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With Medicare implementing its value-based purchasing system in October, patient experience has moved into center stage, with incentives given to organizations that meet quality and HCAHPS patient satisfaction targets. But just what is patient experience-and how does a hospital go about improving it?
Last year, The Beryl Institute issued a white paper on the financial impact of patient experience. In this interview, coauthor Jason Wolf, PhD, executive director of the institute, discusses why healthcare organizations should embrace patient experience and the benefits that can result.
Wolf: We define patient experience as the sum of all interactions, shaped by an organization's culture, that influence patient perceptions across the continuum of care. Experience is not restricted to the four walls of the clinical setting. It starts from that very first encounter with scheduling or with a physician outside the hospital setting. It may even be through the stories shared by a friend or community member that influence a patient's perspective. It is important to recognize the patient experience encompasses a broad range of touch points well before and after the clinical encounter. Of interest is that our research has shown only 27 percent of U.S. hospitals have a definition for patient experience. Without definition how can one have a basis for action? We encourage healthcare settings to adopt or adapt this definition to help guide the patient experience direction.
Wolf: Patients can now go online and compare one hospital to another in every HCAHPS domain. At the same time, with the implementation of value-based purchasing these scores will now have a real impact on the pocket books of hospitals and health systems. This is a significant reason why patient experience has garnered much greater attention in healthcare strategy and leadership today. I also hope it's not the only reason. There is a growing recognition that improving the patient experience actually leads to better clinical outcomes, and positively impacts quality of care and the bottom line for hospitals and health systems. The organizations that have been most successful in improving the patient experience are not solely motivated by financial incentives or penalties. They are motivated by a desire to do what is right for patients.
Wolf: I don't think anyone would argue that engaging your customers in a way that increases their satisfaction tends to lead to higher engagement and ultimately profitability. A study we reported in our paper by J.D. Power and Associates shows that hospitals scoring in the top quartile in satisfaction have around two times the margins of those at the bottom. A similar study by Press Ganey shows that those organizations that are more profitable tend to have higher than average satisfaction scores. Satisfaction should not be equated directly to experience, but it is definitely one indicator in a broader conversation about experience overall. There is clearly a link between the way patients respond to their experience, or the way that they see a facility operating from a quality-and-outcomes perspective, and profitability. In fact, a study just released this spring from Ohio State University shows that organizations that focus on creating both high experiential and clinical quality far outperform their peers in operating margin.
Wolf: The marketing perspective is about the power of word of mouth. We all recognize that-as many billboards you put up on the side of the road or how many ads that you run-the perception of your organization ultimately comes down to what patients and their families and friends hear about your organization when they talk to each other, be it at PTA meetings or at the local market. Research reinforces that dissatisfied people tend to share their poor experiences broadly. One study specific to health care showed that dissatisfied patients tend to tell up to 25 others about a negative experience. What's interesting is that, based on that same research, for every patient who complains, there are 20 others who don't. This has a significant implication on the bottom line. When dissatisfied patients don't complain, we don't even know there's a problem to address. More importantly, only 1 in 10 of those individuals will actually choose to return to your facility. That's lost revenue and a lost opportunity to create lifetime loyalty.
There is a broad clinical impact of experience as well. In line with the Ohio State Study I mentioned, research conducted last year by Duke University showed that experience measures based on HCAHPS were more indicative of whether someone would be readmitted to the hospital than clinical quality measures. The bottom line is that experience matters.
Wolf: I always stress that organizations need to start with a clear definition of what patient experience is and how it supports what your organization is trying to accomplish. I've seen a lot of organizations focus simply on tactics. Although these tactics are important to moving a hospital or health system's overall patient experience strategy, healthcare organizations need a framework in which to operate. Having a clear definition for your organization keeps staff aligned, focused, and intentionally moving in the same direction. It also ensures you are moving toward your desired experience targets and that your efforts support those objectives at every step.
The second critical piece of an effective patient experience strategy is clear leadership vision and support. Senior leaders should reinforce the fact that experience is a critical aspect of their hospital or health system's organizational strategy. Linking the importance of quality, safety, and service ensures a comprehensive and effective patient experience effort. Commitment to a positive patient experience should also be demonstrated throughout the organization, from those who deliver patient care at the bedside, to those who support the delivery of care, to those who call to collect on an outstanding bill. These all are moments in which we encounter the patient and their family. We should also remember that although there are many encounters from our perspective, the patient ultimately only has one experience.
Another critical choice is designating a leader who has primary accountability for patient experience. Ensuring that someone can fully focus on this effort-whether that person is a director of service excellence, vice president of service, or chief experience officer-is also is fundamental. The role cannot be just tacked onto someone else's responsibilities: "Well, you're the CNO; you're now the experience person as well." Research we've conducted in the past year shows that organizations with a committed patient experience role have outperformed other organizations in their HCAHPS and overall satisfaction scores because they've been able to ensure an unwavering focus, a committed strategy, and consistent execution around experience.
For many organizations, that may be a hard choice to make in the face of limited resources. But at the end of the day, the benefits, potential outcomes, and impacts on the bottom line can be significantly enhanced by having someone specifically in charge of patient experience-someone who is responsible for strategy, execution, identification of tactics, and implementation of the entire patient experience plan. That's the differentiator for hospitals and health systems. Our patients and their families deserve nothing less.
Jason A. Wolf, PhD, is executive director, The Beryl Institute, www.theberylinstitute.org.
Publication Date: Monday, August 13, 2012
A leader from McKesson discusses how healthcare reform is forcing hospitals and health systems to take a different approach to capacity management and patient flow.
Patient financial engagement is more challenging than ever – and more critical. With patient responsibility as a percentage of revenue on the rise, providers have seen their billing-related costs and accounts receivable levels increase. If increasing collection yield and reducing costs are a priority for your organization, the metrics outlined in this presentation will provide the framework you need to understand what’s working and what’s not, in order to guide your overall patient financial engagement initiatives and optimize results.
Emad Rizk, MD, president and CEO of Accretive Health, discusses the uncertainty facing hospitals and the transitions affecting revenue cycle management.
No two patients are the same. Each has a very personal healthcare experience, and each has distinct financial needs and preferences that have an impact on how, when and if they chose to pay their healthcare bill. It’s no longer effective to apply static billing techniques to solve the complex challenge of collecting balances from patients. The need to tailor financial conversations and payment options to individual needs and preferences is critical. This presentation provides 10 recommendations that will not only help you improve payment performance through a more tailored approach, but take control of rising collection costs.
Jim Bohnsack, vice president, solution & corporate development for Conifer Health Solutions, explains how the company helps healthcare providers leverage data to deliver better outcomes while optimizing reimbursement for all payment arrangements.
This white paper, written by Apex Vice President of Solutions and Services, Carrie Romandine, discusses the importance of patient segmentation and messaging specifically related to the patient revenue cycle. Applying strategic messaging that is tailored to each patient type will not only better educate consumers on payment options specific to their billing needs, but it will maximize the amount collected before sending to collections. Further, targeted messaging should be applied across all points of patient interaction (i.e. point of service, customer service, patient statements) and analyzed regularly for maximized results.
Steve Scibetta, senior director of channel sales for Ontario Systems' healthcare product line, shares insights into effectively managing receivables.
This white paper, written by Apex President Patrick Maurer, discusses methods to increase patient adoption of online payments. Providers are now seeking ways to incrementally collect more payments due from patients as well as speeding up the rate of collections. This white paper shows why patient-centric approaches to online payment portals are important complements to traditional provider-centric approaches.
Elena White, vice president of risk, quality, and network solutions for Optum, discusses how healthcare providers can leverage data and technology as they enable risk in their organization.
Increased electronic engagement between healthcare providers and patients provides significant opportunities for improving revenue cycle metrics and encouraging patients to access EHRs. This article, written by Apex Founder and CEO Brian Kueppers, explores a number of strategies to create synergy between patient billing, online payment portals and electronic health record (EHR) software to realize a high ROI in speed to payment, patient satisfaction and portal adoption for meaningful use.
Somnia President and CEO Marc Koch, MD, MBA, explains how hospitals can drive transformative change in the perioperative experience for outstanding clinical and financial outcomes.
Faced with a rising tide of bad debt, a large Southeastern healthcare system was seeing a sharp decline in net patient revenues. The need to improve collections was dire. By integrating critical tools and processes, the health system was able to increase online payments and improve its financial position. Taking a holistic approach increased overall collection yield by 10% while costs came down because the number of statements sent to patients fell by 10%, which equated to a $1.3M annualized improvement in patient cash over a six-month period. This case study explains how.
PMMC President Roger L. Shaul discusses the effects of healthcare reform on revenue cycle management and how PMMC's products help clients adapt to a changing financial environment.
With the ICD10 deadline quickly approaching and daily responsibilities not slowing down, final preparations for October 1 require strategic prioritization and laser focus.
Greg Burgess, Founder and Chief Product Officer at Burgess Group shares insights and opportunities for payment integrity in the rapidly changing healthcare IT landscape.
Read how Gwinnett Medical Center provides clear connections to financial information, offers multiple payment options for patients, and gives onsite staff the ability to collect payments at multiple points throughout the care process.
Read how Orlando Health was able to perform deeper dives into claims data to help the health system see claim rejections more quickly–even on the front end–and reduce A/R days.
To maintain fiscal fitness and boost patient satisfaction and loyalty, healthcare providers need visibility into when and how much they will be paid–by whom–and the ability to better navigate obstacles to payment. They need payment clarity. This whitepaper illuminates this concept that is winning fans at forward-thinking hospitals.
Financial services staff are always looking for ways to improve the verification, billing and collections processes, and Munson Healthcare is no different. Read about how they streamlined the billing process to produce cleaner bills on the front end and helped financial services staff collect more than $1 million in additional upfront annual revenue in one year.
Effective revenue cycle management can be a challenge for any hospital, but for smaller providers it is even tougher. Read how Wallace Thomson identified unreimbursed procedures, streamlined claims management, and improved its ability to determine charity eligibility.
Before launching an energy-efficiency initiative, it’s important to build a solid business case and understand the funding options and potential incentives that are available. Healthcare leaders should consider taking the steps outlined in the whitepaper to ease the process of gaining approval, piloting, implementing, and supporting sustainability projects. You will find that investing in sustainability and energy efficiency helps hospitals add cash to their bottom line. Discover how hospitals and health systems have various options for funding energy-efficient and renewable-energy initiatives, depending on their current financial structure and strategy.
Health care is a dynamic mergers and acquisitions market with numerous hospitals and health systems contemplating or pursuing formal arrangements with other entities. These relationships often pose a strategic benefit, such as enhancing competencies across the continuum, facilitating economies of scale, or giving the participants a competitive advantage in a crowded market. Underpinning any profitable acquisition is a robust capital planning strategy that ensures an organization reserves sufficient funds and efficiently onboards partners that advance the enterprise mission and values.
The success of healthcare mergers, acquisitions, and other affiliations is predicated in part on available capital, and the need for and sources of funding are considerations present throughout the partnering process, from choosing a partner to evaluating an arrangement’s capital needs to selecting an integration model to finding the right money source to finance the deal. This whitepaper offers several strategies that health system leaders have used to assess and manage capital needs for their growing networks.
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