Tag: state of patient access

The delta variant is still surging – and flu season is about to begin. How can healthcare providers leverage innovative technologies to streamline care and prepare for a potential “twindemic?” The summer of 2021 has not been kind to healthcare professionals.  After a brief period of hope that the worst of the COVID-19 epidemic was over, the delta variant started its march across America, flooding hospitals and physician practices with a new wave of seriously ill patients. Autumn and winter look like they might be trouble, too, as delta joins forces with the seasonal flu to form a potential “twindemic.” After a mild season in 2020, many experts are predicting that the flu will reemerge with a vengeance this year as people return to in-person work and school. The combination of the two illnesses could easily overwhelm providers who aren’t prepared with technologies and workflows that allow them to serve patients efficiently and remain responsive to fluctuating demands. As providers look to navigate the coming months, they will need to make sure that they have self-service tools in place to keep patients safe and relieve strain on staff.  With a few key digital solutions, resources can be maximized, unpredictable patient volume can be managed effectively, and difficult circumstances won’t slow down operations. Online self-scheduling can improve experiences for patients and staff Online self-scheduling is in high demand because it provides flexibility. patients want to move on with their busy lives without having to sit on hold with a representative. In Experian Health’s recent survey, the State of Patient Access 2.0, more than seven out of ten patients wanted to take the appointment-making process into their own hands, citing the speed and convenience of choosing their own appointments. Providers and physician groups appear eager to oblige.  More than 70 percent of providers responding to the survey stated they are planning to offer online appointment tools to improve experiences and manage complex operations as the pandemic continues. The benefits for providers are significant.  Online self-scheduling can measurably reduce administrative burdens on staff, allowing practices to reallocate their people power to other high-priority tasks. Giving patients the tools to make appointments may also help to reduce patient no-show rates, which can drain billions of dollars each year from provider organizations. Using self-scheduling tools, patients with transportation issues or concerns about exposure risks may be able to opt for telehealth visits, as opposed to unplanned visits to urgent care centers or the emergency department. This can help protect other consumers and staff from illness while allowing them to manage their own calendars. Mobile patient registration keeps patients safe from exposure during a "twindemic" Shifting patient registration from the clinic to the home can also be beneficial for patients and providers.  When patients fill out new forms or update existing information in person, they increase their exposure risk by staying in the waiting room longer than necessary. In contrast, a digital registration accelerator solution offers a quick, touchless, and convenient intake experience on the patient’s own mobile phone.  Patients can complete the process in their homes (where they are more likely to have all their personal information at hand), or in the parking lot while waiting for clearance to enter the building. On the provider’s side, automating patient intake improves operational efficiency and avoids errors that come from illegible handwriting and verbal information communicated through masks and plexiglass.  Data integrity algorithms and real-time feedback for patients can correct mistakes quickly to ensure high accuracy of patient data – a crucial competency for treatment and reimbursement. Patient portals boost convenience, communication, and security As providers prepare to battle two illnesses instead of just one, practices shouldn’t forget to leverage one of the most important parts of the digital arsenal: the patient portal. Portals are instrumental for staying connected with patients, particularly with the 40% of patients who skipped medical care in the early months of the pandemic. As a complement to necessary in-person care, patient portals offer a convenient way to communicate with providers, complete administrative tasks, and access personal health information at their leisure. Providers must be certain, however, that their portals don’t become avenues for medical identity theft.  Healthcare organizations must maintain tight security policies that simultaneously deliver an optimized patient experience. A patient identify-proofing and authentication solution that automates patient portal enrollment while adhering to the high standards of HIPAA and other industry requirements is key.  Solid security can reassure patients that sharing digital health information with their trusted providers is safe - fostering more open relationships and leading to better care. Hopefully, fears of a “twindemic” will fizzle as communities continue to take sensible precautions against the spread of COVID-19.  However, if the flu does roar back into life, providers must be prepared. Self-service technologies and robust security measures can safeguard practices against the strain of higher-than-expected patient volumes and supporting the continued delivery of high-quality patient care. Learn more about how Experian can help your organization incorporate these new technologies and prepare for a potential "twindemic."

In November 2020, Experian Health conducted a survey to capture consumer and provider attitudes regarding patient access. At the height of the pandemic, patients welcomed telehealth services and maintained their distance from hospital waiting rooms. Providers scrambled to implement and provide digital services that would help them maintain quality care for their patients. In June 2021, we revisited these questions to see if healthcare providers and patients changed their views on the state of patient access: The pandemic has forced rethinking how to “do” healthcare in the digital age. Patients want flexible, convenient, and contactless care; providers need to continue providing these services. Download the white paper for the full survey results and get strategies to plan for the future of healthcare.

"93% of providers say creating a better patient experience remains a top priority, up 3% from last year." - Experian Health's State of Patient Access, June 2021 In November 2020, we surveyed patients and providers for their sentiments on how patient access changed because of the pandemic. During this time, patients welcomed the convenience and control that came with digital, contactless care. Providers knew they needed to improve their digital front door to withstand the financial impact of COVID-19, but implementation was difficult for many organizations. Six months on, and millions of immunized Americans later, the pandemic landscape shifted again. In June 2021, we revisited these questions to find out if patient and provider views have changed - in our State of Patient Access 2.0. Now, patients tell us they feel more confident about returning to facilities, though they still want the flexibility and convenience of digital scheduling, registration, and payment options. Providers feel a growing urgency to make sure online services are sufficiently agile enough to withstand any future surges in COVID-19 case numbers. The findings of the survey reveal four major opportunities to rethink how we “do” healthcare. By innovating and building on the digital advances made possible during the pandemic, providers can create better patient access experiences for the future. To start, providers should: 1. Match consumer expectations for convenient and flexible patient access Our recent survey shows that the pandemic has cemented consumer expectations around convenient access to care. Digital and remote channels for scheduling appointments, completing pre-registration, and making payments have become the new baseline in patient access. Nearly three quarters of patients told us they want to schedule their own appointments online. Providers know this: 93% say creating a better patient experience remains a top priority, up 3% from last year. Online self-scheduling can help providers continue to meet their patients’ demands for flexibility and convenient access to care. Patients can find, book and cancel appointments whenever and wherever they prefer. It’s also a win for providers, who can expect to see a drop in administration errors, no-shows, and denied claims. 2. Streamline prior authorizations as more patients return to care Interestingly, new data reveals that patients are less anxious about in-person care. In 2020, 40% of patients were uncomfortable coming into waiting rooms and seeing their doctor in person. Now, only 16% say they wouldn’t be comfortable in a waiting room. As more patients rush to reschedule deferred care, providers are faced with the challenging combination of higher patient volumes, patients jumping health plans as a result of job losses, and changing payer rules around prior authorizations and coverage checks. Automated pre-authorization and automated coverage checks can relieve the pressure, and help providers save time and resources. 3. Promote price transparency for fewer missed payments An encouraging piece of insight from our latest survey reveals that far fewer patients say they’ve been surprised by their final medical bill. In 2020, more than 50% received a final figure that differed significantly from estimates. Six months later, that figure has dropped to just 14%. Price transparency remains important, and the gap between estimated and final costs seems to be closing. More providers are offering patient billing estimates, with 9 in 10 agreeing that accurate estimates increase the chance of bills being paid on time. Many are also giving patients more options to pay bills earlier in the journey, which has helped to minimize the risk of late and missed payments. Easy and accessible digital options are featured heavily in acquisition and retention plans, and can help drive financial recovery. 4. Tighten up data strategies with better security, quality and insights While our first survey revealed that the sudden shift to digital-first patient access was a shock to the system for many providers, the second study shows that both patients and providers are settling into digital ways of working. But as these digital services become the new baseline, providers must make sure their data strategies are fit for purpose, and prioritize data security, quality and insights. Moving forward, a multi-layered approach will help providers authenticate and secure patient identities. When these identities are enriched with information about how patients are affected by the social determinants of health, providers will be better positioned to offer personalized patient access experiences and support marginalized groups. The future of healthcare is digital. Is your organization prepared? It’s clear from our recent survey that the digital trends that emerged in 2020 are set to continue throughout 2021 and beyond. Download the State of Patient Access 2.0 white paper to get the full survey results and explore how data and digitalization can power a 24/7 patient access experience in your healthcare organization.

  “The entire healthcare industry was turned upside down by the pandemic. Procedures were pushed back, insurance companies gave policy holders a lot of mixed information. It has been a mess.”   This is what one healthcare executive told us when we surveyed patients and providers on the state of patient access, in June 2021. Changing prior authorizations requirements were particularly messy, and as more patients return to care, there’s a risk they’ll become even more chaotic.   During 2020, many in-person healthcare services were canceled, delayed, or avoided for fear of infection. Now, patients feel more comfortable about returning for care. When we first surveyed consumers in November 2020, 58% said they’d wait until COVID-19 subsides before rescheduling. In June 2021, only 19% said they’d wait. Canceled procedures have dropped by half, and while the opportunity to recoup lost revenue is a relief for providers, processing prior authorizations for the sudden influx of patients is a worry.   Two thirds of providers say they find it difficult to keep track of changing pre-authorization requirements. Two in three also expect to face issues in securing authorizations for scheduled elective procedures, up from just over half last year. Embedding accurate and efficient workflows will be paramount as patient volumes rise, which means it’s time to rethink the archaic manual processes that often result in delays, errors, and non-compliance. Could automation offer a mess-free way to manage the growing challenge of prior authorizations?   Manually managed prior authorizations cost time, money, and quality of care   Even before the pandemic, prior authorizations were a thorny issue for healthcare organizations who wanted to offer the best possible care to patients, without risking denied claims. According to the Medical Group Management Association (MGMA), 80%-90% of medical groups say prior authorization requirements have grown year over year.   In an ideal world, prior authorizations protect patients from undergoing therapies that are overpriced, ineffective or unnecessary. They assure providers that they’ll be reimbursed for the services they deliver, and confirm that treatments are high-quality, evidence-based, and safe.   In reality, while prior authorizations can help incentivize value-based care, the admin and financial burden for providers is growing exponentially. Frequent changes, increasing denials, and lengthy negotiations with payers mean many providers need to employ additional full-time staff to handle prior authorizations. As the cost of drugs soars, they’re forced to lay out huge sums and cross their fingers as they wait to recoup the costs.   There was a hint of respite at the peak of the pandemic, when payers lifted many requirements, or extended authorizations already held on file. But these changes took time to filter through, and some providers continued to lose up to two entire business days per week to prior authorizations work during the pandemic.   Now, as the pandemic starts to settle, those requirements are back (and growing), and providers are scrambling to re-join the dots using their old, manual processes. As patient numbers surge, traditional manual methods for such an admin-heavy process are straining under the pressure. With so many accounts to authorize, the need for an automated solution is even more apparent.   Leveraging automated solutions for speedy, accurate prior authorizations To ensure patients get the care they need and to keep a lid on further revenue loss, hospitals and medical groups should consider tapping into automated authorizations engines. With an integrated Authorizations management system, you can initiate more authorizations in less time, run automated status checks to avoid rescheduling care, keep abreast of changing payer rules, and avoid unnecessary reworking of claims.   Users are guided through the workflow, which auto-fills essential real-time payer information. Patient information is populated by the SmartAgent feature, so pre-certification can be progressed quickly behind the scenes. Users only need to step in when clinical questions pop up. Notice of Care (NOC) generates a worklist of all pending patient encounters, to ensure that no payer notification requirements for notice of admission, observation or discharge are missed. Staff can escape the time-suck of repeatedly checking payer websites or calling up payers to verify yet again whether a patient encounter qualifies.   Say goodbye to Excel spreadsheets and lengthy calls to payers For organizations worried about rising patient numbers choking their existing manual workflows, switching to an automated system could be a timely move. Chasing paperwork is never a good use of resources, and with the lingering possibility of pandemic flare-ups, automated authorization inquiries could help minimize time spent on tedious manual tasks and running checks with payers.   Find out more about how Experian Health’s Prior Authorization software could help your organization minimize the risk of missed reimbursements, and give your team the breathing space needed to focus on maximizing support for patients returning to care.