligibility, and providing accurate patient estimates. Completing these actions successfully at the beginning of the patient journey, with compassionate and frictionless patient interactions, can facilitate payment and collections downstream.” A better financial experience in 2024 should include self-service and digital tools that guide patients through each step of their financial journey. For example, PatientSimple® gives patients a user-friendly, comprehensive way to generate price estimates, apply for charity care, set up payments plans and even make payments, all through a single web-based portal. Patient Payment Estimates deliver accurate pre-service cost estimates through the patient's preferred channels and point them toward any appropriate financial assistance. And of course, offering a wide range of convenient and flexible payment options will promote timely payments and maximize collections. Learn more about our revenue cycle management solutions or contact Experian Health today to discuss how we can support your strategies, based on our healthcare predictions for 2024.
Could common revenue cycle management (RCM) myths be preventing healthcare organizations from getting paid in full? Does what constituted best practice a few years back still apply to revenue cycle operations today? Many providers are embracing new technology to strengthen their RCM processes, using automations and software to create more accurate and efficient billing and claims management workflows. But if these processes are built on shaky assumptions, the results will be sub-optimal. As year-end financial reviews get under way, there is a prime opportunity to re-evaluate some long-standing beliefs about billing, collections and payments that, if not set straight, could limit financial performance in the year ahead. This article examines four of the most common revenue cycle myths and considers what providers can do to make financial growth a reality in 2024. Revenue Cycle Myth 1: All patients are equally likely to pay Reality: No two patients are alike – whether in their medical needs or financial circumstances. Providers know this, yet many rely on revenue cycle management solutions that lean toward a one-size-fits-all approach to patient payments. Instead, providers should consider RCM tools that use data and analytics to segment patients according to their individual financial situation, to create a more personalized and proactive approach to collections. This should take account of both the patient's ability to pay (i.e., whether they can afford their bills), and their likelihood to pay promptly, which may be enhanced by offering payment options that are convenient and aligned to their personal preferences. Collections Optimization Manager analyzes patients' individual payment history and demographic information so their accounts can be routed to the most appropriate collections pathway from the start. Patients that are likely to pay quickly can be sent billing information automatically and presented with self-service payment options. Alongside this, Patient Financial Clearance pulls together credit and non-credit data to help providers identify patients who may need a little more guidance and connect them to suitable payment plans. It catches any individuals who may be eligible for Medicaid or charity support. Staff get accurate, at-a-glance data to help them have sensitive financial conversations with patients, and can avoid losing time chasing collections from patients who would never have been able to pay. Case study: See how Stanford Health Care improved collections with a tailored, patient-focused approach to healthcare collections. Myth 2: It's hard to have meaningful pre-service financial conversations with patients Reality: Contrary to popular belief, most patients are receptive, and even eager, to have financial discussions with their provider as soon as possible. Doing so need not be challenging. In the past, providers may have worried that broaching the money question could deter patients from seeking necessary care, or simply not prioritized such discussions. Billing and insurance can also be highly complex, which may lead staff to assume that patients would find conversations about these issues to be confusing or overwhelming. But it is for these exact reasons that providers should have financial discussions with patients as early as possible. Experian Health's 2023 State of Patient Access survey found that almost 90% of patients wanted upfront pricing estimates so they could plan ahead for their financial obligations – yet less than a third received one. Tools like Patient Payment Estimates and Patient Financial Advisor can calculate cost estimates, taking account of the patient's claim history, deductibles and other insurance information, and automatically send these to patients before treatment so they know what to expect. These can also be combined with quick payment links so bills can be cleared before care. Giving patients consistent information through whichever digital channel they prefer means they will be better positioned to make informed decisions and discuss their situation with patient access staff if necessary. When patients are better informed and supported, they're also less likely to end up postponing care due to cost concerns. And with the same accurate data at their fingertips, patient access staff can serve as financial concierges, helping patients to understand coverage and copayments and check eligibility for relevant financial assistance programs. In addition to user-friendly data tools, providers should consider whether staff would benefit from additional training to bolster their confidence in leading compassionate financial conversations. Myth 3: It's impossible to know what patients owe across a system with a single look-up Reality: Thanks to data analytics and digital payment technology, it is now pretty straightforward to consolidate a patient's outstanding balance information from across an entire health system, and debunks common revenue cycle myths. Patient access staff can view a comprehensive summary of a patient's insurance status, estimated liability and open balances from multiple providers, enabling them to have meaningful financial conversations with patients. Even if these discussions do not lead to immediate payment, they can still act as a reminder to nudge the patient to act soon, thus accelerating the payment process. Selecting RCM tools from a single vendor makes it easier to integrate data from multiple workflows and generate a unified view of what a patient owes. When systems talk to each other, it's possible for a single tool to leverage the data and create a better experience for patients and staff. For example, PaymentSafe® automatically brings together data gathered throughout the revenue cycle to streamline what was previously a disjointed and time-consuming process. With point-to-point encryption, it accepts secure payments at any point in the patient's journey, using cash, check, card payments and recurring billing, through a single web-based application. Myth 4: Revenue cycle management is “set-and-forget” Reality: Revenue cycle managers may dream of setting up a system once and then forgetting about it, but the reality is that managing billing, claims and collections is an ongoing and evolving process that needs constant attention. Healthcare organizations must regularly review and adjust their RCM strategies to prevent missed revenue opportunities, manage compliance risks and promote operational efficiencies. That said, data analytics and automated revenue cycle management tools do make it far easier for providers to stay on top of RCM demands. These tools help providers with everything from monitoring payer policy changes and identifying billing errors to personalizing patient communications and generating monitoring reports. Artificial intelligence takes it a step further, for example, by preventing and predicting claim denials. In this way, these tools reduce the need for extensive staff input, so staff can spend more time focusing on the issues that need more human attention. With up-to-the-minute reports covering multiple RCM processes, staff also have the information they need to optimize performance and find opportunities to boost reimbursement that may have been previously overlooked. So, while RCM is not quite a “set-and-forget” process, automations and analytics can simplify it significantly, so it's less labor-intensive for staff and more efficient overall. Debunk revenue cycle myths and proactively challenge assumptions to increase profitability Debunking these revenue cycle myths is simple and achievable with tools that integrate a patient's clinical and financial data for a fuller picture of what that patient needs. This is crucial as changing consumer expectations, economic drivers, and new technology reshape how patients, providers and payers interact with one another. Checking underlying assumptions in any RCM process is essential to root out potential misunderstandings and outdated thinking. Not doing so leaves providers vulnerable to inaccurate financial projections, mismatched strategies and poor patient experiences. See how Experian Health's industry-leading Revenue Cycle Management Solutions make streamlined billing and collections a reality.
As retail and technology companies make moves in healthcare, existing providers must find new ways to attract and retain patients. Offering personalized patient payment plans is one way to meet evolving consumer demands and hold on to the competitive edge. The best part of this strategy? Providers can use data they already hold to deliver convenient and compassionate collections. Digital disruptors are driving a consumer-centric approach to healthcare payments Having transformed consumer expectations over the last decade, digital technology giants – along with a new generation of start-ups – are now actively pursuing a share of the multi-billion-dollar US healthcare market. Concierge medicine, on-demand virtual health and other personalized services are solidifying consumer expectations of flexibility, convenience and control. While consumers have more choice, they're also paying more for healthcare. Inflation-weary consumers are apprehensive about rising costs, and many report frustrations with healthcare billing and payment processes. According to a 2022 Gallup poll, nearly four in ten patients postponed medical care because of cost concerns. This tension between demand for choice and concerns about affordability leaves the sector vulnerable to disruption by players that offer alternative payment models that make healthcare more affordable for consumers, while making it easier to pay for care. Creating a more consumer-friendly approach to patient collections is essential for profitability. 1 in 10 patients use payment plans to manage the cost of care Research by Experian Health and PYMNTs shows that patients welcome payment plans to spread out the cost of care. One in ten patients had used a payment plan to pay for their most recent doctor's visit. Nearly three in ten older patients used a payment plan after receiving an unexpected bill. Unsurprisingly, those on lower incomes were most likely to need payment plans. Experian Health's State of Patient Access survey 2023 emphasized patients' desire for more flexible and transparent payment options, including pre-service estimates, payment plans and digital payment methods. Providers see the benefits too: around two-thirds of providers said their organization understands patients' unique financial situations and offers payment plans and financial assistance where appropriate. Using data to tailor patient payment plans For payment plans to work effectively, personalization is non-negotiable. Too often, payment plans apply a generic “one size fits all” formula to patient accounts, regardless of payment history, financial situation or other key indicators of the patient's ability to pay. This runs the risk of delivering a poor consumer experience while doing little to reduce patient bad debt. With a data-driven approach, healthcare organizations can identify the optimal plan for each patient. For example, PatientSimple® uses Experian Health's proprietary data and analytics to assess each patient's propensity to pay and guide them to the most appropriate financial pathway. A self-service portal gives patients a convenient way to generate estimates and consider different pricing plans, so they can make a more informed and confident decision about how to pay their bills. It also supports staff to have more compassionate financial conversations with patients. Similarly, Patient Financial Advisor and Patient Estimates give patients upfront, accurate estimates of what they're likely to owe, drawing on current chargemaster lists, payer contracts and the patient's insurance data. Together with payment plans, these estimates help patients avoid unexpected bills, so they have a more positive payment experience and are less likely to miss payments. A third tactic is to make it as easy as possible for patients to pay. Self-service and contactless payment options remove friction from the payment process, so patients are more inclined to pay promptly where they can. The patient's account data can be securely auto-populated into payment tools so they can pay and go with minimal fuss. Stay ahead of competitors by creating patient-friendly experiences As healthcare evolves, healthcare organizations need to develop strategies to remain competitive while still delivering compassionate care. Personalized patient payment plans are one way to strike that balance. Not only do they give patients the flexibility and convenience they’re looking for, but providers can also use existing data to tailor plans that benefit both company and customers alike. Alex Harwitz, VP of Product, Digital Front Door, at Experian Health, says these tools can help providers stay competitive as patients are exposed to a growing range of consumer-friendly healthcare services: “The move towards more patient friendly online experiences is a catalyst for improved price transparency. The challenge for providers is to adapt to shifting consumer needs while managing their resources wisely. But there's a major opportunity for providers to use data they already hold to help patients figure out the best financial pathway. Putting patients first is a sure-fire strategy to see patient satisfaction and patient collections rise in parallel.” Find out how healthcare organizations can remain profitable in an increasingly competitive market with personalized patient payment plans and patient payment solutions.
Humans increasingly benefit from the convenience of a self-service world. Thanks to the internet and companies like Amazon, online digital interactions yield an almost immediate result. It's a standard consumers have adapted to and unconsciously expect from every service provider, whether it's same-day grocery delivery or scheduling the next doctor's appointment. Today's gold standard for most services is a few clicks with a favorite handheld digital device. But when it comes to healthcare, sometimes expectations don't meet reality. Healthcare providers must accommodate patient expectations by opening a digital front door. Despite the complexities inherent in American healthcare, patients increasingly demand a frictionless online experience where they manage their care at their leisure. Clarissa Riggins, Chief Product Officer at Experian Health, says, “Patients have increasingly high expectations for easy and efficient tech-enabled solutions when it comes to accessing healthcare services. They seek convenient self-scheduling options, accurate cost estimates, and the ability to pre-register through their smartphones.” Understanding the need for a digital front door in healthcare Healthcare's digital front door is a set of online tools that enable patients to manage their care. These tools began growing in popularity during COVID, when the necessity of limiting physical interactions drove many patients to online healthcare alternatives. These digital encounters further increased patient expectations of a seamless healthcare experience from scheduling to service delivery to payment. Meeting patient demand for digital services Increasingly, the level of control that stems from online scheduling is what healthcare customers demand. Digital tools used to book appointments, register for care, and make payments are becoming a norm across the healthcare continuum. Survey results from the State of Patient Access 2023 found that some of the most important digital services for patients that drive a positive experience include being able to schedule appointments online or via a mobile device (76%), having an online/mobile option for payments (72%), and more digital options for managing healthcare (56%). Clarissa Riggins points out the gap between these expectations and the reality of most patient experiences, stating, “In general, findings seem to show progress has stalled when it comes to making patient access functions like scheduling, registration, coverage verification, and cost estimates more efficient.” Yet providers seem aware of their patient's interest in seeing more, not fewer, digital front door tools in healthcare delivery. The State of Patient Access 2023 report shows 86% of healthcare providers want their organizations to improve by adopting digital front door software. Riggins says, “But provider's motivation is not necessarily generating action.” Patients are growing frustrated; nearly half say they can't find appointments to fit their schedule, and 40% complain that even trying to schedule with a doctor is challenging. Today, 87% of patients perceive the across-the-board accessibility of their healthcare practitioners as a problem. Digital front door software is healthcare's solution to provider shortages, decreasing access, and our patient's on-demand scheduling requirements. Patients and doctors want digital front door software to increase access to care Patients are turning to providers who use automated solutions. Recent data from Experian Health and PYMNTS found that a third of patients chose to fill out registration forms for their most recent healthcare visit using digital methods, and 61% of patients said they'd consider changing healthcare providers to one that offers a patient portal. A prior study showed 44% of patients say they prefer to receive test results via a secure online hub. While staffing shortages certainly impact the ability to schedule care, Riggins points out, “Since patients associate 'access' with their ability to see a provider quickly, it makes sense that, without technology in place, staffing shortages will negatively impact the consumer experience.” It's a good point; nearly 40% of healthcare providers say technology solutions like digital front door software offset staffing shortages. Healthcare patients demand digital front door access and their doctors agree. But healthcare organizations are lagging in implementing these tools. Where is the disconnect? Eliminating the tedious human tasks that accompany manual patient registration, automating accurate price estimates, or offering patients one-click, convenient payment options, will free up staff to focus on key initiatives. Not to mention that these digital innovations will give patients and providers what they want. Perhaps the lag in implementing healthcare digital front doors occurs because these organizations find digital transformation daunting. But healthcare providers can work with a third-party trusted advisor with the right expertise to make the transition to digital front door software. Utilize mobile and self-service scheduling Experian Health specializes in opening healthcare's digital front door, beginning at the front door of any practice. Automated patient scheduling gives patients 24/7 control over when they visit doctors. Easy one-click functionality in a comfortable user interface allows patients to reach the right doctor at the best time for everyone. For providers, this kind of digital front door software alleviates the pressure on overburdened scheduling staff by moving these processes to a self-service online environment. Provide a better registration experience Experian Health's registration software also takes the next step, inviting patients through the digital front door by simplifying and streamlining intake. Healthcare organizations can create a better registration experience and increase patient booking with text-to-mobile registration. Two-way automated communications with patients decrease no-shows and engage patients at every step of their journey. For new and existing patients, automated cost estimates with easy payment options let them know their obligations to a healthcare practice, increasing co-pay collections while lessening burdens on providers and staff. Communicate costs upfront Communicating the costs associated with healthcare delivery is a critically important step toward improving patient experience. Experian Health's State of Patient Access survey found that nearly 90% of patients want an accurate pre-treatment estimate, but less than a third receive one. That's why Experian Health expanded their digital front door software to include tools like Patient Estimates and Patient Financial Advisor. These tools creates true price transparency between healthcare providers and their patients. Providing a patient with an on-demand, clear, accurate cost estimate for healthcare should be a standard part of the care delivery paradigm. These solutions automate this process so that every customer understands the costs associated with receiving care. The bottom line There is evidence now that patients want a digital front door to improve access to care. They want to retake control of their health and do it from their preferred digital device. Experian Health has a set of digital front door tools that brings healthcare consumers exactly what they want while lowering provider staffing costs. Adopting innovative digital solutions is no longer an “if” proposition; healthcare customers have shown they will seek out new providers if their scheduling, registration, and payment processes are not seamless. This shift in the consumerism of our healthcare services means that healthcare organizations face a strategic imperative to open the digital front door—or lose patients to the competition. Contact Experian Health to learn we help organizations open their digital front door with automated patient access solutions.
After a brief hiatus, the COVID-19 virus is reemerging, just in time for cold and flu season. According to the Centers for Disease Control and Prevention (CDC) July numbers show COVID-related hospitalizations are ticking upward. A spokesperson from the agency said this is the first notable acceleration of the illness in 2023. In these challenging times, healthcare providers prepare for the next COVID-19 surge. While the American healthcare system struggled just three years ago to cope with COVID-19 as a black swan event, these organizations now have the perspective that comes from hard-earned experience. They also have the potential benefit of time. It makes sense to take the lessons learned from the 2020 crisis and apply best practices to prepare for a COVID-19 resurgence. A new survey shows healthcare teams still struggling with burnout from the last COVID uptick. By leveraging technology and implementing best practices, providers can streamline processes, improve patient access, and alleviate burdens on healthcare staff. Let's explore how digital solutions such as online self-service scheduling, mobile-first registration, and patient portals can help healthcare organizations prepare for the next wave of COVID-19. COVID lesson #1: Online self-service scheduling offers key benefits for patients and staff During the previous COVID-19 outbreak, online self-service scheduling proved to be crucial in mitigating the spread of the virus. Not only did it improve the experience for patients and healthcare staff, but it also reduced the volume of visitors to emergency rooms and prevented sick individuals from congregating in waiting rooms. While self-service patient registration isn't just for a pandemic, COVID-19 clearly illustrated the critical need for digital patient intake solutions. A recent Experian Health survey showed seven of ten patients prefer self-service appointment scheduling. Forbes says, “Scheduling options are now a must-have feature for hospital and health systems…Health systems that do not offer online patient scheduling will not only be left behind but will be left out.” With the potential for an additional COVID upsurge in the future, health providers must also consider the benefits for staff of offering online patient scheduling options. They include: Fewer manual tasks associated with patient registration Real-time scheduling information that streamlines workflows Reduced patient no-shows Improves team communication and closes care gaps Automates unnecessary administrative functions COVID lesson #2: Mobile-first registration increases patient access and satisfaction The Experian Health State of Patient Access 2023 shows increasing the convenience of patient access is the quickest way to improve customer satisfaction scores. The survey showed access to provider care is challenging post-pandemic; four in ten say access has worsened because of scheduling. These challenges are always more daunting during high utilization—such as during the COVID-19 pandemic. As healthcare providers prepare for a COVID surge during flu season, adopting a mobile-centric registration accelerator solution can empower patients and streamline the registration process. Patients can complete registration safely and conveniently in their homes without spending time in a waiting room. Providers benefit from this online solution with reduced paperwork, automation of manual tasks such as appointment reminders, and a lightened workload. Implementing mobile-first registration not only improves patient satisfaction but also eases the burden on healthcare staff. Patients that use these solutions reduce practice call volumes by 50%. COVID lesson #3: Patient portals streamline communication and engage patients Harnessing technology to streamline processes and alleviate burdensome tasks is crucial. Patient portals are revolutionizing healthcare by empowering patients and lightening the load on the system. The pandemic accelerated the use of patient portals. In 2020, the National Institute of Health (NIH) found less than half of insured adults used these tools. Today, the usage of online patient portals such as PatientSimple is much higher—and on the rise. A recent national survey shows even seniors are getting into online patient portals to access healthcare information; 78% of people aged 50 to 80 now use at least one of these online hubs. Five years ago, researchers say just 51% of this population used these tools. Leveraging a patient portal now before cold and flu season makes sense. Patients can use patient portals to manage common tasks such as: Pay balances up front with an on-file credit card Set up payment plans View test results Generate price estimates View statements and test results online Apply for charity care Communicate with providers The latest research from Experian Health and PYMNTS says two out of three consumers use patient portals to “streamline the medical journey,” while the remainder say they'd use these tools if their provider offered them. Online patient portals increase access and convenience for healthcare customers. However, there are just as many arguments in favor of providers investing in patient portals to benefit their staff.As COVID-19 cases rise, patient portals serve as critical information hubs, streamlining communication between providers and the patients they serve. Self-service portals ease pressure on overburdened care teams and upfront administrative staff. They also integrate with electronic health records (EHRs), streamlining the flow of personal health information (PHI) between providers and patients. It's a more engaging and effective experience for patients that lightens providers' workloads. As we move toward increasing COVID cases this fall, patient portals will be vitally important for everyone involved in the patient journey—including the patients themselves. Learn how Experian Health is helping care providers streamline their efficiencies with digital software and prepare for the next COVID surge.
Could patient access software be the 'most valuable player' in healthcare? Experian Health's annual State of Patient Access surveys show an upward trend in the use of digital tools and software to help minimize the hoops patients must jump through to access care. In the most recent, 46% of providers said they expected to increase their digital investment over the next six months. The business advantages around increased capacity, reduced cancellations, improved data accuracy and higher patient satisfaction make a strong case for investing in patient access software. This article looks at how patient access tools can solve for some of the most stubborn problems in patient scheduling, registration and payments. Finding the formula for frictionless patient access Revenue cycle management comes down to minimizing service utilization while maximizing revenue potential. This starts with patient access. Efficient scheduling, intake and financial processes means more patients get better care, sooner – and providers get paid for their services without delay. Patient access software includes a range of digital and self-service tools that allow patients to complete administrative patient intake tasks with ease. Appointment management, patient registration, patient outreach, and patient estimates and billing are common use cases for patient access software. These solutions use in-depth data and automation to pre-fill patient information, check data for accuracy and completeness, tailor patient communications and accelerate workflows. Advances in AI and machine learning are creating new opportunities to remove obstacles in patient access and boost patient satisfaction. 5 problems that can be solved with patient access software 1. Painfully slow scheduling operations Problem: Too often, patient access processes are complex and time-consuming. Over time, small frustrations from errors, delays, and repetitive manual tasks can cause a significant decline in the patient experience. It's unsurprising that 56% of patients want digital options to manage care and speed things up. Solution: Patient access software makes it easier for patients to see their doctor without delay. For example, rather than being forced to call the provider's office and wait for an agent to check for an available slot, patients can use online scheduling software to book, reschedule and cancel appointments whenever suits them best. This also alleviates call center volumes, easing pressure on staff. 2. Error-prone registration processes Problem: Manual intake and registration systems are vulnerable to quality issues, resulting in denied claims, increased admin costs and delayed access to care. Illegible writing, incomplete insurance information and missing forms mean patients and staff must spend more time going back and forth to find and fix mistakes. And at the extreme end of the spectrum, data errors can lead to medical errors, with life-or-death consequences. Solution: Automated patient registration can pull patient data from reliable sources and fill out basic details ahead of time, reducing the need for manual data entry. Preventing avoidable errors in this way improves communication, workflows and profitability. For example, Registration Accelerator is a text-to-mobile patient intake solution that allows patients to complete appointment registration from the comfort of home. The patient takes a photo of their insurance card and driver's license, and then optical character recognition (OCR) technology automatically enters the correct information for insurance verification. The patient can review and sign authorization and consent forms, and confirm their appointments all at once, with just a few clicks. 3. Excessive (and growing) admin burdens and staffing shortages Problem: Patient access is admin heavy. This wastes valuable staff time and resources and diverts attention from patient care. With healthcare staffing shortages reaching emergency levels and patient volumes on the rise, providers must find ways to manage workloads while maintaining output. Solution: By automating administrative tasks and expanding self-service options, patient access software takes the pressure off busy teams. In Experian Health's survey, 36% of respondents reported that technological improvements offset staff shortages, by making better use of staff time and lowering operational costs. Automated prior authorizations are a good example of how digital tools can help tame the admin burden. This software generates real-time updates for multiple health plans, so staff no longer need to cross-reference individual payer policies and websites. It uses exception-based workflows and guided work queues to help staff prioritize their activities. Patient access tools can also issue performance reports, so staff can continue to find ways to work more efficiently. Cutting-edge technology also offers a less obvious but equally important competitive advantage – helping providers attract and retain high quality staff. 4. A patient experience that falls short of expectations Problem: Unnecessary administrative obstacles, unclear communication, and slow processes result in subpar patient experiences. More than 6 in 10 patients don't think their experiences have improved much in the last few years, despite the wider availability of digital patient access tools. Providers need a solution urgently, given that 56% of patients would switch providers for a better patient experience. Solution: With automation and self-service digital tools, providers can finally put patients in the driver's seat and deliver the patient-centered experience that has been promised for years. Patients say they want access and payment experiences to be convenient and transparent, with specific examples including: Accurate pre-care estimates Payment plans Digital payment options A multi-purpose portal Mobile access for scheduling, registration, communications and care Alex Harwitz, VP, Digital Front Door at Experian Health, says that while this list may seem daunting, providers have reason to be optimistic about delivering a better patient experience: “Patients want a lot from the digital front door, especially younger and digitally savvy consumers. Speed, convenience and compassion are through-lines in our patient surveys. As expectations increase, so does the pressure on providers to deliver. But the good news is that technology is advancing too. There's a wealth of patient access software ready to help optimize the patient experience. And you don't have to implement them all at once: Experian Health's patient access tools are specifically designed to work independently or in combination, for hassle-free implementation.” 5. Missed revenue opportunities Problem: Missed appointments, billing mistakes and operational inefficiencies lead to avoidable revenue leakage. A significant portion of denied claims occur earlier in the revenue cycle, so improving patient access processes should be top of the list when it comes to optimizing revenue. Solution: Revenue loss in patient access comes down to data errors, poor analytics and workflow inefficiencies. By leveraging the right software, front- and back-office teams can collaborate to resolve issues and enhance decision-making. Digital tools can also improve the patient billing and payment experience, so providers get paid promptly. Upfront price estimates, payment plan recommendations and one-click payment options can make it easier for patients to understand and pay their bills. Implementing transparent and empathetic billing procedures not only enhances patient satisfaction but also accelerates the collection process. With Experian Health's Patient Payment Solutions, providers can collect payments 24/7 via mobile, web and patient portals. Maximizing revenue opportunities while meeting the changing needs and expectations of healthcare consumers calls for smart patient access strategies. Find out more about how Experian Health's patient access software helps healthcare organizations lay the foundations for a solid revenue cycle and a positive patient experience.
Advances in medical treatments and technology are ushering in a new era of personalized healthcare. Each patient has their own distinct medical history, genetics, lifestyle and preferences, and it is increasingly clear that tailored care plans are essential to improve patient outcomes and elevate the overall experience. Personalized patient care has become more critical than ever, and is key to creating better patient experiences. Equally rapid transformations in data analytics, automations and machine learning have opened up new possibilities for non-clinical touchpoints in the patient journey. Providers can leverage digital tools to personalize everything from scheduling to payments, ensuring that patients get the right information at the right time. Targeted patient outreach and tailored payment plans are just two examples of how providers can use digital tools to foster better patient engagement without compromising efficiency – one patient at a time. Why does a personalized patient experience matter? Patient expectations have changed. Wearables, apps and a steady stream of health-related content on social media mean today's patients are better informed and increasingly engaged in their own health. They expect to be treated as equal partners, not as passive participants waiting to be told what to do by their doctor. Rather than one-size-fits-all communications, patients value proactive outreach and relevant reminders and prompts that help them move through their healthcare journey with as little friction as possible. They're also accustomed to “high-choice, high-convenience” digital experiences that tailor information to their specific needs and preferences. Digital consumer brands like Amazon and Google are moving into the healthcare space, leveraging their insights and technology to offer patients tailored medical solutions. To remain competitive in this changing landscape, providers must embrace a personalized approach to care. Aside from attracting higher patient satisfaction scores, a personalized patient experience also contributes to better health outcomes. For example, research shows that unclear post-discharge instructions result in preventable, unplanned, and high-cost follow-up care. Specific and relevant advice and reminders – communicated through the patient's preferred channels – can greatly reduce the risk of no-shows, delays and gaps in care. There are financial benefits too. As patients consistently report concerns about the cost of care, support to understand and manage bills can make a major difference in their propensity to pay. What does personalized patient care look like in practice? Clearly, there are practical limits to the level of personalization that can be offered. But with the right digital tools and data analytics, providers can segment groups of patients and deliver an experience that is sufficiently tailored so it feels like they have their own healthcare concierge. And rather than adding to the operational workload, the data analytics and automations that facilitate personalization can also streamline workflows and improve overall efficiency. In this way, tailoring the patient experience can contribute to a reduced manual workload, fewer errors and faster collections. Providers don't need to compromise efficiency for personalized patient experiences. Two specific areas that offer a high ROI are targeted patient outreach and tailored payment plans. Strategy 1: Targeted patient outreach Experian Health's State of Patient Access survey 2.0 showed that patients appreciate proactive outreach by providers, though many said this didn't always happen. With digital patient outreach solutions, communications can be tailored for different patient segments. Consumer data can allow patients to be grouped according to need, behavior and preferences, so they can be supported to move to the next step in their healthcare journey with ease. For example, patients with specific chronic diseases can be sent reminders for annual health checks. Those that may be due for regular cancer screening can be sent pre-appointment information. Providers can also engage patients with automated, timely messages through their preferred channels. At the individual level, self-service patient access tools and automations allow patients to book appointments when and where it suits them. Automated text message and interactive voice response campaigns can be used to issue links to patients so they can book right away. And automated appointment reminders are an easy way to ensure patients don't forget to attend, while minimizing the business impact. Strategy 2: Tailored payment plans and billing Patients worry about the growing burden of healthcare expenses. Generic payment plans that do not take account of individual patient circumstances can leave patients feeling unsupported and detached, so they're less likely to pay in full and on time. A more patient-centric approach can help patients manage bills and reduce the risk of bad debt. Digital technology can analyze patient financial information to anticipate the patient's propensity to pay and generate a customized payment plan. This should start with proactively issuing accurate estimates of the patient's financial responsibility. Patient Payment Estimates gives patients a simple breakdown of their costs, directly to their mobile. It draws on real-time price lists, payer contracts and relevant insurance details to maximize accuracy. Similarly, Patient Financial Advisor offers patients a text-to-mobile experience with a secure link to billing information, personalized payment plans and convenient payment methods. Those that can pay upfront in full can do so, while those that need a little more time or advice on financial assistance can be directed to the right pathway. Patient Financial Clearance helps determine the optimal payment plan by screening patients automatically before their appointment or at the time of service, to see if they qualify for charity support. Finally, offering a choice of payment methods rounds out a tailored financial offering. Personalized patient care: the key to greater patient satisfaction To sum up, integrating targeted outreach strategies and tailored financial support can help providers increase patient satisfaction, improve health outcomes and enhance financial performance. At the heart of a patient-centric approach should be a commitment to anticipating patient needs, by simplifying their healthcare journey and offering the flexibility and choice that have come to be expected. Explore Experian Health's suite of patient engagement solutions for more ideas on how to deliver a compassionate and personalized patient experience.
Compared to other industries, healthcare tends to be more resilient to economic turbulence. But the weight of the pandemic, labor shortages, rising costs and increasingly complex reimbursement structures are squeezing hospital margins. A Kaufman Hall National Hospital Flash Report in July 2023 found that many hospitals underperformed, and the gap between high-performing hospitals and those struggling continues to widen. Providers must find new and effective ways to improve revenue cycle management, should any new uncertainties emerge. With pressure mounting to increase efficiency and reduce expenses, more providers are turning to automation and artificial intelligence (AI) to eliminate unnecessary manual work and optimize revenue cycle management processes. For example, Stanford Health Care leveraged automation to reduce their cost to collect. Banner Health improved patient collections with transparent price estimates. Schneck Medical Center zeroed in on claims management and incorporated AI to reduce denials. In the face of a cashflow crunch, healthcare providers increasingly turn to data-driven revenue cycle management (RCM) strategies that span the entire patient journey. This article lists six of the most effective income-generating digital RCM strategies that providers are using to maximize profits. Building blocks of a healthy revenue cycle At its core, revenue cycle management is about ensuring providers are fully reimbursed for the care they provide. The true ROI is much broader – efficient financial and administrative processes for patient billing, claims management and collections contribute to better care, satisfied patients, high-performing staff and good financial health. Realizing these benefits calls for revenue cycle processes built on three principles: Efficiency – streamlining processes to reduce resource utilization across the entire billing cycle Accuracy – ensuring all patient and claims data is correct and complete to avoid denials and delays Transparency – giving patients, providers and payers relevant and timely information, so they can act with confidence in each financial transaction. To achieve this, providers are moving away from slow, costly manual systems. Digital RCM tools are becoming non-negotiable. 6 data-driven strategies for effective revenue cycle management 1. Increase efficiency in patient access Revenue cycle management starts when the patient books their appointment and ends when the final bills are settled. Claim denials and delayed payments often arise from data errors and miscommunications in the early stages of the patient journey, which means patient scheduling and registration processes are critical to streamline RCM. With automated, data-driven patient access tools, providers can simplify tasks across the patient journey, so patients can move from one stage to the next with as little friction as possible. Fewer errors mean delays and disappointment are more easily avoided. Automated registration and online self-scheduling can also lead to savings through more efficient use of staff time and reducing the number of appointment no-shows. Experian Health clients find that online tools allow them to make relatively minor adjustments to their workflows, with a major impact on productivity. 2. Deliver accurate and timely patient billing Patients want the payment process to be as painless as possible. In multiple surveys, Experian Health has found that patients are worried about the cost of care, while 63% of providers believe patients frequently postpone care because of cost concerns. Clear, comprehensive estimates, billing and collections practices can make it easier for patients to navigate their financial journey. And with the end of continuous Medicaid enrollment, it's likely that more patients will find themselves unsure of their coverage situation, and in need of greater support to manage the financial process. For Stanford Health, the key to improving revenue cycle management centered around patient billing and collections. To achieve the dual goals of improving the patient experience and increasing collections, they used data-driven insights and automation to remove uncollectible accounts, prioritize accounts with a high propensity to pay, find missing coverage and reduce the manual workload. Collections Optimization Manager helped Stanford Health identify the best possible collections strategy, by scoring and segmenting patient accounts with the highest propensity to pay. Coverage Discovery® supplemented this strategy by checking for any unidentified primary, secondary or tertiary coverages that can potentially reduce self-pay amounts and avoidable charity designations. As a result, Stanford Health achieved a $4.1m increase in average monthly payments and efficiency gains of $109k per month. 3. Provide transparent price estimates Experian Health's State of Patient Access 2023 report suggests that fewer than three in ten patients know how much their care will cost in advance, while nine in ten consider it important. Delivering accurate pre-care estimates to help patients plan for bills could therefore be an easy win to improve the patient experience and recoup more revenue. Banner Health used Patient Estimates as part of a wider strategy to improve patient collections. This solution generates detailed estimates of the patient's financial responsibility along with recommendations for payment plans and financial assistance, if appropriate. Listen in as Becky Peters, Executive Director of Patient Access at Banner Health, talks about streamlining the patient registration process and improving patient access with pre-care estimates. 4. Effective claims management Perhaps the biggest opportunity to improve revenue cycle performance lies in claims and denial management, which accounts for a major proportion of wasted healthcare dollars. Summit Medical Group Oregon–BMC paired Enhanced Claim Status with Claim Scrubber to submit cleaner claims the first time and avoid lost revenue. These tools help providers submit accurate claims and monitor claim status to prevent denials and resolve issues quickly. For Summit Medical Group, this led to a 92% primary clean claims rate, and a reduction in accounts receivable days and volume by 15%. Experian Health also offers a new solution that leverages machine learning and artificial intelligence for predictive reimbursement. AI Advantage™ uses AI to predict and prevent claim denials based on historical claims data. In the first six months, this solution helped Schneck achieve a 4.6% average monthly decrease in denials and decreased time spent on denials by 4x. 5. Easy ways to pay (plus clear pricing and payment policies) How easy is it for patients to pay? This simple but important question points to another vital element of effective revenue cycle management. A compassionate and convenient patient payment experience that matches consumer experience in other industries can encourage earlier payments. Easy digital options are especially important for millennial and younger patients: research by Experian Health and PYMNTS found that 60% of younger patients are looking for digital services. Experian Health's patient-friendly payment tools are designed to help patients navigate their financial responsibilities with confidence and ease. For example, PaymentSafe® allows providers to securely collect payments anytime, anywhere, including mobile payments and patient portals. 6. Operational efficiency with automation, data and analytics RCM processes generate vast amounts of data, providing valuable insights into the organization's operational performance, revenue trends and areas for improvement. Being able to parse and translate this data into actionable insights is essential to determine the right strategies to pursue to optimize financial performance. But this in itself can be a major lift. Revenue Cycle Analytics is a web-based tool that breaks down data into actionable insights across billing, reimbursement and payer performance, presenting KPI data via comprehensive dashboards. Effective revenue cycle management strategies from start to end From labor shortages to rising costs, healthcare providers are finding creative ways to manage cash flow. While each healthcare organization’s needs and goals are different, understanding these six key strategies of successful revenue cycle management can help hospitals manage their revenue cycles more effectively and efficiently, while responding to new uncertainties. Find out more about how Experian Health helps healthcare organizations leverage automation and AI to streamline processes and boost revenue cycle performance.