Optimizing Your Revenue Cycle Management: Step 1

Office VisitIn our next blog series we will discuss five ways practices can optimize revenue cycle management – collecting every dollar earned.

Step 1: Keep Your Schedule Full and Productive

The increasingly powerful force of consumerism in healthcare is requiring providers to rethink their business models and develop a different type of relationship with patients and members - the ultimate consumers of their services. Historically, the purchasing and financial decisions in healthcare were made at the “wholesale” level, with arrangements between the payors, providers, and the employer. Unlike any other consumer market in the United States, where the power of the consumer is visible, the consumer in healthcare was glaringly absent. Today, that trend is shifting: the clout of healthcare consumerism is growing, as patients become more involved in their healthcare decisions. The following healthcare changes are driving this new consumer-driven model:

  • High Deductible Health Plans (HDHP). Individuals face increased deductibles for their healthcare consumption and now have “skin” in the game. Plans today have an average deductible of $1,000. This is encouraging many individuals to begin demanding improved price visibility and quality metrics to help assist in the decision-making process of where and when to seek services. With consumers shouldering more of the financial burden, services such as decision support, advocacy, and other ancillary services have become a market standard.
  • Insurance Exchanges. With the exponential increase in healthcare costs, employers are beginning to opt into insurance exchange markets to get out of the business of plan design - and increasingly out of the business of paying. Payors must shift their focus away from strictly selling services to the employer to a strategy that reaches and meets consumer demands.
  • New Reimbursement Models. Whether it be the Readmission Reduction Program, Bundled Payments, Value-Based Purchasing, or the ACO model, providers are not only being held responsible for the quality of care they are providing, but must also bear more of the financial risk of consumer decision making.

These forces mean that today more than ever, your practice needs to make it easy and intuitive for patients to understand the value of your services, to schedule appointments easily and efficiently, and to ensure that scheduled appointments are kept. The efficiencies in scheduling create a full, productive schedule that benefits both your practice and your patients.

Setting the Appointment: Your First Opportunity to Make a Good Impression

There are few industries today that make it so difficult and inconvenient for their customers to access them as some medical practices. Traditionally patients call the practice during business hours to try and schedule an appointment. However, they may face many frustrating obstacles to this simple task: If they call during business hours, they may be put on hold (maybe multiple times); if they call during lunch hours they might reach a recording. Once they get through and actually schedule an appointment, it can be a trial and error process that may take 5-10 minutes to find a day and time that works. Patients hate it. The staff hates it. It is process that should have been changed long ago. Leveraging today’s technology, patients can access tools online to schedule an appointment when it is convenient for them. Patients will appreciate the convenience, and staff will appreciate the reduction in inefficient phone scheduling. Online 24/7 scheduling allows patients to set appointments when and where it is most convenient for them. Online scheduling also allows your practice to easily capture key communication information through the process, such as patient email and phone contacts. In addition, you can engage your patients at a more meaningful level by using patient contact information for important follow-up information such as vaccinations, practice updates, and more. Finally, online scheduling drives patients to your website, where they can find additional, in-depth information on practitioner expertise, services provided, directions and other valuable resources.

Making Sure the Appointments Happen

Once patients have scheduled an appointment, getting them to keep the appointment is the next step. According to MGMA statistics, there is a 5-7% no-show rate for the average practice. Time is money for physicians. A missed appointment is a lost revenue opportunity. To help illustrate the potential revenue impact, let’s do some simple math:

Impact of No-Show Rates

No-Show Rates revenue cycle management for healthcare

While this example is rudimentary, and does not account for double bookings or same day appointments (which will offset some of this loss), it demonstrates the point – no-shows will cost your practice money and productivity. With online scheduling, your practice can leverage powerful interactive tools to ensure that patients keep their appointments. When the patient schedules an appointment online, they can simply click on a link to update their personal calendars with the appointment information. In addition, practices can establish automated and interactive reminder messages through automated phone calls, emails, and text messages. These automated reminders cut down on missed appointments and benefit both patients and the providers.