First Pst after migration to Cloud in Health care Blog

During this time when the whole world is wrestling with the Covid-19 crisis, planning for the future is difficult. However, there is no question that as the nation emerges from its stay-at-home status, there will be huge release of pent-up demand – especially for healthcare. Health systems have streamlined their operations to deal with the influx of COVID-19 testing and treatments. As a result, any non-emergent care or care unrelated to COVID-19 has been heavily gated, if not canceled entirely. This of course includes preventative care, non-critical regular screenings, and other services related to care gaps. Once the patient flow moves out of crisis mode, these services will certainly resume – and they will resume in earnest. This increased demand for services, coupled with the time lost to meet quality metrics, will place a real burden on member services and quality teams as they work to ensure missed preventative care, screenings, and other care related to care gaps are being sought and coordinated. It is possible to make small moves now to strategically prepare for what’s coming, so that when the crisis subsides organizations can be well positioned to serve their members. Here are a few key things payers can do to get ready: Get your data and strategy in order – Now is the time to use data to better understand your members and fill in any gaps you may have. For example, it is going to be essential to understand geographies and associated provider groups where care gap non-compliance is likely to be highest, so you can strategically focus on those areas. Also, understanding what the best channel of communication is and ensuring that you have accurate contact info for those members is critical. Fundamentally, plans will need data that can help them identify who to target and can supply needed, accurate contact info.Understand your members' SDOH barriers – Understanding your members' social determinants of health (SDOH) barriers will be more important than ever. One of the unfortunate byproducts of this COVID-19 crisis is the economic damage. As a result, there will undoubtedly be critical gaps, like transportation, that will affect your members' ability to access care and thus need to be accounted for. Likewise, with the downturn in the economy, additional social determinants will be on the rise, like food insecurity, housing insecurity, and access to medications. These should also factor into your overall plan – and thankfully there are increasing ways to identify and track SDOH.Implement digital tools now – Ensure your member engagement strategy is fully informed and your teams are ready to efficiently execute. While data can round out any information gaps that may exist for you – contact info, SDOH gaps, etc. – tools that can provide quick, convenient access to services will be needed to take action. For example, enabling your member engagement team with a digital scheduling platform that allows them to book appointments with providers without calling the provider, is a proven way to accelerate member engagement and close gaps in care. This type of digital engagement not only provides an efficiency gain, it also greatly improves the member experience as call times are shorter and members are given greater access to care. In times like this current pandemic it can be hard to think about much else beyond the here and now, and especially hard to picture a brighter future. But prudence would dictate that taking a little time now to prepare can make a big difference when things do start to open back up. Find out more about data driven solutions for member engagement.

In the span of a single week in March, more than three million Americans found themselves unemployed as a result of the coronavirus pandemic. With health insurance so often tied to employment, the spike in the number of people now without coverage is going to leave many both clinically and financially vulnerable. Even those who still have insurance may be unsure about what it actually covers – and whether they can afford their co-pays. Despite being busier than ever, hospitals are seeing revenue drop due to the cancellation of many services that generate revenue, in order to accommodate the existing or expected surge in COVID-19 patients. That revenue loss may be even more at risk going forward as patients struggle to pay. With many hospitals already operating at slim margins, the consequences of a rise in uncompensated care could be significant. Finding strategies to quickly and accurately identify coverage for patients amidst the chaos is critical. Providers need a collections process that’s compassionate towards stressed out patients, and efficient for staff to manage mounting caseloads in an increasingly complex collections landscape. How automation can help providers get COVID-19 covered Automating the coverage discovery process can help solve for many of the current challenges. Here are five use cases: Speeding up coverage checks for a changing case mix. With elective procedures cancelled, more hospital admissions are emergencies, where upfront coverage information may be missing. Add in changes to billing codes for added, changed and waived COVID-19 testing fees, and the collections process becomes a lot more time-consuming. Experian Health’s reliable, automated Coverage Discovery tool can help verify a patient’s insurance status quickly, and ensure the right bills are sent to the right place. Minimizing face-to-face contact during admissions. Social distancing means the admissions process is almost unrecognizable. Having software run coverage checks as soon as patients arrive will minimize the need for lengthy in-person conversations and help intake teams process patients much faster. Finding missing coverage, even when the rules are constantly changing. With many patients changing plans or switching to Medicaid or Medicare, it’s not always clear who should pay for what. Checking for government coverage and forgotten commercial insurance can eliminate expensive write-offs down the line, but it does take time. Coverage Discovery can quickly comb through available coverage, to find reimbursement options and give patients peace of mind. Sweeping for coverage information on telehealth services. Video and telephone-based platforms are the go-to solution for routine care right now. But billing teams don’t always know if calls should be charged at the usual in-person rate or not. With automation, payer updates can be checked upfront for any new references to telehealth and virtual care, so providers know what to charge. Making life easier for staff.When so many of the staff who’d normally check payer websites are now sheltering in place, homeschooling their kids or even in quarantine themselves, it’s unrealistic to expect productivity to remain high. Automation can reduce the burden by running high volume coverage checks, so staff can focus their attention where it’s needed most. Automated coverage discovery is no longer a “nice to have” Automation was already an attractive prospect for healthcare executives looking to “do more with less” and optimize their revenue cycle for the new quality agenda. In the current crisis, getting the information needed to secure reimbursements is even more urgent. By working with Experian Health, providers can use proven tools to check for missed coverage and reduce the risk of misclassified accounts. Experian Health’s Coverage Discovery generates millions of dollars of found coverage for hospitals when it’s business as usual. This could be exponentially higher in the coming weeks and months, as hospitals look for smarter ways to secure reimbursements. Find out more about how your organization can find missing coverage and streamline the billing process during the COVID-19 crisis.

Virtual and remote healthcare platforms really haven’t been a flashpoint of consumer demand. Basic portals have been available for a while, owing to the completion of healthcare’s years-long process of converting to electronic health records and regulatory encouragement. “Availability” was not evidence of use, however, and consumers have typically not rushed to register a portal account. That will change in 2020. Now, as most Americans stay home to limit the spread of coronavirus, we’re seeing consumers and providers show much more interest in patient portals and telehealth programs. Thankfully, it has become easier than ever to deliver virtual healthcare. The President’s national emergency declaration removed many barriers to the adoption of patient portals and telehealth, so more patients can access care remotely. In an editorial for the Kansas City Star, CMS Administrator Seema Varma said that as a result of these measures, “all Americans can receive telehealth services in their homes, through their smartphones, for any medically-appropriate purpose. This increased flexibility will allow the healthcare system to prioritize in-person care for those who need it most and minimize unnecessary use of personal protective equipment.” So, how can providers maximize the use of virtual healthcare channels – especially when health services are under increasing pressure? Raising awareness of the role of patient portals in response to Covid-19 Those who might not have engaged with digital life much in the past are now getting used to ordering food online and speaking to family on video and are likely to be more open to the concept of virtual care. Providers like the idea of telehealth and the efficiencies that come with it but are currently more focused on keeping people away from situations that may lead to infection – like a visit to the doctor’s office. That immediate need and consumers’ expanded interest may be the perfect scenario that creates a tipping point for telehealth – both in the immediate weeks and months ahead, as well as on an ongoing basis. Providers must make sure consumers are aware of digital alternatives, however, and be proactive in demonstrating how the patient portal makes their healthcare journey easier and safer. Consumers have no limits to the information they want about Covid-19. Portals are useful in communicating up-to-the-minute news and providing guidance around symptoms, testing and keeping safe from infection. Beyond the care focus, the portal presents patients with a convenient, private and full service means to handle payments, without any staff engagement required. Portals offer a sense of security, too, and – to protect patients from fraud – providers should take a multi-layered approach to protecting the portal, including two-factor patient identity verification, device recognition and extra checks where a log-in request looks suspicious. Positioning patient portals as the future of healthcare The coronavirus crisis stretches material and people resources to their limits. Using technology to gain efficiencies and reduce some of the workload through automation or patient self-help capabilities are critically important; patient portals are playing an increasing role to help manage the tremendous demands being placed on the healthcare system. But, beyond the immediate coronavirus needs, no one really knows what business-as-usual will look like. The Covid-19 response is challenging many deep-rooted norms around how we deliver healthcare. Managing the administrative aspects of health online will very likely become the default. As providers use patient portals to their fullest potential in the short-term, there is a huge opportunity to demonstrate the true value of virtual care – and transform the healthcare industry for the long-term. Find out more about how to optimize your patient portal to help your patients stay safe as they access care during the coronavirus pandemic.