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When was the last time you tried a new restaurant without reading at least one Yelp review beforehand? If you’re anything like the majority of American consumers, the answer is just about never. We live in an experience-driven world, after all, and whether you’re grabbing a bite to eat or trying out a new coffee shop, reviews are a great way to set expectations. But do patient reviews operate in the same way when it comes to hospitals? The answer is a resounding yes. Research shows that higher online ratings correlate with previously established metrics for evaluating hospitals, such as lower potentially preventable readmission rates. When it comes to overall satisfaction, patients are extremely perceptive, and they’re unafraid to share their opinions — good and bad. Yet Vanguard Communications found that about two-thirds of Yelp reviewers gave the top 20 hospitals rated by the U.S. News and World Report either a mediocre or poor rating. So where is the disconnect? One explanation might be that the areas assessed by U.S. News are too narrow. For instance, a hospital might rank highly for a certain specialty, bumping up its overall rating, but at the same time, its bill-pay system could be severely lacking, souring patients’ perception of the organization. Individual hospitals have the ability to assess all aspects of patient care — way beyond the scope of a top-20 list. The onus is on you to identify areas of improvement, and the best way to uncover hidden patient pain points is feedback.  And those pain points are more than just the bedside care received, but are often related on the financial experience. Creating a better experience At Experian Health, we don't focus on tackling every issue in healthcare; one of our specialties is helping healthcare organizations process and collect payment. However, that specific aspect of healthcare has a significant impact on overall patient satisfaction. In a recent study, Experian Health found the highest amount of opportunity for improvement is around the patient financial experience, which includes things like price transparency, understanding one’s ability for health payments, as well as options to pay for care. When it's easier for patients to pay their bills, they rate hospitals higher. Unfortunately, the first big obstacle in bill-pay is that patients often don’t understand what they’re paying for. Even if the quality of care was excellent, when a patient is unsure how much he or she owes, it’s all too easy to get frustrated and give a poor review. El Camino Hospital, a nonprofit hospital located in Mountain View, California, saw this problem play out with its own patients and, in response, made price transparency a major priority. Experian Health teamed up with El Camino to address this pain point. We debuted a self-service portal, allowing patients to access and manage a greater amount of data while still making account management, e-payment, eligibility, estimates, and billing information available. The most exciting element of the portal for patients and administrators alike was the addition of the patient price estimator, which gives instant estimates on a wide variety of procedures. The response to this tool was so positive that patients immediately began using it, even before El Camino promoted it. There was still room for improvement, though, so we worked to gather more patient feedback by incorporating a feedback survey into the portal. As surveys and comments rolled in, we discovered that patients were looking for a wider variety of services in the price estimator, so we’re now expanding the options. This consistent, patient-centered approach has shown tremendous benefits already. For instance, because availability to the portal is on demand, patients no longer need to directly contact the hospital for estimates, which typically results in a 24-hour waiting period. Because the call volume has greatly reduced, El Camino is now able to provide far more estimates in far less time. While El Camino Hospital's portal implementation is still in its early phases, other hospitals have seen impressive results with similar systems over a longer period of time. At Cincinnati Children's Hospital Medical Center, for example, they worked with Experian Health to revamp their online patient portal to make it more attractive and easier for patients to use. After the launch of their revised portal, online payments increased from $200,000 to $800,000, and patient billing satisfaction dramatically increased, as enrollment in their billing portal jumped from 900 to more than 45,000 families in a single year. The medical center’s patients now use the portal to ask questions of their healthcare providers, change on-file insurance information, and schedule or revise appointments. These features also reduce customer service phone calls and other related costs. The 3 steps of the patient feedback process When hospitals empower patients with access to their individual data and listen to their feedback, everyone wins. Patient feedback is essential at every level of implementing a new service to guarantee maximum efficiency. A successful patient feedback process includes these three steps: 1. Identify where feedback is needed. You don't need to harass patients for feedback on every single aspect of their hospital experience. Instead, look at which services would most benefit from patient insight; then, deploy surveys in those areas. Gathering feedback on high-volume services should be a priority simply because they affect the highest number of patients. Similarly, services that routinely trip patients up can only be clarified by directly asking patients what’s causing problems. At El Camino Hospital, creating the charge description master (CDM) was the first step in identifying where feedback was necessary. The list provided a convenient overview, so hospital administrators could easily pick out which services were high-volume or problematic and address them immediately. Whatever the method, pinpointing the services that are particularly troublesome for patients proves much more effective than trying to elevate the entire experience with no direction. 2. Make it multichannel. Feedback is often subject to selection bias, meaning a customer is more likely to write a Yelp review when he or she is either extremely pleased or extremely angry. Offering people several options for providing feedback increases the chances that you'll get a good sample size. You can gather patient feedback via polls using various methods, including text message, email, phone, and paper mail. El Camino Hospital chose to add an SMS feature, building a feedback function on its desktop interface while continuing to field phone calls regarding more complex issues. Its choice proved rewarding, and patient feedback rolled in. Limiting your feedback channels limits the amount and type of feedback you receive, so the more options that are available to patients, the more likely they will be to share their opinions and suggestions. 3. Identify patients who need help and offer it. Patient feedback is only valuable if you act on it. Once you’ve identified specific problems, reach out and offer a solution to patients who expressed concerns. In conjunction with increasing transparency, El Camino Hospital set a goal to identify and assist at-risk patient accounts. After gathering feedback and information on these accounts, El Camino integrated a medical billing fundraiser to lend a helping hand. From there, it created alerts for other at-risk accounts to spread the impact of the fundraiser. By responding to feedback, hospitals can respond to concerns before they become more serious problems, as well as anticipate patients’. If one patient encounters a problem, it's likely that several more will encounter the same issue — if they haven’t already. If hospitals aren't listening to their patients, they’re missing valuable insight into their problems and limiting their scope of improvement.

In an ideal healthcare world, third-party payers would always make payments accurately and on time. Unfortunately, human error is unavoidable, so missed payments and underpayments happen. Identifying and correcting these inaccurate payments often falls to healthcare providers, and without a strategy to make sure payers are complying with your contract terms, these errors are bound to cause stress and volatility to your revenue cycle. There are, of course, external causes of underpayment that a provider can't necessarily control, such as payers misinterpreting contract terms or incorrectly calculating a payment. Providers, however, can counteract this by limiting internal mistakes like incorrect billing or failure to provide appropriate documentation. Still, it’s easy to let incorrect or late payments slip through the cracks, especially without a robust contract management system. Experian Health's Contract Manager and Contract Analysis tools can help providers make sure they're reimbursed quickly and accurately. How Contract Manager and Contract Analysis eliminate payment problems Experian Health's Contract Manager for Hospitals and Health Systems verifies the amounts owed for all applicable claims, monitors payer compliance, and models the financial implications of proposed contracts. And because Contract Manager’s data processing and storage is completely remote, providers get 24/7 web-based access with no capital investments required and no added cost for software or data updates. Contract Manager helped Timothy Daye, director of managed care contracting and reimbursement at Duke Private Diagnostic Clinic, part of the Duke University School of Medicine, identify underpayments and discover ways to avoid them in the future. “In addition to identifying underpayments,” Daye said, “there’s tremendous value in identifying billing issues that may result in underpayments and also identifying process improvements that can be implemented to eliminate the underpayments in the first place.” Contract Manager alone can identify and prevent late payments and underpayments, but when providers pair it with its companion solution, Experian Health's Contract Analysis, they can find added data and negotiating power to set contract terms that optimize third-party reimbursement. Because you don’t have a crystal ball to predict how all of the hundreds of variables in third-party contracts will affect payment, you need a contingency plan. That's where Contract Analysis comes in. By spotting unfavorable contract terms and offering real-world “what if” scenarios, Contract Analysis tells you exactly how proposed contracts with payers might affect your revenue cycle. You’ll know before signing on the dotted line how each part of the contract will play out. The Contract Manager and Contract Analysis combination allows you to audit payer contract performance to ensure compliance and maximize revenue. You could, for example, use it to check the accuracy of a reimbursement by comparing the expected payment to the actual payment, or you could recover from underpayments by finding lost revenue with data-driven insight. Contract Manager and Contract Analysis can also help you identify unusual causes of underpayments. For instance, when Daye and his team were working on a recent anesthesia project, they had to correct a non-standard billing situation. “The payer was taking a reduction by billing the QS modifier, which is outside of the norm of standard billing protocol,” Daye says. “We changed that process through the appeal with the payer by showing documentation that the QS modifier was informational only and doesn't warrant a reduction in payment." Had Daye and his team not been able to identify this system issue, they’d still be scrambling to determine why the payment was lower than they were expecting. However, by using Contract Manager and Contract Analysis, Daye was able to pinpoint an outside-the-norm situation and correct the payment discrepancy as quickly as possible. What makes the combo unique The Contract Manager and Contract Analysis combination is essential for any healthcare provider wanting to ensure it receives payments that are accurate and on time. By using proprietary valuation logic, these tools will give you more precise insight into your contracts, giving you a solid foundation to protect against any payment problems. Experian Health reimbursement specialists even offer complete contract maintenance to make things easier. Whether it's a coding typo or a misinterpreted contract item, there will always be some factor that could cause a payment error. And while you can’t control some of these unforeseen hiccups, you can use Experian Health's Contract Manager and Contract Analysis solutions to correct them in the most reliable, efficient way possible.

Providers can improve the customer experience and bottom line with the power of data and analytics. Introduction In an increasingly competitive and consumer-driven healthcare marketplace, it’s no surprise that providers are working harder to acquire and retain customers. Higher out-of-pocket expenses combined with more choice and control in when and where consumers receive care are driving more retail-like shopping behavior. As a result, healthcare organizations are looking for ways to slow or stop customer churn, drive audience engagement, and redefine how they interact with their customers instead of seeing them through a clinical transactional lens. Providers understand that they must deliver a positive overall experience to maintain a favorable brand in the community and earn customer loyalty, key factors in maintaining their financial solvency. While there are many facets to consider in providing customers a great experience during their healthcare journey, there hasn’t been much attention paid to the intersection between the clinical and financial sides of this experience. According to findings from an Experian Health study among 1,000 consumers and select providers, the greatest pain points and opportunities for improvement around the complete customer healthcare journey center on the financial aspects, from shopping for health insurance to understanding medical bills. This means organizations that want to meet the new demands of consumerism in healthcare and improve the holistic customer experience must address the end-to-end revenue cycle. Typical consumer healthcare journey* *Consumers revealed 137 “jobs” or “needs” associated with their healthcare experience, with varied levels of importance, difficulty and satisfaction. Money matters give consumers high levels of discomfort Using a “jobs to be done” methodology, qualitative insights were gleaned as to the jobs, or microtasks and decisions, consumers associate with a healthcare journey. Despite the staggering number and complexity of different “jobs” consumers must undertake just to access the care they need, patients’ biggest dissatisfaction centers on the process of paying for their care. Of all the activities included in a consumer’s healthcare experience — from acquiring health insurance to making appointments with providers to receiving treatment — the top “pain points” relate to money matters. Specific issues for patients surveyed include: Understanding how much is owed for services and if the amount is a fair market price Making sure they have money available to pay for services Determining what financial support is available (e.g., a payment plan) Ensuring that what is owed to the provider is accurate Understanding the amount covered by their health insurance [click on image to enlarge]   Providers also feeling the sting from unpaid collections, lack of customer service   The most glaring opportunity for improvement in the patient experience comes early in the journey — price transparency. Patients are understandably confused about what their health insurance covers. They can’t always understand medical bills, and they have difficulty finding out how much their out-of-pocket charges will be and what payment options are available to them. Providers are also suffering — from unpaid collections, low customer satisfaction levels and an inability to address issues holistically. Here’s what providers had to say: We’re addressing the patient experience in one-off initiatives. Help us holistically improve the end-to-end patient journey. Providers said key impediments to progress include lack of clear and consistent prioritization, significant interoperability issues, and complicated organizational structures. They are frustrated by how hard it is to execute holistic changes efficiently. We need to measure our customer experience better. We want to standardize an approach that will drive progress and impactful change. Providers don’t have a clear path to move from customer experience as a concept to a measurable discipline. It’s a priority for them, but few are using a measurement system they feel is helping them understand and improve their patient experience. Patients are suffering, in part due to a lack of understanding of their charges. We want to set better expectations and make the charges and the value of our services easier to understand. Rising patient responsibility and the proliferation of high-deductible health plans drive the desire for full transparency in costs. Managing expectations at each step is crucial to providing the most accurate information to the patient. We’re not equipped to address customer acquisition and loyalty. Help us efficiently attract more consumers and keep them with us long-term. The focus has always been on healing people, with less attention to the business and marketing aspects of providing care. Providers need to focus efforts on acquisition and loyalty, but they’re generally understaffed and lack the skills to do so. There’s no doubt that healthcare organizations want to evolve and are thinking differently about how they deliver services and the value associated with those services. Ultimately, those that see driving customer engagement and redefining how they interact with their customers as a necessity, rather than a luxury, will succeed. Revenue cycle solutions for today’s consumerism environment    Where to start? Key areas that can be addressed in the healthcare financial journey include: Comprehensive data – One of the core components of a patient-centric revenue cycle begins with the ability to use reference data to address duplicate medical records, understand a patient’s propensity to pay and identify social determinants of health. Incorporating this type of outside data into the revenue cycle won’t just create better patient experiences from the moment patients begin interfacing with staff, it will also optimize revenue for health systems while enabling a revenue cycle that puts the patient at the center of care. Patient identification – As hospitals must now deal with hundreds of thousands of electronic patient records, spanning multiple systems and departments, the traditional technologies for managing patient information are no longer sufficient. Using sophisticated matching technology and outside data sources can improve patient identification and prevent duplicate or overlapping records that result in inappropriate care, redundant tests and medical errors — as well as improving data accuracy for clinical, administrative and quality improvement decision purposes. Insurance reconciliation – Organizations can use automated technology to monitor claims data, real-time eligibility and benefits information, payer contracts, and charge description master (CDM) information to ensure that payers are meeting their obligations fully and achieve accuracy and transparency in healthcare costs. Closing the gap in payer contracts and reimbursement allows organizations to focus on providing transparent cost estimates throughout every patient’s continuum of care and helps patients know their costs so they are better prepared to pay them. Price estimates – Providing accurate patient estimates is quickly becoming the norm for health organizations. But to ensure patient satisfaction rates are being met, health organizations need to empower patients with a frictionless financial experience. By incorporating credit data into the patient billing process, health organizations can enable a people-first product design to price transparency and collections that extends benefits to more people by understanding the unique financial needs of each patient. Self-service portals – One way to engage patients is with an online and mobile-optimized experience that’s proactive, smooth and compassionate to empower patients to set up payment plans, apply for financial assistance, estimate the cost of care and review insurance benefits. Conclusion   With so much to consider when addressing the evolving patient/customer journey, providers are well-served to start by improving their customers’ financial experience. As the link between customer satisfaction and a health organization’s revenue continues to grow, efforts to create a better financial experience are crucial. Using comprehensive data and analytics to power the revenue cycle and customer relationship management initiatives will allow health systems to encompass the end-to-end customer journey to ensure streamlined operations, measure and improve performance with payers, and provide accurate insights into each unique customer and their needs. The key to establishing this customer-centric mindset is embracing the power of data and analytics. From offering access to automated, personalized tools to providing price estimates to informing about charity aid options and offering payment plans — all these innovations help customers feel they can make better decisions about their care and how to pay for it. The result is more satisfied customers and an improved bottom line for providers.