1 proprietary & confidential creating the “ritz-carlton effect” in patient access maryland...
DESCRIPTION
3 Proprietary & Confidential Why?... Market Drivers 14 million access insurance through new exchanges or expanded Medicaid* $1,200 is the average annual deductible under job-based health plans $2,563 average Silver plan deductibles $5,300 average Bronze plan deductibles $6,600 per individual, $13,200 per family additional copays and coinsurance in 2015** In short, consumer-driven healthcare is here *Source: What to Expect in Round Two of the Health Insurance Exchanges, HFMA.org, Sept 2014 **Source: Kaiser Family Foundation, Medical Debt Among Insured Consumers: Role of Cost Sharing, Transparency, and Consumer Assistance, Jan. 2015TRANSCRIPT
1Proprietary & Confidential
Creating the “Ritz-Carlton Effect” in Patient Access
Maryland AAHAM ANI 2015
Daniel V. Hobbs, CRCE
2Proprietary & Confidential
So... How different are we?
3Proprietary & Confidential
Why?... Market Drivers
14 million access insurance through new exchanges or expanded Medicaid*
$1,200 is the average annual deductible under job-based health plans
$2,563 average Silver plan deductibles
$5,300 average Bronze plan deductibles
$6,600 per individual, $13,200 per family additional copays and coinsurance in 2015**
In short, consumer-driven healthcare is here*Source: What to Expect in Round Two of the Health Insurance Exchanges, HFMA.org, Sept 2014**Source: Kaiser Family Foundation, Medical Debt Among Insured Consumers: Role of Cost Sharing, Transparency, and Consumer Assistance, Jan. 2015
4Proprietary & Confidential
• Why can’t we have in health care what we have in other sectors?
GasBuddy: 121,000 gas stations and 160,000 places that vend fuelo 4 types of fuel
Health care:o 8,000 CPT codes, 12,000 ICD-9
codes, 1,000,000 providers/suppliers, 100,000’s plan designs, 430 MAS’s or 44,000 zip codes
– Demand for both price and quality information
Why? Price Transparency
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Pre-Service Collections
PreService Collections of Patient's Portions Last Year0.0%
20.0%
40.0%
60.0%
80.0%
100.0%
50.2%
49.8%
Reg./Check-in PreService
Pre-Service: Scheduling and Pre-Registration
(Collected: $870,000)
Patient Arrives Registered or Checked-In (Collected:
$880,000)
Before Patient Goes to Service Area there was a total Collected of $1.7
million (one year)
This is money collected during the Pre-Reg call)
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Processes
Improved Cash
Collection Performanc
e and Customer
Service
ED Financial Clearance
Improvements
Per-Service Collection
Scheduling Process
Improvement
PreRegistration
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Pekin Hospital Experience
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Patient Access• System wide Scheduling• Order Checking• Medicaid Roles checking• Charity Guide• Financial Assistance Screening• Doctor Checker• NOA/Precert• Patient Identity Verification• Patient Payment Estimator• Patient Payment Portal• Registration Quality Assurance
Patient Satisfaction• Press Ganey Scores• Healthgrades• Payer Web Sites• Communication Management System
Recording and scripting
Tools
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• “Why bother… we are a community Hospital and have to treat everyone!”
• “I like giving my customers the convenience of coming directly from the Doctors office for those small Outpatient tests!”
• “I’d like to preregister more patients but we have trouble catching them before they arrive for their appointment!”
• “We cant have the patient self-schedule, the doctor needs to know the test got scheduled!”
• “I cannot ask for money in the ER!”
Common Concerns
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The experience begins before the front door
Benefits of a centralized
model
Patient financial communication best practices
Recording and scripting promotes
more valuable communications
Monitoring and measure the
impact of change
Conclusion
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Contact Us
www.QHR.com | (615) 371-7979
Daniel V. Hobbs, CRCE
Senior Consultant
Quorum Consulting Services
615.483.7079
12Proprietary & Confidential
13Proprietary & Confidential