Turnover is cut by 15% with ladders
Patient access leaders at Lee Memorial Hospital in Fort Myers, FL, have seen a greater than 15% reduction in turnover rates over the past few years. Colleen Edwards, CHAM, system director of registration and patient business services, attributes this reduction, in part, to the department's career ladder.
"Our average seniority in our departments is approximately eight years, with 25% employed from 10 to 33 years," says Edwards.
The department offers four levels of staff positions: financial counselor, emergency department (ED) financial counselor, lead financial counselor or patient business representative, and trainer.
A pay program fast tracks advancement. All new hires for the same position start at the same pay rate, but instead of receiving only the annual merit increase, they are re-evaluated every three months. Staff receive a 50 cent per hour pay increase as long as they are performing at the expected level, until they reach the midpoint pay rate of the position.
"Merit raises then kick in at year end," says Edwards. "Prior to this pay plan, it took many years to reach the midpoint pay rate of the position."
The three-month evaluations are focused on checking the quality of the registrations as well as the volume. "We review the documents table to ensure they are scanning the cards and photo IDs and getting all necessary forms signed," says Edwards. Here are other things that managers review:
- Are staff choosing the correct payers and reading the electronic eligibility response?
- Are they creating duplicate medical records because they aren't accurately checking the patient's identity or not using the proper search criteria?
- Are they banding the patients using the two patient identifiers?
- Are they bypassing warnings instead of completing the fields?
- Are they working their edits from the work queue?
- In general, are they having more difficulties acclimating to this role than a typical person with the same length of employment?
The department makes a point of hiring from within when leads and trainer positions become available. "Whenever a higher level position becomes available, we always look inside first," says Edwards. "This encourages career growth."
She has promoted ED financial counselors to lead positions and then onto registration trainers. "They were exceptional in each job they held," she says. "We were thankful a higher level position became available so they didn't have to look elsewhere."