How Spectrum Health built an effective work-from-home policy

Many U.S. healthcare organizations have responded to the COVID-19 crisis by implementing new work-from-home policies. Spectrum Health in Grand Rapids, Michigan, went one step further, establishing a work-from-home committee to set new policies for staff across every point in the revenue cycle.

Spectrum Health is a large not-for-profit integrated health system, with 14 hospitals, 4,300 physicians and $8.2 billion in annual operating revenue. At HFMA’s Digital Annual Conference on July 17, in their session “Creating a work-from-home playbook,” four revenue cycle leaders described how the health system implemented the new policy, sharing results and lessons learned.

Amy Assenmacher, senior vice president of the revenue cycle, discussed the factors that led the health system to embark on a work-from-home policy in patient financial services (PFS).  Developing the policy, she said, was in line with the health system’s efforts to realize its key strategic priorities:

• Reimagine the personalized experience
• Cultivate breakthrough talent and culture
• Think and act digitally
• Build and partner innovatively
• Drive value

Spectrum Health began to experiment with the policy in 2017, Assenmacher said. But in mid-March 2020, COVID-19 prompted the organization to fully embrace it.  

“[Add] a few other factors with that, including an increase in consumerism and digital transformation, sprinkle on some acceleration in advanced technology and having more well-established ways and proven methods in tracking productivity and quality, and you are primed for a very effective work-from-home model,” Assenmacher said.

Policy effects and implementation

Maria Kamenos, CHFP, CHAM, vice president, patient access services, presented statistics on Spectrum Health’s current and projected experience with its work-from-home policy. By 2022, she said, only 41% of its revenue cycle staff will be onsite full time, compared with 50% in 2019. Over the same period, staff working from home full time are expected to increase from 29% to 38% (an outcome she suggested is understated).

Developing a work-from-home committee has been a key step. “This committee was instrumental in putting together a strategy, the policies and procedures that were necessary to govern work from home effectively, and it included a good cross-section of the organization,” she said. She underscored the importance of including experts in coding and representatives from human resources.

Kamenos noted that important steps taken by the committee included:

• Revising Spectrum Health’s telecommunications policy to ensure patient-facing staff in the contact center would be in a quiet, private environment to support interactions with patients.
• Creating an inventory of productivity standards that all revenue cycle staff would be required to meet to qualify for working from home.

The committee was fortunate to have completed its work just prior to the onslaught of COVID-19, when nearly all administrative staff and leadership, except for essential on-site personnel, were temporarily required to work from home.

Policy foundations

Spectrum first piloted a rudimentary PFS work-from-home policy in 2014, involving one day per week, in response to staff advocacy for such a policy, said Courtney Guernsey, senior director of patient financial services. The experiment met with many obstacles, including security issues with staff working on personal computers. In ensuing years, the organization incrementally addressed administrative issues and challenges, including adding work-from-home days, developing an audit process for productivity and quality, and creating a telecommuting agreement that outlines expectations for staff.

For organizations seeking to pursue a similar approach, Guernsey said: “I’d recommend start planning early. Collect data to ensure you have baseline productivity metrics for every position. Set productivity and quality expectations with leaders and staff, and make sure all expectations are documented.”

She also advised, “Sell it!”

Guernsey further underscored the importance of keeping remote staff engaged, including mandatory weekly huddles where staff are encouraged to turn on their cameras to allow for a more personal interaction among team members. The response from staff has been very positive, she said.

ED registration during the pandemic

Spectrum Health was forced by the COVID-19 to implement a temporary work-from-home program for emergency department (ED) registrations. Davina Davidson, director patient access services registration, described how ED registration staff were able to overcome many challenges to quickly respond to the work-from-home imperative.

“We were able to hatch 22 staff members to home in that two-week period,” she said. “We trained two cohorts of patient service reps, or registrars, in that time frame as well.”

All this effort was accomplished with remote training, using video and chat functions, as well as live phone calls. Team members provided images of their workspaces to ensure that phone interactions with patients would be private and secure. An important success factor was having a patient access supervisor on call 24/7 during this time to serve as a lifeline to support team members.

Among the key takeaways from the Spectrum Health’s entire work-from-home initiative, Kamenos concluded: “Make it an element of your employee retention strategy.”