Are co-pay collections part of staff evaluation?

Make registrars accountable

Registrars at Cincinnati (OH) Children's Hospital Medical Center now have an added incentive to obtain co-pays: It could determine the amount of their pay increase.

Michelle C. Gray, MHA, director of patient access and outpatient registration, says that in her area, co-pay collection is a metric on each registrar's scorecard, which gives an additional incentive to ask for the co-pay.

"If they have a lot of uncollected co-pays, they will end up scoring low on that metric," says Gray. "Ultimately, it will end up affecting their merit increase."

If registrars are not held accountable, says Gray, there is really no incentive to ask for co-pays. "It is somewhat of a sore point for our registrars," she says. "They don't like being held accountable when a parent refuses to pay his or her co-pay. They feel they are unfairly penalized."

When registrars made this argument, Gray asked them, "So how do I know you are actively asking for co-pays?" "They didn't have an answer," she says. "If we don't monitor this, there is no incentive for them to ask."

Gray also uses the data to identify problems with particular registrars or clinics. "We don't expect registrars to collect 100% of eligible co-pays, but in order to be successful, you must have some accountability," she says. "They need a goal to strive for."