With Amazon's entrance into the healthcare sector coinciding with rising consumerism in the industry, hospital leaders are feeling more pressure to increase revenues while also keeping expenses down. When considering expanding patient access, it may seem obvious to add physicians or extend clinic hours, but doing so may drive up expenses and exacerbate physician burnout.
However, there are ways to improve patient access without requiring additional physicians or more hours. In an April 17 webinar, Mary Baker, chief clinical operations officer for Waukesha, Wis.-based ProHealth Care, and a Prism executive answered five questions related to expanding patient access and generating new revenue without adding providers or extending hours.
1. What challenges are associated with improving patient access for individual providers and medical groups?
At ProHealth Care, administrators and executives encountered several common challenges in their quest to improve patient access. One of the biggest obstacles was provider and staff burnout, which ProHealth uncovered as a significant issue in an engagement survey.
Other challenges included providers’ strong desire to retain control and personalized preferences, inconsistent data and definitions that resulted in variable approaches at the provider level, and insufficient infrastructure to support analytics and decision making. Limited technology and metrics inadequately positioned ProHealth to track its patient access improvements.
2. What are the most common drivers of restricted patient access for provider practices, and what impact do provider schedules and templates have?
As standalone practices merge into larger organizations, systems are challenged to address practice variables and variations in processes in newly acquired entities. "One of the key drivers of restricted patient access is schedule templates and provider preferences," a Prism executive said. "We have seen a number of very restricted preferences and [often] these preferences are developed over time for good reason. But this also leads to some restrictions around complex scheduling rules and algorithms. In a vacuum, these aren't problematic, but when you begin to manage over a large group … variability makes it extremely difficult for scheduling staff to support and manage schedules."
The Prism executive also touched on other key drivers, including not empowering staff to make schedule decisions and serving challenging patient populations with high no-show and cancellation rates. Some health systems and hospitals may be apprehensive about giving control and decision-making autonomy to different staff members; however, in allowing staff members to schedule appointments through a uniform system, the physicians and the hospital can ensure the scheduling is correct and does not disrupt day-to-day operations.
3. What are the benefits of improving access for patients, providers and hospitals or health systems?
"For patients, the benefits for improving access include [improved] satisfaction from easier and faster communication and access to services they need," said Ms. Baker. "Patients also experience shorter wait times to see their providers or a particular specialty, which then leads to greater loyalty from that patient to the healthcare system."
From a hospital and health system perspective, there are various benefits to improving patient access. Executives may see better optimization of provider productivity, increased revenues and more informed strategic decision making along with an expanded market share with greater visibility to determine demand.
"And finally, we try to make changes to patient access as provider-focused as possible," Ms. Baker said. "With improved patient access, providers receive more balanced schedules and [better workflow]. … In addition, we can make adjustments to schedules without interrupting a physician's day, and a provider's down time in the day is eliminated by an increase in productivity." Improved productivity can lead to additional compensation for many providers.
4. How can organizations enhance revenue by improving patient access?
"One of the critical success factors to improving patient access is generating financial benefit,” a Prism executive said. “As a patient is managed more effectively at the provider and system level, we see higher utilization of visit slots and fewer vacant slots. Additionally, simplifying templates allows staff to effectively manage more patients."
When providers are more productive and see more patients, the system generates more patient revenue. Health systems may also see staffing needs shrink as a result of consistent and clear rules for managing provider schedules. Centralized resources become more effective and efficient, and fewer staff can then support a more productive group of providers.
5. Which specific strategies and solutions can improve patient access?
"First, you can certainly enhance provider scheduling efficiency with consistent criteria and protocols," Ms. Baker said. "If you have the consistency with visit lengths and standard definitions, it makes the process easier at all levels. Additionally, limiting the number of times these processes can be changed, such as quarterly, allows the improved access to be sustained."
Other tactics to improve patient access include:
• Better utilize scheduling resources to manage provider schedules
• Reduce un-booked appoint slots and gaps on provider schedules
• Establish a consistent policy and process to manage practice closures
• Standardize utilization and protocols for advanced practice providers
• Reduce impact of no-shows and cancellations
• Engage physician leaders across the organization early and often
Involving physicians at all stages is essential to the success and sustainability of a patient access improvement initiative. "Having physician champions who can wrap their heads around the full scope of the issue and bring in other physician leaders throughout the organization allows for cohesive decision making and empowers physicians to drive change," a Prism executive said.
To view the webinar slides, click here.
To watch a recording of the webinar, click here.
To learn more about Prism, click here.