Few registrars at Connecticut Children’s Medical Center in Hartford had earned the Certified Healthcare Access Associate (CHAA) credential, offered by the National Association of Healthcare Access Management (NAHAM). Now, it is required for advancement.

“Our team members’ interest in the CHAA has grown tremendously,” reports Jessica Budri, RN, MSN, APRN, senior manager of patient access.

The patient access career ladder includes three levels: Level 1, Level 2, and Team Lead. Employees hired as Level 2s must earn a CHAA certification within a year. They also are required to complete the following:

  • Participate on at least one hospital committee outside their immediate department;
  • Cover other patient access areas as needed;
  • Train new team members.

Registrars pay for the exam, which is difficult for some. However, the department reimburses the cost once registrars pass. “That has certainly motivated and increased our testing rates,” Budri reports.

Registrars who are new holders of the CHAA certification have a lot to look forward to. These employees:

  • are publicly congratulated in the department newsletter;
  • receive a personal card signed by department leaders;
  • can add the CHAA credential after their names in their email signatures;
  • are listed in the newsletter of the New England chapter of NAHAM. “That is very cool because it goes out to all NAHAM members in our region,” Budri notes.

Before the department made these changes, registrars expressed little interest in earning a CHAA certification. The main problem was lack of enthusiasm. “Employees did not really see the importance of a certification for their career,” Budri explains.

Only financial counselors and the authorization team took the exam because it was a job requirement for those roles. “There was no incentive for anyone in patient access to get the CHAA,” Budri recalls.

Anyone who did take the CHAA had to go it alone. Managers asked their Level 2 employees to make it a group effort instead. As part of their career ladder requirements, the Level 2s formed CHAA study groups. Right away, attitudes changed. “Employees know they will be supported up until the exam,” Budri says.

Many patient access staff earned the CHAA and advanced to Level 2 status. This caught the attention of Level 1 employees. “They see it’s a way to be taken more seriously in the department,” Budri observes. “They have taken it upon themselves to get the certification.” Budri led by example, and obtained a Certified Healthcare Access Manager (CHAM) credential, adding to the momentum.

Before the department made the CHAA a requirement in March 2019, only 16 employees had earned the credential. “Since then, an additional 11 have gotten the CHAA,” Budri reports.

The surge in CHAA credentials has jump-started other changes. Newly certified registrars are highly motivated to choose patient access as a career. Many are networking with peers in the field online for the first time. “It has greatly increased engagement,” Budri says. “Employees now see the potential for growth in their position.”

Lucianna Easton, CHAA, went even further by becoming involved on the national level (she joined NAHAM’s membership committee). As one of the Level 2s charged with forming study groups, Easton’s first step was to create flashcards. “This helped get the momentum going,” Easton says.

Next, all participants took a practice test to identify their trouble spots. Vocabulary definitions were a big focus, not because they are included on the CHAA exam (they are not) but because they are necessary to understand the questions asked.

Outside of study groups, employees prepared for the test in their spare time. “While we try our best to study at work, there is a certain amount of initiative that needs to be taken outside of work,” Easton notes. Many registrars relied heavily on scenario-based questions on Quizlet.com, which are similar to those on the CHAA exam.

Easton urges colleagues to take their time when sitting for the exam. During her own CHAA exam, passed on the first attempt, that is exactly what she did. “I utilized the whole two-hour testing timeframe. I was the last individual in the room,” she says.

Registrars must see the big picture. “A patient access department has to have a mission and vision on why CHAA is important,” says Cheryl Barrett, director of patient access at Parkland Health & Hospital System in Dallas. Even so, registrars want to know what is in it for them. Some already want to advance in the field.

“But for short-term employees who don’t plan to build a career in patient access, becoming certified may not be as important,” Barrett acknowledges. Currently, fewer than 10% of registrars have earned their CHAA. The department recently started group study sessions to increase this percentage dramatically.

For managers, securing buy-in from a smaller group of motivated employees is easier than trying to convince an entire department. For registrars, camaraderie is an important motivator. “Patient access employees befriend one another,” Barrett notes.

Sessions are held at convenient times, at the start or end of a shift, and limited to 30 minutes. “By keeping the sessions short, employees see that it does not have to impinge too much on their personal time,” Barrett explains.

The single best approach they have found for training sessions: To cover material that is relevant to both the CHAA exam and the employee’s job. “Then, the time spent becomes a win for both the employee and the organization,” Barrett says.