The Evolution of Consumerism in Health Care Friday, January 19 th , - - PDF document

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The Evolution of Consumerism in Health Care Friday, January 19 th , - - PDF document

Championship Revenue Cycle: Passion & Purpose The Evolution of Consumerism in Health Care Friday, January 19 th , 2018 Gillette Stadium Clubhouse Aliina Hopkins, Managing Director The Advisory Board Company Joann Barnes-Lague, Director


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Championship Revenue Cycle: Passion & Purpose

The Evolution of Consumerism in Health Care

Friday, January 19th, 2018 Gillette Stadium Clubhouse

Aliina Hopkins, Managing Director The Advisory Board Company Joann Barnes-Lague, Director of Customer Care Shields Health Care Group Sandy Clay-Hillyard, Director of Patient Access Lowell General Hospital

Championship Revenue Cycle: Passion & Purpose Title Here

An Emerging Up-At-Night Issue for Hospital Leaders

Source: Howard P, “Power to the Patients: How To Increase Consumerism in Healthcare,” Forbes, January 13, 2016; Jain SH, “Getting Consumerism Right in Healthcare,” Forbes, October 1, 2015; Landi, H, “Is Your Health System Prepared for Consumerism?”, Healthcare Informatics, July 27, 2017; Zamosky L, “Healthcare reform law to usher in new age of consumerism,” LA Times, September 8, 2012; Evans M, “Value Shopping: Employers, payers and patients are looking beyond quality measures in their provider comparisons,” Modern Healthcare; June 23, 2012; Financial Leadership Council interviews and analysis.

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Championship Revenue Cycle: Passion & Purpose

Health Care Facilities Lag in Customer Satisfaction

8.59 8.52 8.41 8.35 8.33 8.28 7.89 7.88 7.82 7.73 7.71 7.71 7.66 7.55 7.39

Average Customer Satisfaction Scores

Average Score, 1-10 Scale1 Hospital executives for whom improving the patient experience is a high priority

90%

Hospital with established capabilities to improve the patient experience

30%

Most providers continue to take a reactive approach to consumer issues— responding to complaints as they arise—rather than proactively working to improve the consumer experience.”

Kaufman Hall Consumerism Report, 2017. Brokerage Auto Insurance Retail Banking Physician/Specialist Hotel Mobile Phone Airline Utilities Phone Postal Health Insurance Internet Pay TV Healthcare Provider (Facility)

Source: Cordina J. et al, “Winning with consumers: What payors can learn from ‘consumer’ companies,” McKinsey, 2013; Kaufman Hall, “2017 State of Consumerism in Healthcare: Slow Progress in Fast Times,” Kaufman Hall, 2017; Financial Leadership Council interviews and analysis. McKinsey Consumer Experience Survey, 2013. Customer satisfaction was measured on a scale of 1 to 10; includes up to three companies per industry per respondent.

Championship Revenue Cycle: Passion & Purpose

Higher Deductibles Driving Increased Price Sensitivity

Fail to Pay?

0% 20% 40% 60% Total Patient Obligation Likelihood of payment when patient

  • bligation is
  • ver $2,000 is

almost null

Shop Carefully?

56% 74%

Consumers with deductibles higher than $3,000 who have solicited pricing information Consumers searching for price information before getting care

3

Forgo Care? Spending Reductions Following Implementation of High-Deductible Health Plans

1

25%

Reduction in physician office spending

18%

Reduction in ED spending Low probability of collecting patient

  • bligation without a POS payment

1,2

1,000 $ 4,000 $ 2,500 $

2

Source: Brot-Goldberg Z et al., “What Does a Deductible Do? The Impact of Cost-Sharing on Health Care Prices, Quantities, and Spending Dynamics,” The National Bureau of Economic Research, October 2015, available at: http://www.nber.org; Altman D, “Health-Care Deductibles Climbing Out of Reach,” Wall Street Journal, March 11, 2015, available at: www.blogs.wsj.com; Financial Leadership Council, “Are You Asking for Enough at Point-of-Service?,” January 11, 2016; Financial Leadership Council interviews and analysis. n=382,288 patient encounters, 18 facilities. Analysis for a median performing facility, defined as collecting 26.5%- 71.7% of total patient

  • bligations when no POS payment is made.
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Championship Revenue Cycle: Passion & Purpose

Patient Debt Neutralizing Benefits of Coverage Gains

15.4% 8.6% 5.0% 19.0% 2008 2010 2012 2014 2015 2016 U.S. Uninsured Rate % Workers With Deductible>$2,000

Coverage Expansion Met with Rise in HDHPs

4.1% 3.1% 0.9% 4.4% 2008 2015 Patient Bad Debt Patient Payments Hospital Potential Revenue from Patient Obligations1

More Commercial Patient Obligations Going to Bad Debt

Households without enough liquid assets to pay $2,500 deductible

35%

Many Americans Lack Cash Flow to Cover Potential Out-of-Pocket Costs

Potential Revenue defined as the sum of Total Insurer Payments, Total Patient Payments, and Total Patient Bad Debt.

Championship Revenue Cycle: Passion & Purpose

Moving Beyond Price Shopping

Experience Drives Loyalty… …and Loyalty Drives Business

Percentage of top 10 loyalty drivers for primary care physicians that are related to experience (rather than cost or clinical quality)1

60%

Percentage of top nine loyalty drivers for specialists that are related to experience (rather than cost or clinical quality)1

66%

Revenue growth rate for companies with loyal followings compared to those without

2x >25%

Predicted increase in profits due to a 5% increase in customer retention

25%

Increase in customer retention resulting from an organization’s commitment to customer experience

6x

Amount of revenue generated by a patient who returns within 18 months compared to one who doesn’t

Source: “What Drives Consumer Loyalty to a Primary Care Physician?” Market Innovation Center, The Advisory Board Company, 2015; “What Do Consumers Want from Specialty Care?” Market Innovation Center, The Advisory Board Company, 2015; Coffman J, Yale P, “Would you recommend this hospital to a friend?,” Bain & Company, 2007; Reichheld FF, Sasser WE, “Zero Defection: Quality Comes to Services,” Harvard Business Review, 1990, 68:105-11; Murphy EC, Murphy MA, Leading on the Edge

  • f Chaos,” Prentice Hall Press (TR), 2002; Friedman F, “Do portals make patients more loyal?,”

Practice Notes, The Advisory Board Company, 2015; Financial Leadership Council interviews and analysis.

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Championship Revenue Cycle: Passion & Purpose

Consumer Strategy Extends to Revenue Cycle

Consumer Experience

  • Expanded capacity
  • Convenient sites
  • Navigable facilities
  • No-wait visits
  • Cost discussions
  • Respectful interactions
  • Customized payment plans
  • Compatibility
  • Reviews
  • Availability
  • Price transparency
  • Care coordination
  • Personalization

Convenient Access Durable Relationship Positive Encounter Transparent Search

  • Enterprise scheduling
  • Frontload payment
  • Comprehensive services
  • Frictionless transactions

1 2 3 4

 Do staff engage in respectful payment conversations with patients?  Do we offer customized payment plans?  Do we provide price estimates on

  • ur website?

 Do we provide price estimates during scheduling?  Do we frontload patient payment?  Is each point of financial contact professional and of consistent quality? Patient Financial Experience Checklist Transparent Search Convenient Access Positive Encounter Durable Relationship Championship Revenue Cycle: Passion & Purpose

The Patient Financial Journey

  • 4. Have my

financial

  • bligations

changed?

  • 1. Whom

should I choose?

  • 2. How much will I

have to pay?

  • 3. Why/what

should I pay now?

  • 5. What do

these bills even mean?

  • 6. How

can I pay my bill? Access Arrival Care Encounter Post-Care

  • Price

transparency

  • Affordable,

competitive prices Documentation and Coding Scheduling and Pre- Registration

  • OOP1 estimate
  • Insurance verification
  • Eligibility screening
  • Discussion of

payment options

  • Smooth

registration and POS2 collections Registration

  • Single bill
  • Easy to

access

  • Easy to

understand

  • Customer

service

  • Multiple

payment

  • ptions
  • Automatic

withdrawal Billing and Collections

  • Financial

counseling Denials Management The Patient Financial Journey Revenue Cycle Functions Requirements for a Positive Experience

Out-of-pocket. Point-of-service.

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Championship Revenue Cycle: Passion & Purpose

Shields Health Care Group

30+ Facility Radiology Group

  • Massachusetts
  • New Hampshire
  • Maine

5 Offerings

  • MRI
  • PET
  • CT
  • Mammo
  • Ambulatory

Six Sigma Driven Company

Championship Revenue Cycle: Passion & Purpose

Pedal to the Metal

Price Transparency Keep Patients Informed iPad Check- in Process

Price transparency is advertised on our website, educating patients on cost

  • f service in a user-friendly

way The registration process is hardcoded to ensure every patient receives an estimate or financial disclosure We have started emailing pre-service estimates and post-service balances to patients Our iPad patient check-in technology will help us streamline patient access processes and workflow, ultimately creating a seamless patient experience

Online Payment Option

Our online payment solution allows patients to pay prior to service, at the point of service, and after service.

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Championship Revenue Cycle: Passion & Purpose

Improving Collections

$886,000 $1,400,000 $2,600,000 $2,300,000 $3,900,000 $5,200,000 $5,700,000 $7,300,000 $- $1,000,000 $2,000,000 $3,000,000 $4,000,000 $5,000,000 $6,000,000 $7,000,000 $8,000,000 2010 2011 2012 2013 2014 2015 2016 2017

Collections

Collections

Increase in POS in 5 yrs

622%

Championship Revenue Cycle: Passion & Purpose

Lowell General Hospital

Our mission: Patients First in Everything We Do

» Part of Wellforce- Circle Health with Tufts Medical Center and Hallmark Health are setting a new standard for healthcare » Not-for-profit » Two primary campuses located in Lowell each with an ED, a Patient Service Center and medical and surgical inpatient services » Three Urgent Care centers located in surrounding towns » A series of satellite patient service centers throughout greater Lowell

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Championship Revenue Cycle: Passion & Purpose

Setting a New Standard

Financial Conversations Curriculum Educating Patients/ Engaging Staff PFR and Prior Balance Visibility

Patient Experience Excellence Registration and Eligibility Verification Estimation and Scripting Laws and Regulation Identify Inform Collect Document Connect pricing estimator with e-cashiering tool Connect prior balances with e-cashiering tool Offer payment plans through e-cashiering tool

Uninsured Patients and the 501r

AGB Financial Signage Website Financial Brochure 501r Discounts

Championship Revenue Cycle: Passion & Purpose

TRAINING

  • 200 team members
  • Multiple sessions/module
  • APR-SEP 2017

FY18  Q1 Cultural Competencies  Q2 Insurance Identification  Q3 Point of Service Collections  Q4 Metrics and Goal Setting

Creating a Curriculum

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Championship Revenue Cycle: Passion & Purpose

Discussion

Joann Barnes-Lague Director of Customer Care Shields Health Care Group Sandy Clay-Hillyard Director of Patient Access Lowell General Hospital Aliina Hopkins Managing Director The Advisory Board

Championship Revenue Cycle: Passion & Purpose