Tag: Data and Analytics
Imagine being able to offer your patients a financial experience that doesn’t stress them out. That makes patient billing quick and simple. That knocks off a few minutes from each patient registration. And that even boosts your revenue. These are just some of the benefits attendees at last week’s Cerner Health Conference were considering as they discussed opportunities for faster innovation, smarter working and transformation in the future of healthcare technology. When it comes to working smarter, attendees seemed to agree that one aspect of the healthcare experience comes out top for providers and patients alike: the cost of care. This is especially true because patients are increasingly responsible for paying their healthcare costs. And since the way services are reimbursed is constantly changing, patients are often left in the dark about how much they’ll have to pay, or how they’ll be able to afford it. Patients are struggling under the weight of financial burden We know this can have serious implications for their physical, emotional and financial health. A recent survey by the Nationwide Retirement Institute showed that as many as one in three patients aged 25-45 are delaying medical care because they’re worried about the cost, instead keeping their fingers crossed and hoping that the issue will disappear by itself. A third shop around for better prescription prices, with many not taking their meds as often as instructed in order to save money. More than half of patients wouldn’t be able to afford an unexpected bill over $1000, while a staggering 530,000 families are bankrupted by medical costs every year. Healthcare providers often end up bearing the burden of uncompensated care, or waste valuable time and resources working to uncover missing or undisclosed coverage. Either way, all this wrangling for payment has a major impact on the organization’s bottom line as well as the patient financial experience. To tackle some of these challenges, we’ve teamed up with Cerner® to support healthcare organizations to provide more compassionate and convenient billing practices. At last week’s conference, we launched the Cerner Consumer Financial Engagement suite, a newly embedded experience within Cerner’s Consumer Framework that will optimize the billing process for both patients and providers, powered by Experian® data. 3 ways the Cerner Consumer Financial Engagement suite can optimize your patient collections One of the biggest pain points for patients when it comes to managing their healthcare bills online is needing to switch between different systems for different administrative tasks. This new partnership will let patients who use the Cerner Consumer Framework access and manage all aspects of their online healthcare account in one place, creating a more convenient financial experience. The new tool will help providers improve patient collections in three ways: Smarter patient engagement When you have insights into your patients’ financial circumstances and propensity to pay, you can make more informed decisions about how to approach collections and get them on the right program from the start. Using Experian’s industry-leading datasets, providers will be able to use the Consumer Financial Engagement suite to spot patients who may benefit from alternative payment plans or financial assistance and make personalized offers that are compassionate and relevant. Giving patients a one-stop-shop for managing bills Patients are coming to expect a better experience – similar to what they might see in online retail and financial services. When it’s easy for them to settle their bills, they’re more likely to conclude their healthcare journey on a positive note and feel reassured about sticking with your organization the next time they need care. With an all-in-one patient dashboard showing current billing information, insurance deductible status, transparent cost estimates and tools to activate pay plans or financial assistance, the Cerner Consumer Framework creates a frictionless and transparent billing experience, leading to fewer late or unpaid bills and more satisfied patients. Simple and efficient collections When it comes to payments, proactive communication can help ward off some of the sticker shock that comes with unanticipated treatments and bills. The new financial engagement tool uses a simple interface that makes medical billing clear and quick for patients. When consumers aren’t put-off by the technology, they’ll be more likely to act promptly to get billing out of the way. In addition, providers will be able to add their own branding, so the patient experience is consistent from start to finish. Creating a positive patient financial experience powered by reliable data In today’s climate of increasing costs, big data and healthcare consumerism, data and analytics are now the driving force behind an efficient revenue cycle. Person-centered healthcare services that prioritize quality and patient outcomes should be a given, but the financial experience is an integral part of the total equation. This is especially true when we consider that the three biggest pain points for consumers during their healthcare journey are all related to payments! Learn more about how data-driven technology, such as the new Cerner Consumer Financial Engagement suite, can help you offer patients a better financial experience and optimize revenue at the same time.
When nearly 80% of health outcomes can be traced to non-medical social and economic factors, we need to look beyond the medical world to improve them. Perhaps a lack of transportation prevents a patient from attending an appointment, or juggling two jobs makes it difficult to collect a prescription. Maybe a patient’s care plan calls for lifestyle changes that are simply unrealistic in their current circumstances. When life gets in the way, there’s only so much the physician can do. Creating and maintaining a healthy, happy population truly takes a village – from your clinical team to the community resources around your organization. For many healthcare providers, there’s probably a lot more going in their ‘village’ than they realize. Do you know who your patients really are, beyond their lab tests? Do you know what nearby services are at your disposal to help you offer the best possible care? Knowing your patients and your health improvement ‘village’ means you can offer a personalized experience to your patients, to improve their care management and ultimately help them achieve better health outcomes. 3 ways to tailor care management for better patient outcomes Let’s imagine two patients, who have both recently broken their wrists and been treated in your facility. Gene is 71 years old and David is 34. From the clinical perspective, it might be reasonable to assume that David, being younger, should simply receive discharge directions and a time for a follow-up appointment, and be on his way. Gene, being older, might require a series of follow-ups. But thinking of the village analogy, is there more you could learn about Gene and David to engage with them in a way that’s tailored to their specific needs? Here are three ways social determinants of health data can help you do just that. Use non-clinical data to get to know your patients Non-clinical data can help you learn more about your patients and the lifestyle factors that might affect their health. This allows you to address issues like excessive healthcare utilization, preventable readmissions, no-shows and low patient engagement. Surveys at the point of registration are one way to get fresh socio-economic insights. But these can be cumbersome to implement, and findings can be limited by the nature of the questions. You might also review geographical and community-level data to discover your local population’s income, housing situation, employment status, and so on. This can be useful for population-level care planning, but it’s not patient-specific. A better way is to analyze securely collected marketing data for more specific and accurate information. This could tell you that Gene’s living situation actually has a minimal impact on his ability to access care, healthy food and reliable housing. Additional follow up appointments may still be appropriate, but perhaps less urgent. By contrast, you might find that David has limited access to care because he lives alone and far from public transportation. His lifestyle suggests he’d be unlikely to prioritize getting gas to drive to a follow-up appointment over getting to work. In this situation, a remote health appointment might be the better plan. Know your community resources Once you know what David and Gene might need, you can point them towards any appropriate community resources to increase their chances of a quick recovery. Of course, to do this, you need to know what and where these resources are. For example, can you link David to an appropriate home health or telehealth program, or is there a non-emergency medical transportation service in your area to get him to his appointments on time? If Gene needed support to follow a healthier diet, would a local food bank be available? If either had an unstable living situation, would you know which local or national housing coalitions could help put healthcare within reach? Tools such as NowPow, Aunt Bertha and Healthify exist to connect the dots between patients, providers and wider community resources, and close the gap in holistic care. Be proactive and preventative by holding conversations with your care teams prior to seeing patients When you have reliable insights and data analytics to anticipate what patients like David and Gene might need, you can work with your care teams to develop a shortlist of options ahead of time. In this way, they’ll have realistic and ready-to-use solutions to give the patient right there and then. To truly get the most out of social determinant of health data, your care coordinators need easily digestible patient profiles which they can understand and use in a split-second. Bringing the whole patient into the care plan Healthcare is growing more and more sophisticated in identifying ways to better manage care for patients by using data science and machine learning to predict health events. These insights help coordinate care plans that are preventative and proactive. Essentially, it’s about knowing your patients as well as possible, and being able to quickly match them to the services they need. — Discover how we can help you leverage social determinants of health data for your patient population, so you can bring in the whole ‘village’ of resources to support them on their healthcare journey.
It’s a puzzle many healthcare providers are still working to solve: when over 80% of health outcomes are influenced by non-medical factors, how can health systems help their patients achieve better outcomes? From affording time off work so they can attend an appointment, to accessing healthy food, childcare or transport, your patients’ ability to engage with and benefit from health services can be heavily influenced by a host of social and economic dynamics Understanding these social determinants of health (SDOH) gives you a more complete picture of your patients’ health and life circumstances. You can anticipate their needs, coordinate their care more effectively, and ultimately give them a better healthcare experience. What’s more, harnessing the right data on SDOH leads to smarter investment and operational decisions, yielding advantages for your health system as a whole. That’s why many providers are starting to use non-medical consumer data in their care management planning. Here we look at some of the top use cases for SDOH data. 5 top use cases for data on social determinants of health Reduce missed appointments No-shows cost providers an average of $200 each (plus a lot of wasted physician time). Often these are down to lack of access to transportation or childcare. SDOH data can help you anticipate where these challenges might occur, so you can offer additional services like a free shuttle bus or crèche. You’ll make the experience a little easier for the patient, and potentially prevent an unchecked health issue from becoming something more serious. Save costs from preventable health events Unfortunately, life circumstances can lead to many people using health services in a way that could be avoided. Missed appointments or difficulty following a care plan can lead to escalating medical issues, entailing more treatment and readmissions. Patients might also fall back on emergency services because they can’t easily access appropriate alternatives. SDOH data helps you understand the circumstances that might lead to this kind of patient behavior. For example, if you can spot patients who may be likely to dial 911 because they have no other way to get to the health services they need, you can offer alternatives that avoid an unnecessary visit to the ED. This could help you save up to $2000 per Emergency Department visit and around $10,000 for each hospital stay (which often can’t be fully reimbursed if the patient ends up being readmitted). Increase care plan compliance A patient’s living situation can often determine whether or not they’ll be able to stick to their care plan. For example, specific dietary advice can be a real challenge for a diabetic patient if they have a limited food budget, lack of time to shop and prepare food, or a plain lack of options of where to buy it. An SDOH needs assessment can flag this in advance so clinicians can help patients find a plan that will work for them. Similarly, pharmacies might use consumer data to help minimize abandoned prescriptions or situations where a patient fails to follow dosage directions, which is estimated to cost the industry $290 billion per year. Save administrative and clinical time Analyzing consumer data can help your operations run more efficiently, which benefits your patients through well-coordinated care, timely information sharing and prompt referrals. Many providers are taking advantage of automated solutions for leveraging SDOH data, saving massive amounts of administrative time for care managers by pre-populating patient data and automating SDOH needs assessments. Consumer insights solutions like Experian Health’s ConsumerView analytics can optimize operational efficiencies and ensure your care managers use their time well. Investing in relevant community health programs One of the most impactful use cases for SDOH data is to gain a richer understanding of your member base, so you can invest in the most relevant community health programs. For example, a 2018 pilot project by Atrium Health in North Carolina screened for food insecurity in older patients who may have been at risk of readmission. Emergency food services were provided where needed, and as a result, readmissions dropped by 60%. Your purchasing power can also be a force for change. The Cleveland Clinic outsourced its laundry service to Evergreen Cooperative Laundry, a local collaborative working to combat poverty. Ralph Turner, executive director of patient support services at the Cleveland Clinic says: “Establishing the foundation for people to stabilize their incomes and become part owners in a business… in itself generates health and wellbeing in our community.” Leveraging consumer data to improve patient outcomes These examples show some of the varied ways screening for social determinants of health can open the door to understanding your patients and creating truly person-centered care services. Who knows what opportunities are hidden in the SDOH data for your patient population? Are there gaps in your data? Could you combine different data sets for a fuller picture? What exactly is your consumer data telling you, and how do you turn it into meaningful management decisions? At Experian Health, we have comprehensive data assets and analytics platforms to help you answer these questions and more, and leverage consumer data most effectively.
The President, members of Congress and consumer advocates are all demanding price transparency within the healthcare universe. The major push of late is President Trump’s executive order that will be issued in June 2019; while critics hope this initiative will fade, the topic has been on the industry radar for many, many years. How did we get to today’s scenario? We have a robust perspective on this subject at Experian Health because we’ve been working with healthcare organizations offering various solutions that inform consumers about the costs of their care for more than 10 years. We brought to market the first iteration of our current Patient Estimates product back in 2008, responding, in part, to the growing issue of medical debt and inherent risk to providers not getting full payment for services. The challenges presented by medical debt are well documented, but the important point to focus on is that as long as Americans continue to lack the ability to pay for their care and health organizations struggle with collections, the push towards price transparency will continue. Perhaps this is much needed progress? Since 1957, nearly 75% of Americans have consistently reported being insured but unable to pay their medical bills, according to a study by the Centers for Disease Control. Now, more than 50 years later, many legislators hope mandated price transparency will alleviate the surprise factor of medical costs and spur a more competitive environment. In 2008, helping patients understand their costs was intended to improve providers’ collections success. The term ‘price transparency,’ with additional connotations (e.g. better experience for the patient, improved efficiencies), popped up about the same time as the introduction of very high deductible health plans. The phrase started gaining traction following passage of the Affordable Care Act, and as patients were responsible for more of their medical costs. Add in the rise of consumerism within healthcare and Americans’ digital lifestyles, and it’s no surprise there are calls for pricing to be as easy to understand as they are in the retail space. We harness the power of data and analytics to fulfill these needs in the marketplace. The healthcare industry was ripe for change more than a decade ago, as evidenced by the desire of organizations to leverage what we could offer. While there is continued debate on the transparency topic, the good news is today’s data-driven technology can create a patient financial experience that is friendly, understandable and accessible, delivering the good-faith estimates many consumers, legislators and the industry-at-large wish to see. Consumerism drives price transparency expectations Ultimately, the financial aspect to care is a key component to consumers’ satisfaction with a provider. This realization began to bubble to the surface over the last several years. In fact, Experian Health conducted research last year to understand consumer pain points during the healthcare journey. Consequently, it was no surprise when the study revealed consumers’ biggest frustrations and challenges – above clinical areas – is dealing with the financial aspects of healthcare: 90 percent of respondents ranked worrying about paying their medical bills as a very important to extremely important pain point. 30 percent acknowledged the challenges of determining what financial support options (e.g., payment plans, government grants, and hospital charity care programs) are available 90 percent reported significantly underestimating the costs associated with major medical procedures (e.g., knee replacement) The takeaway from this study is clear: consumers want a streamlined payment process that builds confidence and provides peace of mind. We know that healthcare providers want to increase the efficiency and success of their collections efforts. Ultimately, everyone benefits from clarity around pricing. So whether government-mandated or not, there is no denying that price transparency, in some form, is here to stay and a transformation in the industry is taking hold. Experian Health is leading the way to innovations that will help healthcare organizations thrive in this new era. By leveraging our expertise in data and analytics and our understanding of healthcare costs, we can help patients successfully navigate their financial obligations from primary care appointments through subsequent diagnostic procedures and surgeries. The potential is there for everyone to benefit from an evolved, modern system. Related Articles: How Blessing Health System personalized estimates to improve patient satisfaction How to make price transparency less confusing for patients
Artificial Intelligence (AI) and automation are the latest buzzwords in business innovation. But what exactly do they mean, and how can they help your healthcare organization? Put simply (if that’s possible!), AI is when a machine mimics human thinking. It can spot patterns, learn from experience and choose the best solution in a given situation, solving problems with little or no human involvement. While AI is focused on achieving a particular goal, automation is process-oriented. You can set it to follow rules depending on certain data inputs. It’s ideal for completing repetitive tasks efficiently, so the humans in your team can spend their time elsewhere. In healthcare, there are endless opportunities for AI and automation to assist doctors in diagnosing and treating medical conditions, like Microsoft’s “Hanover” machine, which helps oncologists predict the best combination of drugs for each patient. Harvard Business Review investigated 10 promising AI applications in healthcare, which could save the US healthcare system $150 billion per year by 2026. Examples include AI-assisted robotic surgery, faster and more accurate image diagnosis, and determining ideal drug dosages for individual patients. The opportunities aren’t all on the medical frontline either: AI and automation can be of significant value to a hospital’s revenue cycle. But many providers have only scratched the surface when it comes to integrating new technologies within their revenue cycle operations. There are plenty of repetitive processes within the revenue cycle that can be time-consuming, tedious and prone to human error. Thanks to automation, many rote tasks such as handling denied claims and missed authorizations can be taken off your team’s to-do list, keeping productivity high and resource costs low. Here are four ways AI and automation can help reduce claims denials specifically. Staying on top of ever-changing payer policies Constantly changing payer payment rules create serious challenges for many providers, causing delayed payments, denied claims, increased billing costs and lost revenue. Providers often have no central repository to share updates with the right people across their health system, meaning individual departments have to allocate staff time to digesting the same notifications and newsletters. It’s extremely inefficient and can cost thousands in reworked claims. With automated Payer Alerts you can avoid all of this. Payer Alerts give staff a convenient service that monitors more than 52,000 web pages by more than 725 payers, so you know you’re up to date with any changes. Handy daily email digests notify you of any specialty-specific updates, so you stay a step ahead. John Neumeier from Arkansas Health Group says: “Payer Alerts has been a very valuable tool. Before, our certified professional coders would go out and read all of the payer alerts and manuals from Medicare, Medicaid, Blue Cross and United Healthcare, and try to boil down and assimilate the things that were important to our organization. With Payer Alerts, we’ve got an email sitting there every morning with those things already done for us, so within just a couple of minutes we can scan through and identify what’s important to us, and then very quickly communicate that out to all of our clinics and managers.” Better patient matching to reduce claims denials A third of all denied claims are linked to inaccurate patient identification. This costs hospitals an average of $1.5 million per year. The go-to solution often involves an enterprise master patient index (EMPI) to match and identify patients electronically. However, EMPIs are limited by their reliance on a single data source – their patient rosters. And if an error sneaks into the patient roster, it’ll be passed down when patient records are matched. Instead, patient matching can be automated using a platform like the Universal Identity Manager. This draws on a variety of broader, more reliable data sources including Experian’s demographic and credit data, then calculates the likelihood that two records refer to the same person. A Universal Patient Identifier is assigned to each patient, so their correctly matched data is always trackable. More efficient claims verification Your claims team can probably guess the likelihood of a denial based on their experience and data, but actually turning those insights into a robust, efficient process is not easy. Machine learning tools such as Claim Scrubber can look at which claims have been denied in the past and why, and use that data to predict future denials. It tags at-risk claims so you know to run additional checks before sending them off to the payer. Kahlynn Lawrence, Coding Operations Manager from Northwell Health, told us: “It was a way to automate and create a worklist so that the coder could then focus on true coding issues. By doing this we were able to see results… From 2013 to 2017 we’ve been able to reduce our denials by 50% through using the Experian Claims Scrubber tool.” Actionable insights to help optimize your revenue cycle A high-performing revenue cycle relies on powerful data analytics. But monitoring and synthesizing all the data that flows through your organization can be challenging. Machine learning algorithms can help here, giving you deeper insights about the performance of your revenue process. With a business intelligence tool like Analytics, you can leverage multiple datasets to find predictive solutions that boost productivity and maximize your ROI. This tool gathers several data sources into a single dashboard so you can monitor and compare your organization’s performance against your most important KPIs. Industry comparisons and trends analysis will also help you find opportunities for more efficient billing, predictive reimbursement and improved payer performance. Healthcare providers devote vast quantities of time and money to interactions with payers, often due to untracked payer policy changes, error-strewn patient records, or avoidable denied claims. More streamlined revenue cycle management can help you get those claims right the first time. You can stop wincing at the revenue and staff time lost to denials that could be invested elsewhere. So, if you’re looking for ways to do more with less and stop the bleed of rising healthcare costs, perhaps cutting edge AI and automated solutions could hold some of the answers? Visit us at booth #405 during HFMA’s annual meeting or visit www.experianhealth.com/analytics to learn more.
Big data is helping every industry take giant leaps forward. Healthcare should be no exception. Household names like Amazon, Netflix and LinkedIn have made personalized consumer experiences the norm: predicting your next purchase, suggesting products you’ll love, and tailoring your news feed to your preferences. The modern consumer experience is intuitive and frictionless. Patients have come to expect the same of all the companies they do business with – including their healthcare provider. Like these consumer-driven industries, information about lifestyle, interests, purchasing behavior and even social media activity can all help create a more comprehensive picture of each consumer patient, and how they choose their provider. By understanding patients as individual customers, providers can use consumer data insights to offer personalized experiences, creating loyal customers and brand advocates. From building awareness about your brand to customer support interactions, these insights ensure your efforts resonate in the right way with the right consumers at the right time – and in a way that makes the consumer feel like they’ve chosen a provider that ‘gets them.’ We’ve all seen headlines about bad players using consumer data in a negative way, so compliance is key to avoid any mis-steps. Making sure you stay compliant with consumer privacy and data protection laws will keep your organization safe. Data-driven healthcare marketing is a huge opportunity The providers who thrive in the era of value-based accounting will be the ones who embrace a consumer insight-based approach throughout the customer journey. In fact, research suggests companies that leverage consumer insights outperform peers by 85% in sales growth and more than 25% in gross margin. But here’s the rub: while it’s a massive opportunity, using consumer data must be done safely and securely. Consumers don’t want to think about their data being traded in the shadows, even if they’re happy to live-tweet the data from their smartwatch. Trust and transparency are paramount. So, what’s a consumer-centric, security-conscious healthcare provider to do? 3 ways to stay safe and secure using healthcare marketing data Working with consumer (or marketing) data is somewhat new to health. The rules for how you source, store and use it bring a whole new set of compliance concerns. Failure to comply can result in eye-watering fines, not to mention the potentially devastating loss of trust. If you’re handling it in-house, beware of vendors popping up with data solutions that don’t quite make the grade. Here are three ways to practice good data hygiene and keep your organization compliant: Safe sourcing First things first: know where your consumer data comes from. Is your vendor collecting this data from original sources, or via a third party? Do consumers know their data was collected, and how it would be used? Can you point to the original source’s privacy policies? When you use consumer data, make sure you know its source and can quickly point to the privacy policies associated with the data. Working with original source compliers of consumer data, like Experian, can ensure you meet privacy policy rules. Consumers should always be told their data is being collected, why, and by whom. Despite the challenges around the introduction of the General Data Protection Regulation (GDPR), its main requirement is actually pretty simple: don’t use consumer data without active consent. GDPR may or may not apply to your organization, but it’s a good model to work to, especially as others are following its lead (like the California Consumer Privacy Act). Safe storage Tales of data breaches at Yahoo and the English National Health Service send a shudder through healthcare C-suites everywhere. And no wonder – a Ponemon Institute Study found the average cost of security breaches is around $3.62 million per incident, while consumers are reported to be more worried about data privacy than losing their main source of income. Safe to say, secure data storage and processing should be a top priority for your organization. Writing for Law Journal Newsletters, Mark Sangster says: “Privacy and data responsibility must be as important to the officers of a business as profitability is to the investors. As such, privacy and compliance blur together, and security becomes the guardian, keeping the others in check.” Familiarize yourself with the rules around storing marketing and non-medical consumer data, such as ensuring you have a written data security policy, identifying data protection officers, and having strict controls on access to data files so that it’s never shared with anyone who doesn’t absolutely need to see it. The Direct Marketing Association and American Marketing Association both have handy resources on ethics, regulations and data privacy. It may not be light bedtime reading, but it’ll keep you right. Appropriate use of data Marketing data is there to help you find promising prospects and keep them interested. Use it to guide your messages and content. It should never be used to deny services to anyone or create unequal access, so always keep an eye out for potential adverse effects. People love to get useful information, but when it’s a little too specific about their lives, that’s verging on creepy! Don’t give the impression that you know solid facts about them. For example, instead of writing “Dear Family of 4”, choose images that would resonate with that family, or offer health fair invites focusing on pre-teen or infant health, according to what marketing data tells you is more relevant. With marketing data, you can avoid wasting time and money (and the embarrassment of) sending your geriatric services promotion to young newlyweds. Or you can connect the dots between services that marketing data suggests will appeal to the same demographic, such as women’s clinic patients who are interested in fitness, who may appreciate a poster about your orthopedics or dietetics promotion. Mastering healthcare marketing best practice Using customer insights to drive your marketing strategy has huge payoffs for patients and providers. Partnering with a reliable data steward will help you take your data analytics to the next level, and stay compliant at the same time. As the gold standard for consumer data privacy, Experian Health offers access to clean, original-source data and robust analytics platforms that give you the most comprehensive view of your health consumers – and peace of mind when it comes to compliance.
How well do you know your customers? Do they have kids? Do they drive an electric car? Are they working two jobs? Do they use social media? Are they more likely to watch the Beyoncé documentary or live stream the PGA tour? The more you understand your patients and their inclinations, the more you can customize their experience with your brand. You can match your marketing messages to their personal preferences. You can refer them to information that’s relevant, and not bother them with stuff that’s not. When your patients feel taken care of as individuals, your brand will be top-of-mind next time they need healthcare services. This kind of personalization is at the heart of healthcare transformation. When you see your patients as customers and prioritize their experience above all else, in your services and your marketing, you’ll see returns in the form of increased patient satisfaction, rock-solid brand loyalty, better patient outcomes, and growing revenue. Consumer insights give you the competitive advantage In our Digital Onboarding Report 2017, we found that 60% of organizations considered customer experience to be the number one way to stand out from the competition over the next three years. Healthcare brands can learn from other industries and use data-driven consumer insights to personalize their marketing strategies and enhance the customer experience. In an example from the leisure industry, Adi Clowes, Head of Data & Analytics at Center Parcs said: “Influencing customers’ decisions, buying behavior and loyalty cannot be achieved in silos – it’s about using data to make a difference, connecting the business with their customers across the entire customer journey. At Center Parcs we’re committed to our vision of delivering the most personalized and proactive guest experiences at every single touchpoint. That relies on our ability to bring together millions of interactions, combining the voice of the customer with good quality data, and delivering it back to the business.” Harvard Business School points to big consumer brands like Under Armour, Rent the Runway, Peloton and Uber as examples of how consumer data can be used to make sure their brand is in the right place at the right time with the right message about the right product for each individual customer. From predicting a style of training shoe based on previous athletic purchases, to letting you know how long you’ll have to wait for a cab, other industries are leveraging data insights to optimize pretty much all aspects of the customer experience. The value for customers is immense, and so is the payoff for brands. There’s an untapped opportunity for healthcare to enjoy the same benefits. Kathy Giusti, co-chair of the Kraft Precision Medicine Accelerator at the Harvard Business School observes: “When I worked at the Gillette Co., we lived and breathed market research and consumer dynamics. We studied consumer behavior like crazy and we’re not necessarily doing that on the healthcare side as much.” Other sectors don’t think twice about leveraging consumer insights, like demographic, lifestyle and behavioral data, so why should health? Three ways to use consumer data in healthcare marketing From attracting new customers and supporting existing ones, to customer retention and future planning, insights offer value at every stage of the customer journey. Here are three ways to leverage consumer data for a stand-out customer experience: Attract new customers Think about how many healthcare adverts you see featuring a happy family with two parents, two kids and a golden retriever, playing sports in their sunny garden. Now consider how many of your patients actually fit this image. Healthcare content often doesn’t match the reality of the condition or the patient’s life. When you learn what ‘real life’ looks like to your target population, you can throw away the tired clichés and stop relying on hunches. Insights help you determine what type of messaging and communication channels resonate best, so prospective patients feel like you’re speaking directly to them. Personalized marketing becomes a time-saver, a trust-builder and a problem-solver for your audience. The bland ‘voted best’ slogans mass mailed by your competitors won’t stand a chance. So how do you build a relationship with consumers you don’t yet know? You need good marketing data, directly from the consumer, and managed carefully by a data partner who bridges healthcare and marketing. Segment and target your current customers Personalization is a proven way to boost retention. Research shows customized emails convert at a rate six to seven times higher than generic messages. Healthcare payers who tailor members’ experiences see five times higher retention rates. It’s a no-brainer. Consumer data lets you separate out the married couple with teenagers, who make buying decisions on impulse and like spending big on hiking and fishing gear, from the empty-nesters who enjoy horror movies and consider themselves savvy researchers when it’s time to choose a provider. How would your outreach messages differ for each family? Should you emphasize convenience or reliability? Safety or cutting-edge technology? Should your images reflect an active lifestyle or a cosy home? You could guess, or you can let the data guide your decisions and put the most relevant messages up top in your communications. Gain consumer insights to optimize your offerings Another important way to leverage consumer data is in analytics. Let’s say you’re rolling out a new healthcare app to let patients set up appointments or check test results. Working with quality consumer data can help you identify the early adopters, and build models to help predict likely next adopters, allowing you to allocate resources accordingly. When you know a segment of your audience is uninspired by new technology, you know not to waste effort or budget trying to sell it to them in the early stages. Instead, you can give them alternatives that better match their preferences. You won’t get this from simply knowing their ailments. Clinical and claims data tells you plenty about what’s gone before, but it’s only when non-medical consumer data is pulled into the mix that we see real predictive power. Healthcare consumerism means putting patients first Perhaps it’s time to ask what’s missing from your healthcare consumer marketing strategy. Is it the consumers themselves? If so, you’re not alone. Healthcare marketing isn’t new, but marketing based on consumer insights is something that many healthcare providers aren’t fully tapping into yet. This is about using data to make a difference and connect with your customers in a meaningful way at every touch point. A one-size-fits-all approach just isn’t going to cut it.
What if you could flag patients who are at risk of readmission? What if you could anticipate missed appointments or know ahead of time that someone is going to face challenges with their care plan? This knowledge could help you improve patient outcomes, streamline staff workflows and improve your bottom line. So how can you get this non-medical information and use it to improve treatment outcomes? A person’s circumstances can help us understand potential challenges in access to care to predict their behaviors More than 80% of health outcomes are unrelated to medical care. Instead, they are attributable to outside social and economic forces, such as housing, education, unemployment, low income, transportation, access to green space, loneliness, inequality and other non-medical factors. These social determinants of health (SDOH) are the living and working conditions that come together in just the right combination to either promote or a limit a person’s health and wellbeing. As a healthcare professional, you’re no doubt aware that people struggling with financial or life circumstances have a more difficult time focusing on their health and subsequently face more urgent hardships. And it isn’t just the patients who suffer. It has a negative impact on the entire healthcare ecosystem. Why providers should care about social determinants of health When patients struggle to access healthcare services, they’re less likely to follow treatment plans or adhere to follow-up visits. They’re more likely to need to come back with more serious conditions that could have been detected earlier, had they felt equipped to follow the care plan. Not only is this worrying for the patient, but it also leads to excessive service utilization that is costly for providers. Missed appointments are estimated to cost the US healthcare system a massive $150 billion, while each unused 60-minute slot costs an average of $200. And that’s not to mention the opportunity cost of equipment and rooms sitting idle, and all those wasted hours of billable physician time. The shift to value-based care puts more pressure on providers to improve outcomes. But how can they do that when those outcomes are partially determined by factors beyond their control? Considering that 68% of patients have at least one social determinant challenge, the only sensible move is to bring solving for SDOH to the forefront of care planning. “No patient wants to skip appointments and dial 911 as their only reliable means to get the care they need,” said Karly Rowe, Experian Health vice president of product management. “We want to level the playing field by helping providers identify and solve for these socio-economic challenges that make it hard for some patients to get the care they need. SDOH has the ability to improve outcomes, lower costs and increase patient satisfaction, removing the socio-economic obstacles hindering healthcare.” An example of providers and payers collaborating to solve for social determinants of health is the Aligning for Health coalition, which in 2016 referred 33,000 patients to community initiatives. Andy Friedell, a senior vice president at Maxim Healthcare Services said of the program: “We are prioritizing community-based care and social determinant solutions for our patients and clients. In fact, we have effectively used these tools to help reduce readmissions by over 65% for high-risk patients.” How can social determinant data improve outcomes? Let’s look at two examples of how healthcare providers might analyze social determinants to help improve care management. 1. Reducing appointment no-shows For many patients, a lack of transportation is the main barrier to compliance. How do they get to an appointment or procedure if they don’t have a car, don’t live in an area well served by public transport, and can’t afford a cab? Looking at vehicle registration data and public transport services in the area would be one way for a provider to gauge access to care. But does that give the full story? Even if they can find transport, are they juggling two jobs? Do they need childcare? By synthesizing data on transportation, family arrangements, average incomes, and more, providers can anticipate the propensity of someone being unable to access care, and offer solutions such as a free hospital bus service or crèche facility. 2. Preventing escalated health conditions Understanding social determinants is not about identifying unhealthy behavior. For example, a provider might see poor health and point to poor diet. But a patient’s poor diet may not simply result from poor choices. A provider who’s aware of the potential impact of social determinants might consider the propensity of food insecurity – maybe the patient doesn’t have access to healthy food? However, putting the patient at the center and truly understanding social determinants means thinking beyond the ‘food desert’ explanation. Even where healthy food is available, the ability to eat it might be limited by lack of time to cook it, or money to buy it. The provider must adjust their lens and understand how a stressful work schedule, chaotic household and readily available cheap food converge to make it virtually impossible for the patient to even think about putting their health first with a healthy meal. As a result, a patient who could have been identified early on with symptoms indicating the onset of diabetes, for example, instead has their diagnosis delayed because they can’t get to an appointment, while their condition worsens due to their unhealthy diet. Instead of offering dietary advice or signposting to a wholesome supermarket, the provider might choose to work with a registered dietician nutritionist, direct patients to community resources, participate in community partnerships, or even engage with local planning departments and commercial developers. When you understand what drives your patients and recognize the real barriers preventing them from prioritizing or accessing healthcare, you can proactively identify opportunities to solve them. 3. Using the right data to understand and solve for social determinants of health Better care management and improved health outcomes start with understanding the whole patient and the social determinants impacting their life, and then turning those insights into actions. For providers to be proactive, preventative and patient-friendly, they need to know the patient’s socioeconomic background before they enter the room. They must have an idea of what that conversation should look like before they even say hello, and know which SDOH-related programs might be relevant to this patient. Analytics platforms can help leverage wider consumer data sets to spot patterns that affect operational efficiencies so providers can offer more patient-centered care. Of course, if you’re using consumer data, you must have confidence both in its accuracy and in your ability to safeguard consumer privacy. Both can be achieved if you work with a data management partner who can collect data from consumers at scale, with solutions that check all the privacy boxes necessary to allow this data to be used in a healthcare setting. Identity management protocols can guarantee robust patient-matching and cross-system interoperability. So if you weren’t already thinking about what social determinants of health mean for your organization, perhaps think about what you could do now to incorporate a solution that tells you what patients need, provides the right amount of context to understand what external factors might be causing or affecting that need, and then solve for it at the point of care. — The solution exists to help you. You could have the power to identify and solve for social determinants at your fingertips.
It\'s no secret that claim denials cost healthcare organizations. They take about 16 more days to pay out than claims that have not been denied. On average, this delay in payment equates to one percent of a healthcare organization’s cost structure. Final claim denials — or claims in which the payer never pays the provider — lowers a typical hospital’s annual net revenue by 1.9 percent. These tack on additional administrative costs because of the work it takes to close them. The good news is that 76 percent of claim denials are eventually paid off — but the staff time it takes to get the payments can be costly. Claims roadblocks Experian Health recently worked with a large healthcare organization that manages more than 200,000 claims per month, which exceeds $1 billion in claims dollars. The organization has almost 50 hospitals in its network, as well as urgent care and cancer care centers, which creates a large number of transactions and claims to process. This includes Medicare, Medicaid, private insurance, worker\'s compensation, managed care, and more. Before partnering with Experian Health, a number of errors were leading to denied claims, including discharge-not-final-billed errors, claims errors, stop bills, late charges, clearinghouse edits, and other factors that created roadblocks. But claims automation helped turn things around. Automation reduces errors Automation provides benefits to healthcare organizations and patients because it speeds up evaluation, ensures correct and timely billing, and reduces the number of manual touches needed for each claim. According to the Council for Affordable Quality Healthcare, manual processes slow down claim reimbursement. People take an average of four minutes to process claims, but automation reduces this to three minutes. Although a minute doesn\'t sound like much, it translates to thousands of hours saved for a healthcare organization that processes 200,000 claims each month. Automation also frees up time for billing teams to focus on more pressing tasks. How organizations can benefit By automating, this healthcare organization could ensure clean claims by utilizing an expansive library of national payer edits and implementing custom edits. This eased the follow-up process because teams had detailed insight into claims status, an analysis of denial reasons to efficiently process them, and automated workflow and payment posting to handle splits and contractual adjustments. One of the biggest reasons this healthcare organization partnered with Experian Health was the ease of implementation with its medical records system, Epic. For example, ClaimSource easily loaded customized edits and the edits library into Epic, tracked and corrected claims, found and repaired issues with the system build, and created opportunities for cross-training and centralized reporting. Long-lasting results Through this automated process, the healthcare organization now has detailed insight into its claims management process and can monitor rejections data, review effectiveness, and find ideas for even more system automation. Through its partnership with Experian Health, this healthcare organization has improved its claims metrics across the board. It improved its acceptance rate by 10 percent, and it became an Epic top performer for claims acceptance, averaging a 99 percent acceptance rate. It has also increased its clean, paid claims percentage by over 10 percent. Start automating to streamline your claims process.
