Goals in patient access areas at Cincinnati (OH) Children’s Hospital Medical Center have three areas of focus: the patient’s and family’s satisfaction, finances, and compliance, says Michelle Gray, MHA, director of registration services.
"For instance, if insurance plan information is put into the system incorrectly, in the long run it is going to impact our patients and families," she says.
One financial goal is the collection of copayments at the time of service. "From a compliance perspective, we have a goal that targets accurate completion of the Document Content field in Epic," says Gray.
This goal ensures that consents and other relevant registration documents are complete and can be easily located in the system by a surveyor from the Centers for Medicare & Medicaid Services or The Joint Commission.
At the end of each fiscal year, Gray meets with the department’s project specialist and the vice president of access services to determine what changes need to be made to existing metrics.
"We look at all of our historical data from the current fiscal year and decide which scorecard categories we are going to keep and which scorecard categories we will change out," says Gray.
Sometimes, they decide to keep the scorecard category but make an adjustment to the metric. "Recently, we adjusted our copayment collection metric because we’ve seen a decline in copay collection rates across the organization," says Gray. "It’s all data-driven."
The evaluation scores fall into one of three ratings: exceptional, on target, or needs improvement. "The goal is for the ratings to look like a bell curve," says Gray. Patient access leaders want to see most staff members falling in the "on target" rating and the rest being evenly distributed among the "exceptional" and "needs improvement" ratings.
At Novant Health in Winston-Salem, NC, patient access goals are increased as needed. "We are very clear that if you are exceeding your goals at the end of a quarter, we will increase those goals for the next quarter," says Craig Pergrem, senior director of revenue cycle, pre-service, and onsite access.
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Members of the patient access staff at Riverside Regional Medical Center in Newport News, VA, are required to meet goals for registration accuracy, quality of data, patient wait times, and time-of-service collections.
"Our front-end registration scrubber allows for reporting on individuals and departments with a report card grading score," says Melanie Stanius, CHAM, patient access senior manager.
Managers review random accounts on each patient access team member. They use a scoring system to see if individuals are meeting additional quality assurance standards. "We look at our top performers for both departments and team members, and set our goals around their high standards," says Stanius.
At Central DuPage Hospital in Winfield, IL, cash collection goals are set for the emergency department, the financial clearance center, and surgical registration areas, says Barbara Novak, revenue cycle manager.
"We have had feedback from a consulting group on what it takes to be in the top 10% of hospitals. That is what we have gone on," she says. Cash collections have increased progressively over the last 12 months.
"The goal for the ED is just shy of $90,000 a month," says Novak. "That breaks down to approximately $300 per day per full-time staff member."
Managers have begun reviewing registration errors from claims denials. "Every year, our goal is to have a certain percentage less, such as 25%," says Novak.
Patient access areas at Novant Health are required to meet goals that are set each quarter and monitored daily, weekly, and monthly for all onsite access facilities as well as pre-service departments.
"We have had changes in our management structure due to a few promotions, so we are currently looking at a one-team’ approach," says Pergrem.
All onsite patient access teams will share the same goals, such as iris scanning patient identification usage. Some goals will be shared with the entire revenue cycle.
"We have several new systems that have been implemented in the past year, in addition to our rollout of Epic," says Pergrem. "We are measuring now, not only for our own use, but also from an ROI [return on investment] perspective." (See story, below, on avoiding pitfalls with patient access goals.)