First Pst after migration to Cloud in Health care Blog

Knowing that clinical care accounts for only a portion of health outcomes, understanding how patients are affected by social determinants of health (SDOH) continues to gain attention as a critical factor in care delivery. COVID-19 has thrust the issue even further into the spotlight, with socially and economically vulnerable groups hardest hit by the pandemic. At the same time, the expansion of telehealth services over the last year has benefited some marginalized groups, who may feel uncomfortable visiting health facilities or may, for example, sometimes face challenges finding transportation to and from their visits. What’s clear is that when it comes to mitigating the impact of COVID-19’s lingering effects, patient identities based on clinical data alone simply won’t cut it. Providers need a holistic view of patients – both clinical and non-clinical.   Many providers do not have updated contact information for the patients they want to engage, in addition to missing patient-level insights such as housing, food, access to technology, transportation and financial stability data that could help better engage patients. Given the many complicated personal and structural barriers that may exist to accessing healthcare, providers lacking SDOH data in patients’ records are risking avoidable readmissions, unnecessary ED visits, poor care quality ratings and denied reimbursements.   Understanding patient needs and preferences via lifestyle factors – like occupation and technological knowledge – helps providers improve engagement, outreach and access. The results can be game-changing.   The benefits of an enriched, more robust patient record with SDOH Improved certainty of patient needs to achieve healthy outcomes Whether it’s missed appointments, lack of engagement, deferred treatment, or failure to comply with care instructions – if SDOH is the cause, providers need to know.  An enriched patient record that includes clearly defined SDOH risks and insights to those risks is invaluable.   For example, if a patient record includes recommended engagement strategies suggesting medication delivery, or ensuring medications are with the patient at discharge, due to the patient’s difficulty accessing a pharmacy, negative outcome risk is reduced. Significant provider blind spots that might otherwise interfere with desired health outcomes can be eliminated or extensively mitigated with access to this kind of data.   Consumer data gives additional insight useful in risk stratification efforts, allowing care teams to get granular and proactive if, for example, a patient’s lifestyle makes office-hour calls impossible, or if a lack of transportation requires the patient be informed that telehealth is available. Additionally, the data can flag if the patient prefers reminders by text, voice message or email. These considerations make a difference; 80-90% of modifiable contributors to healthy outcomes for a population are regularly attributed to the social, economic and environmental factors that comprise SDOH.   Connecting the dots can improve care coordination SDOH data doesn’t just help flag general access issues; it can also help providers dig into specific challenges that may warrant referrals to community programs or additional staffing support. SDOH data may lead to the discovery that a patient is struggling to access healthy, affordable food and prompt a conversation about getting referred to an in-network nutritionist or local food partnership.   Patient-specific information can be merged with consumer databases covering a range of socio-economic data, initiating proactive conversations with patients that can solve non-clinical gaps in care.   Clarity of the “why” behind patient insights, for better communication and engagement Someone experiencing financial instability as a result of pandemic-related unemployment will expect a different financial conversation than someone who has lived in poverty for their whole life. Further, two patients with high readmission risk can have completely different social determinants of health impacting that risk.  Knowing that patients are affected by SDOH is only one piece of the puzzle. Understanding the bigger picture helps create a whole picture and enables personalized, sensitive, and helpful communication.   A turn-key SDOH solution that helps define the “why” behind the score avoids analysis paralysis and enables a quick, effective engagement strategy based on what really matters to patients. Supplementing patient surveys with consumer data is also important, as it provides deeper insights and recommendations for engagement strategies.   Of course, a connected system only works when the patient identity is accurate and tracks them from service to service. With a universal identity manager, you can have confidence that your teams are all working from a complete, current and insights-rich view of each patient.   Find out more about how Experian Health can help your organization make sense of SDOH data for better patient identity management and a more personalized patient experience.  

Thanks to the global pandemic, providers were forced to re-imagine how healthcare is delivered beyond the four walls of a physical care setting. As they closed their doors to non-emergency and elective care, a massive shift in innovation, acceleration and adoption of patient engagement technology occurred, serving as a much-needed catalyst for digital transformation.     As industries like retail, banking, food, and airlines embrace digital experiences, healthcare should be no exception. The renewed focus on a digital front door strategy allows patients the flexibility, personalization and convenience they’ve grown accustomed to. It’s the beginning of a new age in healthcare where quality patient information is fundamental to delivering and exceeding patient expectations.   The New Age of Patient Information Patient identity is the backbone of everything in healthcare, providing the fuel for healthcare consumerization and the keys to the digital front door. As organizations focus on improving the patient experience, enabling patient access, and measuring and reporting performance, a patient identity strategy is core to enabling these enterprise-wide initiatives.   As patients seek care across multiple settings, both in-person and virtual, care coordination challenges increase without a single view of the same patient. Enter patient identification—paramount to ensuring patients receive safe, accurate, and personalized care. According to one estimate, matching within facilities can be as low as 80% — meaning that 1 out of every 5 patients may not be matched to all his or her records when seeking care at a location they’ve already received care from in the past.   The vision of an integrated, interoperable healthcare ecosystem starts with consistently and correctly linking disparate clinical and non-clinical data across silos to generate the single best, most accurate patient record. Having and maintaining a single, accurate view of the patient — the “golden record” — is critical to close gaps in care at the individual level, address patient safety concerns and revenue leakage associated with incorrect patient matching.   The vision of an integrated, interoperable healthcare ecosystem starts with consistently and correctly linking disparate clinical and non-clinical data to a single person. In AHIMA’s 2020 Patient Identification Survey, 22% of respondents reported they achieved a 1% or less duplicate error rate in their electronic health record (EHR). How does an organization successfully get there? It starts with resolution, enrichment and protection — the three pillars of identity management that are foundational to achieve the most accurate, comprehensive and secure view of today’s healthcare consumer.   Resolution – Confidently identify and match patient records & ensure accurate patient demographic data Enrichment – Update and enhance patient information for the most current, accurate, holistic patient view Protection – Authenticate a patient identity before sharing sensitive information     Enabling Digital Transformation Patient identity management can prevent medical identity theft, optimize the revenue cycle, reduce denied claims, prevent duplicate record creation and enhance patient safety – leading to improved financials and boosting bottom lines in the process. In today’s vastly connected world, consumers expect a seamless patient experience based on accurate and secure data. If other industries have long accomplished this undertaking, why not healthcare? In the New Age of Patient Information — a single, best patient view is required. Download our latest guide to understand where your organization stands within the three pillars of patient identity management and how to develop a roadmap for ensuring you have the most accurate, comprehensive and secure view of today’s healthcare consumer.  

Collections were tough even before COVID-19 hit. Provider’s bottom lines were already strained, and the high-deductible trend continued, putting patients on the hook for a bigger chunk of their medical bills.   A highly volatile – but improving – employment environment hasn’t helped, and some patients’ ability to pay hasn’t kept pace with their growing financial responsibilities. Many have new health plans, lapsed coverage or are more focused on other debts, making collections even less predictable. Providers may also feel that payer policy changes haven’t made recouping lost pandemic revenue any easier, with some losing two whole business days per week to completing prior authorizations. It’s no wonder that nearly one in five providers have overhauled their patient collections strategy in the last year.   Now, after a year of the pandemic’s impact on revenue, three dominant trends continue in this space: rising patient balances, an accelerated move toward innovative payment experiences that are moving toward digital engagement as a preferred option to paper or “payment at the counter,” and a realization that compassion is a key factor in solving this challenge.   Avoiding new pitfalls in patient collections   Go-to strategies for improving patient collections before the pandemic might have only included offering more patient payment options, doing more to check for missing coverage, or focusing efforts on patients who are most likely to pay. These are sensible options but, if implemented poorly, they’re more of a band-aid than a cure. Some shortcomings include:   Models relying on historical payment data don’t show the full picture Providers know that focusing their collections efforts on patients who are most likely to pay is the most efficient approach. But determining a patient’s ability to pay on historical payment data alone is likely to be unreliable.   Experian Health’s research suggests that when a collections model relies on historical data alone, around 50% of accounts end up being worked on the basis of no data at all. New accounts are assigned to a “highly likely to pay” segment, whether or not that reflects the reality of their situation. This model costs four times more than utilizing Experian Health’s Collections Optimization Manager, which can predict the ability of patients to pay, even without historical payment, by using multiple data sources.   Collections based on limited data will require more resources to work more accounts, but which ultimately will collect the same as collections based on multiple data sources.   Beware of artificial claims about artificial intelligence To streamline workflows and avoid losing staff hours to inefficient processes, many providers are turning to automated patient collection solutions. Artificial intelligence in healthcare is an exciting prospect, but not all solutions are what they seem.   Matt Baltzer, Product Director at Experian Health, says:   “Many collections tools claim to use artificial intelligence when they’re really using basic automations based on incomplete data. Since the quality of the output is only as good as the data that’s put in, the insights generated by these tools will be severely limited.”   To solve the collections workflow challenge, providers need an end-to-end strategy that integrates multiple high quality data sources, intelligent analytics and a responsive platform that learns and adapts in order to prioritize patients and communicate with them in a way that makes collections easier. Cash payments and price transparency can be part of, but not all of, the solution One way to smooth out a bumpy revenue cycle is to offer discounts to patients who pay in cash. It saves on admin costs and guarantees at least some of the bill will be paid. While this makes sense for minor ailments, admin and treatment costs for chronic conditions and major medical events remain persistently high. A resilient collections strategy needs to work across the board, addressing the many treatments, procedures and care plans that providers deliver and manage every day.   Requirements for improved collections, post-COVID-19 The cohesive, integrated model that providers need has the following key elements:   Multi-data sources for comprehensive analysis Optimal collections modeling uses different sources of data to build a more reliable prediction about a patient’s ability to pay. Combining credit data, behavioral modeling and socio-economic insights can help providers better understand their patients’ financial situation and group them accordingly – quickly and accurately.   Convenience and clarity for patients and staff Automated workflows with easy-to-use interfaces will make collections easier for staff, and eliminate time-wasting manual tasks. At the same time, a smoother, more targeted collections process means staff can engage with patients on the basis of accurate information, with fewer (and less stressful) calls and emails.   Advanced data analytics and automation for fewer errors and denials In-depth data analytics allow providers to screen and segment patients quickly to help prioritize accounts by payment probability, to achieve a higher rate of collections. A tool such as Collections Optimization Manager will evaluate collection performance in real-time, to help providers forecast patient payments and avoid bad debt. Expert consultancy support to stay on top of industry trends With the payments landscape in constant flux, having an expert on hand to help navigate the changes and advise on industry trends is a major asset. Experian Health’s team stands ready to help providers monitor and improve collections with industry insights and best practice strategies.   Find out how Collections Optimization Manger can help your organization avoid patient collections pitfalls and reduce lost revenue in the wake of the pandemic.