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The Vancouver Clinic was facing the same problems that all healthcare organizations grapple with: too many claims denials and too much bad debt. So, Paul Brown, the clinic's chief financial officer, turned to his background in manufacturing technology to see how his organization could find efficiencies. He used his experience and knowledge to inform his and the clinic's roadmap to implement change. The first step was looking at quality. In manufacturing, every step in the process is studied closely and tested to ensure absolute accuracy. Vancouver Clinic did the same. From a patient perspective, it wanted a seamless experience, including making appointments, reducing patient time at reception, ensuring labs were returned quickly, and making sure patients had quick access to any prescriptions they needed. Although the improvements Vancouver Clinic wanted to make originally were seen as a technology project, it quickly became evident that improving the process would also require training for staff and defining performance indicators. However, as technology played a key role, Paul reached out to Experian Health to implement some much-needed automation in the revenue cycle process. One big goal for the partnership was to improve revenue and collections, which is important as U.S. healthcare spending continues to skyrocket. Spending has reached $3.5 trillion, and Medicare bad debt adds up to more than $3.69 billion. Experts predict these numbers will continue to grow, and soon, the nation will spend close to 20 percent of the gross domestic product on healthcare alone. Vancouver Clinic was also grappling with these issues. It had higher-than-average claims denial rates, which cost the clinic $10.5 million each year. It also had higher-than-average bad debt of $3.5 million. The goal was to reduce that by 50 percent, and the numbers are going in the right direction. To get there, Vancouver Clinic took a multifaceted approach to implementing software solutions. One solution was Payer Alerts, which creates authorization updates that reduce errors and inconsistencies before claims are submitted. When they’re detected, the alert format is easy to read and understand so corrections can be made quickly. Other technology solutions included Eligibility, which simplifies the insurance verification process; Payment Safe®, which is an efficient and seamless way to process patient payments; and Claim Scrubber, which helps submit clean claims to payers and reduce claim denials. The results for Vancouver Clinic were quick and dramatic. Claims denial rates dropped more than 30 percent. The denial rate, which was around 14 percent, is now under nine percent. Vancouver Clinic also reduced bad debt through more efficient patient processing by ensuring the clinic has the right insurance and personal information on patients. By collaborating with Experian Health, Vancouver Clinic has turned things around and has already realized a reduction in claim denials and bad debts to save them $2.3 million. An additional benefit of implementing these software changes is the ability for patients to use the self-service portal for the clinic. It allows patients to get estimates for services, set up payment schedules, pay their bills, schedule appointments, and provide feedback to the health system. Giving patients the ability to take control of these tasks simplifies the process for everyone, reduces busywork for staff, and improves patient satisfaction. Another efficiency that was implemented for staff was revamping software work lists. By reducing the number of lists they had to manage, employees were able to streamline their work. In an effort to maintain and continue to improve efficiencies, several key performance indicators are monitored to ensure quality throughout every step of the process. In much the same way that manufacturing keeps an eye on each process along the way, Vancouver Clinic has sought to improve every detail to create a seamless experience for patients. Through its continued partnership with Experian Health, it is well on its way to getting there.

This time last year, the Centers for Disease Control and Prevention and hospitals across the country weren’t quite ready for the flu season, which turned out to be the deadliest in 40 years. The flu and complications arising from it resulted in the deaths of more than 80,000 people.   Hospitals felt the brunt of the 2017-2018 epidemic early. Hospital and medical center staffs were forced to work overtime, setting up triage tents and treating flu patients in recovery rooms. Alabama declared a state of emergency, and doctors in California had to treat patients in hallways.   Experts predict a milder flu season this year, partly due to an updated flu vaccine that protects against H3N2, which was the severe strain that dominated last year’s flu season. While it's hopeful that this year’s flu season will be better, it's always a busy time for hospitals and providers, so they should be sure they're using the most efficient healthcare IT solutions to streamline their workflow.   Greater efficiency is key   When it comes to efficiency, hospitals should take a cue from Martin Luther King Jr. Community Hospital in Los Angeles, which collaborated with Experian Health to streamline patient registration and insurance verification.   Before the collaboration, MLKCH had to consult websites and make phone calls to confirm a patient's insurance eligibility, which was time-consuming. The hospital has a large Medicaid and managed care population, which means employees had to consult both a state website and a health plan website.   The hospital also had a high-traffic emergency department and limited front-line staff to handle the incoming flow of patients. Additionally, employees performed manual quality assurance, which is a time-consuming task.   Understanding its challenges, Experian Health was able to help the hospital streamline its system to improve efficiency in insurance verification through Coverage Discovery. It also helped the hospital improve patient registration with Registration QA, which has improved data quality and patient registration accuracy.   Since MLKCH integrated Coverage Discovery and Registration QA into Cerner, it has saved precious time when it comes to validating patient and payment information.   “We have a lot of returning patients to our emergency room, so once we check that patient in, their eligibility automatically runs in the background and our staff doesn’t have to go into another website to check their eligibility," said Lori Westman, patient access manager at MLKCH. “This has saved us two to three minutes of our registration time.”   “We average about 300 patients every 24 hours,” she continued. “Heading into flu season, they're expecting to hit a 400-per-day volume, so the fact that we can take off two to three minutes at least on half of our registrations is going to speed up the work for the team that much faster, to have a turnaround time that much better for more patients to come through.”   Managing the season   Only 42 percent of Americans got a flu vaccine last year — painfully shy of the CDC’s 70 percent target. Misconceptions and fears about the vaccination and its effectiveness can keep people from getting it, which only increases the spread of the flu.   Flu season is always going to be a busy time for healthcare providers. But finding ways to manage staff and resources and work more efficiently is going to help hospitals and other facilities better manage the busy season.   Learn more about Experian Health’s Patient Access solutions.

  In healthcare, patient-facing technology and electronic health records are meant to improve the overall patient experience. Yet, in a recent Black Book survey, the limited use of these technologies by some organizations has diminished the experience for 89 percent of their younger patients.   More specifically, 69 percent of respondents said that dissatisfaction was due mainly to the discharge and billing process. A lack of transparency, confusion about what the total costs are, and borderline harassment from third-party collections agencies can ruin otherwise great experiences.   What’s lacking?   To achieve the level of engagement and transparency that consumers demand, hospitals need to offer more than just electronic records. In Black Book’s survey, 78 percent of hospitals aren't prioritizing investing in the IT necessary to offer more. That number is shrinking, though, as hospitals depend more on payments from patients.   A brief prepared by the Office of the National Coordinator for Health Information Technology showed a 10 percent jump in the use of IT, such as patient portals, between 2014 and 2017. However, 24 percent of patients won’t view their EHRs despite being offered access. Many cite privacy concerns, others see no need, and some just don’t know how.   While confusing and unclear billing processes can negatively impact the patient experience, the opposite is also true. When organizations make it easy for patients to understand and pay their bills, their patients are more satisfied with their experiences. That requires revamping both billing and customer service — the two most important avenues of engagement.   3 areas to improve   To achieve that goal, more healthcare organizations and hospitals are turning to online patient portals. They not only give patients access to their records, but also consolidate doctors’ and hospitals’ bills into single, easy-to-understand statements. This increases a patient’s ability and willingness to engage, as well as reduces a hospital’s risk of uncompensated care.   Still, patient portals don’t automatically translate to better engagement. They offer a wide range of features and interactions, but they can do little to positively impact the patient experience until organizations become more adept at optimizing them. In many cases, that means changing their approach to these three main obstacles:   1. Limited use   A recent Healthcare Financial Management Association survey revealed that 94 percent of organizations that use patient portals only use them to collect payments from patients. This is an important feature of a portal, but it’s only one of several equally important ones designed to create an entire experience for patients.   Most portals offer the ability to schedule appointments, receive accurate patient estimates, research and select different payment plans, communicate with care team members, and more. Organizations can use them not only to collect payments, but also to help patients be active participants in the administrative side of their care.   2. Limited interoperability   For a healthcare organization to make full use of patient portals and other health IT solutions, large amounts of data must be gathered from many different sources. For a single patient, that data can include financial information from credit bureaus, health histories from other institutions, and data from personal medical devices.   Limited interoperability makes it difficult for providers to centralize disparate sources of data, which hinders their patients’ ability to make full use of a portal’s features. By creating a portal around a more comprehensive IT infrastructure, organizations can improve their interoperability and, therefore, their patients’ overall experience.   3. A lack of self-service   In the HFMA survey mentioned above, 86 percent of organizations that responded admitted that a portal’s most valuable contribution is creating an intuitive, self-service environment for patients. The ability to schedule appointments and payment plans means organizations don’t have to cold-call patients to remind them of upcoming visits or past-due bills.   When hospitals make full use of a patient portal’s features, they can help patients manage their own accounts from home, work, or the doctor’s office. This level of self-service empowers patients to engage in their healthcare, reducing the likelihood of missed appointments, uncompensated care, inadequate patient experiences, and poor health outcomes.   The fact that more healthcare organizations are offering patient portal access is encouraging, but low patient interaction means they could do more to optimize that access for maximum engagement. Fortunately, the pieces are there; organizations just have to learn to adapt the rest of their operations to make it all fit together.   Start engaging with patients today.