The continuing influence of consumerism in healthcare coupled with the escalating focus on outcomes has produced at least one constant in the ever-evolving healthcare market: increased competition. In fact, in just about any community served by more than one healthcare provider, competition for patients is at an all-time high.
But at a time when performance, if not survival, is based on how well an organization can contain costs, how do you differentiate yourself from the competition, yet do so in a fiscally responsible way that drives down healthcare costs?
You focus on your most valuable asset — your patient
It's well understood that patients expect quality care from their physicians. But, as they reach into their own pockets to pay more and more of their healthcare costs, patients want quality to be a part of their entire experience — from the first phone call to schedule an appointment through to the physician visit and post-visit contact.
The question then becomes: How do I re-engineer my organization in a way that enables it to drive better patient engagement and experience?
Focus on what you can control
Physician organizations fundamentally must concentrate on what is within their control: the ability to administer patient services in a consistent manner across all aspects of the patient encounter to ensure peak efficiency and engagement. Some of these services include:
Pre-visit
• Finding the right physician to meet care needs
• Scheduling office appointment
• Providing eligibility and benefits education
• Outlining financial policies and payment options
Visit
• Checking in/answering questions
• Setting up appointments with specialists
• Checking out/collecting co-payments
• Outlining financial policies and payment options
Post visit
• Sending patient bills and posting payments to accounts receivable
• Educating the patient on payer reimbursements and billing questions
• Setting up follow-up appointments
• Outlining financial policies and payment options
Improving these and other services across the patient encounter involves providing those who deliver such services and deal directly with patients what's needed to do their jobs better, so they can ultimately provide a better patient experience. This involves:
• Empowering staff to build patient relationships via consistent expectations
• Arming staff with processes and tools that will enable them to smoothly and efficiently lead the patient through their encounters
• Creating access to patient, clinical and financial information to enable staff to empower patient education
• Matching functions to expertise in order to enable staff to focus on tasks that are directly patient-touching
Five core processes of reengineering
Enabling staff to better serve patients requires reengineering how staff interacts with patients throughout their experience within the organization. This re-engineering initiative encompasses five core processes that should be executed in sequence:
Standardize — Patients should have a consistent experience across the patient encounter and across practice sites each time they interact with practice staff. Standardizing processes, such as the steps involved in scheduling an appointment or checking in a patient for an office visit, will create a smoother experience for patients. The patient receives the same message, understanding and comfort level throughout every step of each encounter with the practice.
Automate — Once processes are standardized, best practices can be identified and automated through technology to simplify processes and reduce the amount of time required to complete them. A manual process for determining a physician's next available appointment, for example, might involve flipping through a paper appointment book, or even a series of computer screens, which can be time consuming and may result in patient frustration. Automating the process will streamline the search, leading to a more efficient encounter and satisfied patient.
Consolidate — When implemented properly, standardization and automation will result in more efficient practices and the need for fewer resources, such as scheduling staff. A staff of 10 may be able consolidated to five; those five staff members can then be reallocated to more strategic positions, such as patient advocates, that further drive patient experience to a higher level. Likewise, technology may be consolidated by choosing one scheduling system to use across practice sites and discontinuing use of the rest.
Outsource — As organizations continue to economize, they will have to become better at maximizing resources. Standardizing, automating, and consolidating processes will help an organization determine how to best allocate resources to the right initiative without jeopardizing patient experience. For example, by outsourcing back-office, revenue cycle functions, organizations can shift their focus to those functions that interact directly with patients.
Reduce waste — Running a practice has become a risky and complex undertaking over time, and typically it is challenging for one organization to be an expert in every area of operations. Streamlining processes and reducing wasted efforts will help to control costs. By understanding how to match functions with expertise, an organization will reduce those steps within the patient encounter that get in the way of rather than improve the patient experience.
Overall, these steps work to reduce wasted time and actions in serving patients, so they can consistently receive the essentials required to solidify their bond and loyalty to your practice and physicians.
As a managing director in Navigant's Healthcare practice and leader of Alleviant, John Boland is responsible for delivering solutions that help physicians and physician organization maximize their overall financial performance. With over 20 years of experience in the healthcare field, he has specialized in revenue cycle management, practice assessment and operations, and he has designed and implemented solutions with many large health systems and physician groups in the country, focusing on process and business function as the building blocks for world class financial performance.