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When monitoring productivity of patient access staff, managers should use subjective and objective methods, recommends Mark S. Rodi, MHA, CHAM, associate vice president of revenue management at Geisinger Health System in Danville, PA.
"Data on the number of completed patient access transactions, the number of claims denials, and cash collection percentages is important," Rodi says. "But it’s not the only way to measure productivity."
Rodi uses satisfaction scores, third-party observations, and patient interviews. "A combination of productivity data and satisfaction data allows the patient access manager to gauge the overall effectiveness of patient access employees," he says.
If a patient access manager solely focuses on production and pays little attention to patient satisfaction scores, warns Rodi, "demand for services will decrease, as will overall patient satisfaction scores. These can be directly related to heathcare reimbursement."
Frank Danza, senior vice president and chief revenue officer at North Shore — LIJ Health System in Manhasset, NY, expects to see these scores for these metrics:
• 95% or better accuracy of demographic data collected;
• 70% of copays and deductibles collected at the point of service;
• 95% of insurance verified and authorized prior to service.
Metrics are also collected on patient throughput per registrar, and the number of financial assistance applications taken and approved, with expected percentages varying by area.
"Key metrics include both productivity and quality of actions performed," says Danza.
He sees having and applying the right technology as the biggest challenge in measuring productivity in patient access areas. The reason is that each person involved in the process often has multiple functions he or she performs throughout the day.
"We have installed tools specifically designed to measure work performed by our registrars," he says. These tools also give managers the information they need to assess and track the quality and completeness of the work performed by each registrar throughout the organization.
"These metrics are tracked and shared back with each department on a routine basis," says Danza. "Staff can get timely counseling, and staffing levels can be assessed continuously."
At Geisinger Health System, scorecards are emailed to patient access staff and are posted on a secured shared drive. "This gives employees immediate feedback related to the critical work they do on a daily basis," says Rodi.
The scorecards list the total calls answered, the calls answered percentage, appointment slot utilization, copay collection percentages, outstanding balance collection percentage, and percentage of successful new medical record numbers created. "However, it’s extremely important to use this information in a positive manner to ultimately achieve the results we all look for: satisfied patient access staff, patients, and providers," says Rodi.
Rodi suggests highlighting the positive aspect of the measure instead of the negative. He gives the example of two popular access measures: the percentage of duplicate medical records created, and the abandonment rate of phone calls.
"Both of these measures can be reflected in a positive manner by focusing on the successful completion of new medical record numbers and the percentage of patient calls answered by agents," says Rodi.
Florence Davis, director of patient access at Children’s Healthcare of Atlanta, recommends tying productivity to key performance indicators (KPIs) for patient access, such as point-of-service collections as a percentage of net revenue, length of registration, and turnaround time.
"Another effective way to assess productivity in patient access is by establishing productivity by core job function," such as scheduling, registration, insurance verification, obtaining authorizations, or financial counseling, Davis says. "Once the productivity metric is identified, a goal should be set for the team or department and, where feasible, per employee," she says. "Communicate the expectation."
Patient access leaders can use the data to make operational decisions and to recognize top performers. "Partner with your analytics team to help create productivity reports to track," Davis advises. "Timely feedback should be given to employees."