First Pst after migration to Cloud in Health care Blog

The U.S. is currently struggling with a critical healthcare labor shortage that is impacting every part of the revenue cycle. In fact, the American Hospital Association has deemed this challenge a “national emergency” that is only expected to worsen. Staffing shortages leave healthcare providers vulnerable to reimbursement delays, low morale and negative patient experiences.  As a result, many healthcare providers are leveraging automation to tackle this staffing crisis. Revenue cycle management (RCM) software and analytics can help providers navigate labor shortages by relieving staff of repetitive, process-driven manual tasks and improving operational efficiency. As healthcare labor shortages continue, how can providers maximize the return on their investment in automation? The snowball effect of healthcare labor shortages The first quarter of 2022 ended with a peak of 11.9 million open vacancies in the United States. Just about every industry is feeling the impact of the Great Resignation, driven largely by the fact that more people are reaching retirement age than are entering the labor market. In healthcare, the challenge of attracting and retaining top talent is felt even more acutely – in May 2022, the healthcare vacancy rate was 8.8%, second only to hospitality services. While the pandemic created greater pressures on healthcare staff, chronic understaffing and burnout were already a problem. Now, healthcare workers are contending with the snowball effect of increasing stress, sickness absences, lack of time to train new staff and loss of morale. Potential recruits may be tempted away to industries touting fewer COVID regulations, competitive pay, and more flexible and remote positions. Healthcare providers need smart and creative staffing strategies to close the gaps. Automation should be at the heart of HR contingency planning Providers may look to traditional market forces to solve the staffing challenge. Reducing services, increasing wages, improving working conditions and partnering with local education facilities to attract new staff are all on the table. But tight margins and inflationary pressures limit the options available, and policy changes can take time to be implemented. Automation can help mitigate healthcare labor shortages in three main ways. It can reduce the workload and increase staff capacity, improve operational performance and free up resources that can be reinvested in the workforce, and create better experiences for staff (and patients). Using automation to increase staff capacity Repetitive tasks that follow the same process every time are perfect for automated programs. Shifting the load from staff to software means that fewer team members are needed for those activities, and available staff can focus on more complex issues. Patient access is a good place to start. Many hospitals have already started to scale back care due to severe staffing shortages. Online scheduling and automated registration can ease the burden as patient volumes increase. These self-service tools cut down call center queues and eliminate labor-intensive data entry. With automated pre-registration, the correct information for each patient can be pre-filled and follow them throughout their healthcare journey, so staff no longer lose entire days spent resolving data input errors. Automation can improve operational efficiency, even with labor shortages Automation is more than replacing human effort with software programs: it also strengthens operational performance. Automated revenue cycle tools can complete tasks such as data entry, coverage checks, pre-authorizations and eligibility verifications much faster – and with fewer errors – than staff. If data-driven tasks can be completed with greater accuracy and efficiency, then the entire revenue cycle will move more quickly, leading to faster reimbursement. This is especially obvious when using automation to streamline collections. It doesn’t make sense for staff to pursue all past-due accounts, but with automation and advanced analytics, they can identify the patients most likely to pay and focus their efforts accordingly. Collections Optimization Manager uses multiple data sources to automatically screen and segment accounts, so staff doesn’t waste time chasing the wrong ones. Accounts are then distributed to appropriate collections channels using specific routing and recall rules. With a better understanding of each patient’s financial situation, staff can engage with patients in a more compassionate way and resolve issues without repeated calls and emails. Alongside this, automated patient outreach can provide personalized and convenient communications about patient collections. PatientDial frees up staff from time-consuming calls by providing automated inbound, outbound and blended calls with live agents or automated interactive voice response (IVR) services. “Queue callback” automatically calls patients back when a suitable agent becomes available, maximizing staff time while improving the patient experience. PatientDial also monitors agent performance so managers can make strategic decisions to improve workflow. Using automation to create better user experiences Existing staff may worry that increasing the use of automation could lead to their jobs becoming redundant. This isn’t really the case: while automation and artificial intelligence (AI) allow RCM teams to “do more with less” and reduce the need to recruit additional staff, they should be seen as complementary to rather than replacing staff. By removing time-consuming and tedious tasks, automation creates a better experience for staff. User-friendly interfaces give patient access, claims and billing teams all the information they need to help patients quickly and accurately. And as prior authorizations and payer policy changes change ever more frequently, staff will be relieved to hand over the task of checking each payer’s website to a software program that can complete the job quickly and accurately. Shifting to online and mobile options gives patients a more convenient and satisfying user experience, too. For example, automated self-service tools can be used to give patients upfront estimates about their expected cost of care, and link to convenient payment methods. It’s a quick win for providers who will find it easier to comply with new price transparency rules and makes it easier for patients to clear their bills faster. And the result? A happier workforce, a better patient experience and a healthier revenue cycle. Find out more about how Experian Health’s automated revenue cycle management solutions can help healthcare organizations build resilience and thrive in the face of healthcare labor shortages.

COVID-19 provided an unexpected use case for patient portals. In a matter of weeks, the benefits of remote patient access were undeniable. Patient portals allowed patients to schedule, register and pay for care from the comfort and safety of home. Now, as the latest omicron sub-variant triggers another surge in case numbers, providers are again reminded of the value in making digital channels available to minimize face-to-face interaction. With staffing shortages continuing and patient numbers rising, it’s worth recapping the benefits of patient portals. Why should healthcare providers prioritize patient portals? Here are 7 reasons: 1. Patient portals can be used to communicate safely with patients as Covid-19 cases rise Health officials may be cautious about reinstating extreme measures in response to the latest wave of infections. However, they can’t afford to be complacent about an uptick in hospital admissions. Patient portals can mitigate the risks associated with increasing foot traffic by allowing patients to schedule and register for care without attending in person. Completing paperwork from home eliminates the need for patients to share clipboards or sit in stuffy waiting rooms, while online scheduling platforms enable staff to manage the flow of patients safely and efficiently. Remote patient monitoring, secure messaging and online prescription refill requests can also be managed via portals, further reducing the need for in-person visits. 2. They can ease pressure on understaffed teams Providers need to find efficient ways to handle the administrative workload that comes with higher patient volumes. It’s even tougher given increasing retirement and resignation figures. More nurses are embracing the occupational benefits of remote and virtual care and are opting to switch from high-stress facilities to telehealth positions. While this speaks to the growth and impact of remote healthcare, it leaves a gap to be filled in hospitals. Patient portals can alleviate some of the burdens by reducing the need for staff input at various points in the patient journey. For example, online scheduling reduces the number of calls to call centers. Pre-filled data and automated registration can reduce the risk of errors during patient intake, which are time-consuming to fix. Portals can also be used to help patients navigate the payments process, speeding up collections and reducing the time staff spend chasing payments. 3. Patient portals can address inefficient patient access workflows Because patient portals are tethered to the patient’s electronic health record (EHR), they provide a hub for every piece of data relating to the patient. Patients can access that golden record at any time. They get an engaging and transparent experience, and are less likely to call up to ask questions – they already have the answers. They can also check data to make sure that it's accurate, which helps avoid the delays and misunderstandings that cause friction for patient access teams. It's important to ensure that the portal itself doesn’t introduce friction. Patients need to be able to enroll in the portal without too much trouble. Automating the patient enrollment process and implementing a multi-layered identity-proofing solution can create a secure and efficient way for patients to get the most out of their portal, without compromising safety or efficiency. 4. To improve patient engagement and meet consumer expectations One of the biggest reasons to invest in patient portals is because patients say they want them. Research from Experian Health and PYMNTS found that 44.1% of patients have obtained test results through patient portals, while 18% used patient portals to fill out forms for their most recent healthcare visit. Overall, two-thirds said they use patient portals. Beyond offering a convenient patient experience, this is also a matter of patient loyalty and retention: 61% of patients say they’d consider switching providers to one that offered a patient portal, which could have a significant impact on revenue. 5. They can boost revenue by offering easy ways to pay Experian and PYMNTS research shows that around a fifth of patients uses their portal to make payments. Unfortunately, 16% of those patients said they’d faced difficulty viewing invoices, setting up payment plans and making payments through their portal, which suggests some room for improvement. Experian Health’s Patient Payment Solutions solves these challenges. A range of self-service, mobile-optimized tools simplify the patient financial journey by giving patients upfront pricing estimates, personalized payment plans and easy ways to pay. 6. Using patient portals can improve health outcomes (especially for “frequent flyers”) Patient portals also play an important role in promoting better health outcomes for patients. Research shows that when patients have access to their medical information, they feel empowered and prepared to speak to their doctor and adhere to care strategies. Multiple providers can engage with the patient through the same platform, and see what other treatments are being prescribed. This helps improve communication between the patient and provider and helps improve care management. It’s especially useful for older patients and those with chronic conditions. In this way, portals support effective care coordination, helping value-based care providers achieve their goals of reducing healthcare costs, promoting population health and closing the gaps in care that have widened over the last few years. 7. Patient portals can support compliance with price transparency regulations Finally, portals offer a route to ensuring compliance with new regulatory requirements around price transparency. The No Surprises Act and hospital price transparency rule call on providers to give patients accurate, upfront cost estimates so they can plan for their financial responsibility more easily. Patient Payment Estimates can be delivered in several ways, including through patient portals. And as noted, once the patient has their estimate, they can also be directed to easy and convenient payment methods, including through their portal. Whether it’s a surge in COVID-19 cases, rising inflation, or labor shortages, providers must find ways to build resilience, stay competitive, and continue to offer patients the flexible and transparent healthcare experience they desire. Patient portals should be part of the plan to open the digital front door. Contact us to find out how Experian Health helps healthcare organizations deliver a reliable and secure patient portal experience.

According to the most recent figures from the Centers for Disease Control and Prevention, around 8.8% of Americans are without health insurance. While this has dipped since the pandemic high of 10.3% towards the end of 2020, it still leaves nearly 30 million people facing the often-difficult decision of what to do when they need healthcare. A further 40 million underinsured individuals could find themselves in the same position.  Do they pay for it themselves, avoid care altogether or seek financial assistance? With inflation on the rise and government pandemic support coming to an end, even those with coverage may need additional charity care support. Several regulatory efforts have been made to address healthcare affordability and increase transparency around charity care, particularly at the state level. For providers, the challenge is to find efficient ways to screen for charity care eligibility as more patients become eligible for support, and remain compliant as these new regulations come into effect. Why screen for presumptive charity? Eligibility for charity care depends on a hospital's financial assistance policy and relevant state regulations. Uninsured patients may be offered a full or partial discount on their medical bill, while insured patients may be awarded a discount on the cost of care. Without charity care, these unpaid bills would be tagged as bad debt, which could lead to patients being chased for payments they're unable to make and affect the provider's cash flow. To qualify for charity care, patients are often asked to share their household size and income, among other details. Often a provider will ask patients if they'd like to fill out financial assistance forms during patient intake, but many patients decline or are unable to provide the necessary information. Some may feel embarrassed about needing support or worry about how the information will be used. There may be language or literacy barriers. Some may assume they're not entitled to support and decline the forms. To get around this, providers use automated screening software to identify patients who may be eligible for charity care. This pulls together credit information, demographic data and financial details to determine whether the patient qualifies. Patients get the support – and thus the care – they need, and providers can focus their collections efforts on those who are most likely to be able to pay. Regulation 501(r) permits this type of presumptive screening by a reputable third party. What does the legislation say about charity care? As the use of presumptive eligibility screening has grown, several federal and state regulations have been introduced to encourage clarity, consistency and best practice. Providers must keep pace with changes to charity care policy or risk civil penalties or the loss of tax-exempt status. Under the Affordable Care Act, Regulation 501(r) requires hospitals that offer charity care to have a written financial assistance policy, specify maximum amounts that eligible patients can be charged, and determine a patient's eligibility before sending their bill to collections. Again, it allows for this process to be automated using a third-party vendor. Individual states also have their own requirements around eligibility screening, for example: In Washington, the legislature has recently voted to expand charity care eligibility as of July 1 2022 for patients who meet federal poverty level thresholds and have exhausted third-party coverage options. The new rules require hospitals to identify patients that might be eligible for retroactive Medicaid support and support them in applying for coverage. In California, the AB 1020 rule raises the income level for charity care eligibility to 400% of the federal poverty level. Hospitals must display online notices explaining their policy for financially qualified and self-pay patients. They must also wait 180 days before assigning unpaid patient bills to collections, and provide information to patients before doing so. AB 532 requires hospitals to give patients written details of patient charity care and discount policies at the time of service or at least before they are discharged. How can providers streamline the presumptive screening process? Automated presumptive screening can help providers comply with these new rules and implement their own financial assistance policies in the most efficient way. For example, Experian Health's Patient Financial Clearance uses current financial data to screen patients for Medicaid, charity care and other financial assistance programs in line with the provider's unique charity policies. It incorporates customizable logic that helps providers adhere to regulatory requirements and internal rules around charity care and billing. Screening happens automatically prior to or at the point of service, generating an estimated Federal Poverty Level (FPL) percentage for each guarantor.  A healthcare-based propensity to pay score can also be calculated, giving providers a further data point to work best with patients. This makes it easy for patient advocates to connect patients with the most appropriate financial assistance program, and even auto-enroll them. If the patient does have an amount to pay, they can be guided to the optimal payment plan for their individual circumstances. Patients can get direct access to screening qualification tools too, with solutions like Patient Financial Clearance. They can check their qualification status and upload documentation to qualify for discounted or free care via text to their mobile device. In addition to helping providers ensure regulatory compliance and document charitable services, this tool helps maximize collections and deliver a patient-centered financial experience. Providers should also check that their collections partners are aware of their obligations under charity care law, and ensure they're compliant, too. Keeping patients in the loop during charity care eligibility screening Clear communication is at the heart of a compassionate patient experience, fostering loyalty and trust. In the context of charity care screening, this means making sure that patients know that financial assistance may be available (now also a requirement under charity care regulations). In the past, some patients were not informed about how to apply for financial assistance and struggled with bills they couldn't afford. Others were assigned to charity care without their knowledge and spent months worrying unnecessarily about bills that would never arrive. Automated charity care checks solve both situations, by ensuring that no patient misses out on support to which they're entitled and by making it easy for providers to notify them. Patient Financial Clearance generates scripts for patient advocates to use during financial counseling discussions, to help patients navigate the financial process with greater ease. And with mobile text charity screening, the patient gets the information they need, right in the palm of their hand, so they can engage with the process more easily. Patient Outreach solutions can complement these activities by providing timely and personalized prompts and reminders through the patients' preferred communication channels. Not only will this enhance the patient experience and support compliance with charity screening rules, but it also helps improve patient outcomes by keeping patients on track with their care plans and driving down unnecessary readmissions. And for patients who do have an amount to pay, a payment experience that's tailored to their financial circumstances will further boost patient satisfaction and collections. The ROI on these tools can be significant. Let's say a hospital treats 1,460 uninsured patients per month. If just 10% of those patients qualify for Medicaid, at an average reimbursement rate of $1000, the hospital could claim $146,000 per month by ensuring those patients are enrolled – and avoid writing off nearly $1.8 million per year. As economic uncertainty continues to weigh on providers and patients alike, the pressure's on to streamline patient collections and prevent avoidable missteps such as non-compliance with charity care rules. Find out how using an automated financial assistance process with Patient Financial Clearance can create a safety net for providers and patients, increase collections and reduce bad debt as patient financial responsibility increases.