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“With Coverage Discovery, Luminis Health can now find more billable coverage, whether primary, secondary, Medicare or Medicaid. Luminis can follow up immediately with payers when there is no initial real-time eligibility response available. Not only does this improve financial performance, but it also reduces manual work and minimizes errors before claims are filed.” Sheldon Pink, Vice President of Revenue Cycle at Luminis Health Challenge Luminis Health is a not-for-profit health system with an annual revenue of $1.2 billion and over 9000 employees. As one of the top three hospitals in Maryland (according to the U. S. News and World Report), Luminis’ vision is to break down barriers to health and deliver more high-quality care across the region. Finding and verifying insurance coverage for more self-pay patients was contributing to Luminis Health’s levels of bad debt. Staff relied on manual processes that were time-consuming and inefficient, and a vendor solution that did not integrate with Epic®. Limited productivity led to delays, denials and compromised patient experiences. To resolve these challenges, the organization’s goals were to: Create a positive patient financial experience by providing accurate and quick patient financial estimates Reduce bad debt by finding accurate primary and secondary insurance coverage Eliminate manual processes for following up real-time eligibility (RTE) responses with payers Reduce the number of self-pay patient accounts that end up in bad debt Solution With Coverage Discovery, Luminis was able to maximize reimbursement, reduce bad debt and improve the patient experience. Coverage Discovery finds additional active coverage that patients may have forgotten about. Using verified patient information, proprietary databases and confidence scoring, the tool scans for active coverage across the entire patient journey. This means no financial stone is left unturned before the patient is billed directly. By identifying coverage that would otherwise have been missed, Luminis can avoid misclassifying patients as self-pay, and prevent accounts from being incorrectly sent to bad debt or charity. Staff can focus on accounts most likely to be rebillable to insurance, rather than wasting time on avoidable manual rework. In certain instances when patients do not know they have secondary coverage, Coverage Discovery: Verifies patient demographics to ensure patient details are correct Leverages a range of proprietary databases (including Employer Group mapping) and historical patient search information to find insurance that may have been used and verified at other locations Applies a confidence scoring system to reduce the noise and eliminate “false positives,” so the client doesn’t waste time reviewing incorrect information or irrelevant coverage Outcome As a result of using Coverage Discovery, Luminis found more than $240k in active coverage on average per month in 2021. They reduced the number of self-pay patient accounts ending up in bad debt and created positive patient financial experiences by minimizing patients’ financial obligations. Reducing reliance on manual processes also led to fewer real-time eligibility responses from payers. Sheldon Pink reports that implementation was straightforward, thanks to Coverage Discovery integrating seamlessly with Epic® and support from the Experian Health team: “We’re impressed with these results and with the partnership with Experian Health. Luminis is looking forward to building on this success and continuing to collaborate with the Experian Health team.” Find out more about how Coverage Discovery helps healthcare organizations find missing and forgotten coverage, to improve financial performance and contribute to a better patient experience.

Nearly 40% of patients postponed medical care for themselves or a family member in 2022 due to cost. The percentage jumped 12 percentage points in a year, from 26% in 2021 to 38% in 2022, according to Gallup's annual Health and Healthcare poll. While this trend has clear ramifications for healthcare, it's also bound to affect revenue and collections for healthcare providers. Providers need to stay ahead of the curve when it comes to navigating staff shortages, decreased patient volume, and the range of financial problems patients are currently facing. Matt Hanas, Lead Product Manager at Experian Health, shared how providers can improve collections as patients postpone care. Q1: New studies show that many patients are putting off care due to costs. What does this mean for collections? “We're hearing about this very exact concern directly from our clients,” says Hanas, “and it's unfortunate to see patients put off medical care due to rising costs. Patients across our nation are struggling to balance where to allocate their hard-earned dollars, and they're having to make difficult decisions about whether to seek medical care or use that money on their everyday necessities. Meanwhile, healthcare providers are once again adapting to a shifting climate: “Clients are meeting this trend head-on with adaptable plans of action that allow for customizable contact strategies driven by automation and powerful data sources, using Experian solutions like Collections Optimization Manager,” says Hanas. “[Postponed care] doesn't have to be a heavily felt impact in collections if health organizations can quickly and easily adjust their collections strategies according to economic shifts, such as reduced patient volumes.” When volume is down, efficiency is key. “Experian's suite of products allows clients to utilize the tools and data we can provide to pivot on some of their outreach approaches,” Hanas says. “Segmentation results allow them to consider, for example, focusing on lower balance accounts with a consistent pattern of good payment history, or increasing collections efforts on higher balance accounts that may be harder to collect on. Having access to this data and following it is very key in preventing significant revenue interruptions during these patient volume shifts that we are seeing right now.” Q2: How can providers improve collections amid staffing shortages? “Automate as much of your workflow as possible,” Hanas advises. Automation not only reduces the need for staff intervention but also helps manage the complexity that comes with postponed care. Patients who have put off getting medical treatment may require more extensive (and expensive) treatment. If they've postponed care because of cost, it could be a sign that their finances are stretched. A complicated collections environment needs more than additional staff hours; it calls for data-driven insights and automation. “Visibility, powered by data, drives actionable workflows,” says Hanas, who points out that using solutions from Experian Health allows healthcare providers to accomplish more with fewer staff, including: Automatically pushing updates into an EHR system without manual intervention Setting up automated, prescheduled dialing and texting campaigns Prioritizing collections based on propensity to pay Adjusting scrubs and screens on AR files to remove accounts that are unlikely or unable to pay Sending text-to-pay message alerts Giving patients self-service payment options through online portals and mobile apps “I'm not saying you can completely replace the human touch throughout collections,” says Hanas. “But automation, data-driven insights, and user-friendly, self-sufficient payment collection tools can minimize the impact felt from staffing shortages by ensuring that staff collections efforts are efficient, and by offering patients that power, that freedom to use the self-service payment tools they are very eager and willing to use.” The return on investment speaks for itself. “Our collections solutions have a 9:1 return on investment ratio, based on clients' 2022 data,” says Hanas. “We think that's a pretty remarkable ROI.” Find out how University of California San Diego Health used Collections Optimization Manager and Coverage Discovery to increase collections from $6 million to $21 million. Q3: How does access to multiple sources of data improve collections success in the current environment? “Data gives our clients a compass that guides them very precisely, so they know which patients to focus on and what strategies to deploy,” says Hanas. “Experian is one of the largest data aggregators in the world, which benefits products like Collections Optimization Manager heavily—but it doesn't stop there. Experian Health doesn't rely solely on credit data; it also includes non-credit consumer data. We continually partner to grow our arsenal of data sources, so clients have a laundry list of solutions and products powered by this accumulated portfolio of data sources.” Here's how providers are using Experian's suite of collections solutions to help patients and improve collections efforts: Qualifying patients for Medicaid – “Data sources may show coverage that's been simply overlooked or forgotten by the patient,” says Hanas. “For example, Coverage Discovery has found a ton of Medicaid coverage for patients who simply didn't know they had it—or who failed to report it.” Recently, the expiration of the COVID-19 public health emergency caused millions of patients to lose their Medicaid coverage overnight.  In these cases, providing information to patients who are confused about coverage benefits both providers and patients. Hanas notes: “When we find patients are eligible for Medicaid coverage, they're really pleased to find out that their self-pay balances will be covered.” Filtering out difficult-to-collect accounts can improve collections – Screening can save providers valuable time and resources they might otherwise spend trying to collect from patients who are unable to pay. Hanas says, “Simply being able to identify that someone's address is not current or deliverable saves providers money on statement processing and postage—and saves them the trouble of attempting to send a bill that cannot be delivered.” Gaining insight into financial circumstances – “Our data gives our clients visibility into consumers' financial status changes—paying off a car loan or securing a new mortgage, for example, are things that our clients really need to know. By monitoring these financial status changes, our clients can increase or decrease their collections efforts based on what they see,” Hanas explains. Q4: How can providers support their patients who may need extra financial assistance? “Identifying patients who are eligible for charity care and other forms of assistance is probably the most rewarding use of our data, models, and algorithms,” says Hanas. “Patient Financial Clearance, which falls under the Collections Optimization suite of products, shows which patients may automatically qualify for charity. For those who do, clients can set up automation rules on the back end to automatically write off balances. This happens through a seamless integration, so it's virtually effortless. “Providers can also use the propensity to pay tool in Patient Financial Clearance to identify patients with a low likelihood of paying and offer payment plans that may help them meet their obligations. By having these conversations early in the process, healthcare organizations can keep more accounts out of collections and patients can receive medical care without having to worry about what's going to come after their visit.” The bottom line “Clients want to centralize their business operations around their patients and their care, to find the best approaches to looking after patients' health as well as their financial health,” Hanas says. “We don't want to send everyone who has a balance to collections: We want to use the different tools we have to assist them up front so they can get the medical care they need without feeling stressed and thinking about possible bills down the line. Learn more about how Collections Optimization Manager and Experian Health's full suite of collections solutions can help providers protect profits and drive revenue.

The digitization of healthcare hasn't necessarily translated to better patient access, according to recent findings. Shockingly, almost half of healthcare providers and a fifth of patients have reported that gaining access to care has actually become more challenging in the past two years. Despite significant technological investment, it appears there is still room for improvement when it comes to ensuring patients receive the care they need in a timely, efficient manner. Experian Health’s latest investigation into the state of patient access reveals that patients and providers are enthusiastic about maintaining the digital momentum, but still see room for improvement. The State of Patient Access 2023 – the Digital Front Door is the third in a series of reports that began in 2020. This survey looks at trends, challenges and priorities when it comes to patient access. The new report reveals findings from a survey carried out in December 2022 – which involved more than 1,000 patients and more than 200 healthcare providers across the U.S. As patients become increasingly tech-savvy, their expectations for a streamlined healthcare experience are evolving. It's no longer enough for healthcare providers to offer traditional services – patients now expect digital patient access services to be standard. Providers recognize the advantages of digitalization but remain sensitive to the operational challenges. This article highlights three areas of opportunity for providers to not only open their digital front door, but also secure a competitive advantage for years to come. The State of Patient Access 2023 report is based on a new survey, fielded in December 2022, that gathered responses from 202 healthcare professionals responsible for patient access and 1,001 patients who engaged in care for themselves or a dependent in 2022. It is the third survey in a series fielded by Experian Health since 2020. Opportunity 1: continue to expand digital options in patient access 56% of patients want more digital options for managing their care 69% of providers agree that mobile access is important to patients Both patients and providers want access to be streamlined and efficient. Providers recognize that patients are looking for more digital options, though some are concerned about their current technology’s ability to meet demand. This perhaps explains why nearly half intend to invest in digital technology in the next six months. Providers that leverage technology to reduce friction at patient intake will secure a competitive edge. Beyond delivering a better patient experience, providers see digitalization as a route to operational efficiency, increased capacity and better resource management. 36% of respondents are more optimistic about the state of patient access in 2023, thanks to technology offsetting ongoing staffing shortages. Opportunity 2: implement online self-scheduling to remove barriers to care 78% of patients who think patient access has worsened say the biggest challenge is seeing a doctor quickly 40% of providers have implemented self-scheduling within the past year Speed is the greatest access challenge for patients. In fact, “Seeing a practitioner quickly” has stayed at No. 1 on the patients’ “most challenging” list for the past three years, trending up every year. Patients that think access is worse blame slow scheduling processes, while those that think access is better attribute this to faster scheduling. Meanwhile, providers say that getting patients to engage with digital services so they can see a doctor quickly is their top priority. This points to a huge opportunity for providers to implement scheduling technology that closes this gap, since 56% of patients who think access is worse would switch providers because of this issue. Online self-scheduling gives patients the freedom to book and cancel appointments at their convenience, eliminating the hassle of picking up the phone or waiting on hold. Providers benefit from reduced administration errors, no-shows, and denied claims. With smart integration into scheduling protocols, every timeslot can be filled so patients can see their doctor sooner. Opportunity 3: simplify the financial experience for patients 26% of patients say paying for healthcare is worse than previous years 63% of providers believe patients frequently postpone care due to the cost of care A third opportunity encompasses the patient’s financial journey. Giving patients more power over their payment options is becoming increasingly vital. This is particularly true for younger generations who prioritize digital payment solutions. As these demographics continue to seek more convenient, flexible, and varied payment methods, it will be critical for healthcare providers to address these concerns in order to foster long-term patient satisfaction. Simplifying the experience with accurate pre-care estimates, early payment plans, digital payment options and patient portals means patients will find it easier to pay their bills. Price estimates, in particular, have become increasingly important to nearly 90% of patients; however, the survey reveals that less than a third of patients are actually receiving it before their appointment. This highlights the urgent need for healthcare providers to prioritize transparency and provide clear pricing well in advance. By adopting frictionless payments, healthcare providers can reap many benefits. One major perk is that patients are less likely to put off medical care when the payment process is simple and smooth. Not only that, but providers can expect to see faster collections and a boost in their bottom line. Plus, leveraging digital technology can streamline mundane back-office tasks, leaving staff with more time to focus on other important work. Embrace digital patient access to secure long-term patient loyalty Navigating the pandemic, staffing shortages, and economic volatility has been a bumpy ride for healthcare providers. But amidst the turbulence, one silver lining has emerged: the power of digital technology to enhance patient access. Experian Health’s three surveys show that providers have worked hard since 2020 to reduce friction in patient access, and are seeing the pay-off in higher patient satisfaction. But there’s still work to do. Providers that leverage technology to deliver convenience, transparency and potentially reduced costs to patients will be rewarded with loyalty, and better financial performance in the long run. Download The State of Patient Access 2023 – the Digital Front Door to see the full results.