Hospitals don’t invest in patient access the way facilities invest in clinical areas. One reason is lack of data. Understandably, hospital executives want to see more data that can support these financial decisions.
“The absence of that data makes it hard to drive the investments in resources. Investments in clinical processes sometimes come at the expense of patient access,” says Jason Considine, senior vice president of patient collections and engagement for Experian Health.
Narrow profit margins and widespread layoffs also make it hard to justify investments in patient access. “I don’t know a hospital that’s not talking about operational reductions in staff and being asked to do more with less,” Considine laments.
Patient access has been affected more than other hospital departments. “It’s an area people look to cut,” Considine notes.
Investing in patient access can result in significant return on investment for the organization. But departments struggle for the numbers to prove it. “One of the things that patient access departments need to improve processes is simply to improve visibility,” Considine offers.
Here are some reasons for underinvestment in patient access:
1. Patient access departments lack business intelligence tools.
Patient access leaders know intuitively that things that happen in their departments, such as receiving the incorrect insurance information, affect when and if a claim gets paid. This highlights the need for resources such as training. Yet, there often is no way to show how registrars repeatedly botching the insurance plan ultimately resulted in late or denied payments. “Those can be difficult data elements to tie together,” Considine says. “That is a big challenge to solve.”
2. Some patient access departments don’t have tools to help registrars or schedulers obtain the necessary information to ensure “clean” claims are sent on the back end.
“Patient access is all about collecting and verifying data upfront so back end claims are successful,” says Jason Wallis, senior vice president of patient access for Experian Health. Without data to support the link between the front end and back end, it’s an uphill battle to get needed resources.
3. Patient access lacks data on satisfaction.
The patient experience is a top priority at virtually every organization. Unfortunately, patient access struggles to obtain specific metrics on how they’re faring beyond vague organization-wide survey scores.
“With the increase in consumerism, patient access [departments] need the ability to be customer-facing,” Wallis underscores.
Back when the role of patient access consisted mainly of obtaining the correct subscriber ID, name, and date of birth, satisfaction metrics didn’t matter much. With complex financial conversations calling for top-notch service expertise, satisfaction has become paramount.
“Those soft skills are creeping into the patient access space. But they are hard to quantify,” Wallis notes.
It may seem like a no-brainer that patient access needs training to achieve high levels of patient satisfaction. Without numbers to justify the connection between the two, though, obtaining resources becomes a losing battle. “It’s somewhat of a struggle to get that kind of data,” Wallis acknowledges.
4. Patient access usually can’t compare themselves to patient access departments at other facilities.
Key performance indicators are becoming available to establish industry standards for patient access. The Healthcare Financial Management Association’s revenue cycle MAP Keys are one example.
Some benchmarking tools require hospitals to share their own data to see how they compare against peers. This poses a problem for some patient access departments.
“Some hospitals are averse to sharing data,” Wallis explains.
Patient access makes do by measuring their own improvement over time. For instance, departments can point out that registration accuracy increased by 20% over the previous month. But it’s not cause for celebration if every other hospital in the area is twice as accurate.
“Without the ability to compare against peers, patient access has no way of knowing how they’re really doing,” Considine says. “That’s what you lose with a close-minded approach to your data.”