Improving revenue cycle management (RCM) is often a top priority for healthcare organizations. However, the patient engagement is not always the first consideration that comes to mind in this process. Nevertheless, prioritizing a positive patient experience can have significant benefits for RCM. By simplifying the complicated process of healthcare finances and management, patients can more easily navigate the continuum of care that includes RCM. In this blog, we will explore how a positive patient experience can enhance RCM and how healthcare organizations can work towards achieving this goal.
The Evolution of Patient Focus in Healthcare
In the past, healthcare has operated under a hierarchical system where physicians and providers held power, and patients simply received treatment. Patient engagement was viewed as influencing patient behavior without considering their preferences, emotions, and needs. Consequently, the healthcare system had a limited understanding of patients and their behaviors. However, the healthcare industry has come a long way in prioritizing patient experience and engagement. Today, healthcare organizations recognize the importance of understanding patients’ needs, preferences, and emotions, and are taking steps toward achieving a more patient-centered approach.
Organizations realized the value of improving the customer experience and adopted a horizontal business structure allowing input from departments across the organization.
- This shift led to a focus on “patient success,” where patients’ perspectives on their experience and outcomes were prioritized over institutional preferences.
- Patients began to be viewed as healthcare consumers, and their perspectives were crucial in a competitive healthcare marketplace.
- Revenue cycle management became a collaborative exercise, with feedback loops across the organization and a unified focus on patients.
Despite the unified understanding of the patient experience as a central goal, organizations faced challenges in executing their vision. The gap between aspiring to focus on patients and practically implementing this focus was seen. Nevertheless, the evolution towards a patient-centered approach in healthcare is a positive step forward that benefits both patients and the industry.
Challenges of Patient Access in RCM
High claim denial rates can indicate issues in an organization’s patient access workflows. Change Healthcare’s 2020 analysis states that one in four denials stem from registration and eligibility errors. Additionally, around 25% of potentially avoidable denials cannot be recovered.
To prevent common and avoidable claim denials, patient access staff must ensure complete registration and eligibility verification. However, this can be challenging for the 30% of health systems that rely on manual patient access workflows. Patient engagement in revenue cycle management can be challenging for various reasons, including limited resources, resistance to change, technical issues, and privacy and security concerns.
Technical issues, such as outdated or incompatible technology, can create barriers to effective patient engagement. Additionally, privacy and security concerns about sharing personal health information online can discourage patients from engaging in digital platforms.
Despite these challenges, healthcare providers must strive to overcome these obstacles to provide patients with the best possible experience and outcomes.
Tips To Boost Practice Revenue through Patient Engagement
Engaging patients and providing improved service is crucial for the long-term financial viability of healthcare practices. With new health plans, keeping patients well-informed about their healthcare options, coverage, and medical billing strategies is important. Here are the following tips to enhance practice revenue.
Providing Financial Counseling And Education
One effective patient engagement strategy is patient education. Providing patients with information about their plan’s preventative opportunities, network choices, and coverage can make healthcare more patient-centered and value-based. Empowering patients and their families through education can ensure better adherence to treatment plans. Additionally, it can prevent readmissions and reduce complications that could lead to payment delays or increased costs for the healthcare practice.
Healthcare practices can provide information in a clear, accessible format through an online portal. This can help patients better understand their health conditions, treatment plans, and billing processes, which enhances revenue.
Offer Consumer-Friendly Front-End Technology
Healthcare practices should offer consumer-friendly front-end technology to keep patients engaged and loyal. Patients expect to have easy access to information, the ability to search for what they want, choose from a menu of options, and pay effortlessly online. Online patient scheduling is a critical tool for early patient engagement, and mobile access can also attract more patients.
Digital tools can significantly enhance patient engagement in the revenue cycle management process. By providing patients access to their health information, including billing statements and payment options, practices can empower them to take control of their healthcare and financial responsibilities.
Provide Price Transparency and Financial Information
Providing patients with transparent information about healthcare costs and financial responsibilities is crucial to ensure the long-term financial viability of a healthcare practice. A recent survey revealed that many patients have avoided seeking medical care due to uncertainty about their insurance coverage. This highlights the importance of improving patient understanding of insurance and medical costs.
To address this issue, healthcare providers should outline estimated costs before service to give patients a better idea of their expected out-of-pocket payments. This can help patients discuss coverage with their insurance companies and choose the right payment methods for payment plans before treatment occurs. Additionally, providing patients access to online portals or text message alerts can help establish a productive flow of communication before treatment.
Offering Multiple Payment Options
Offering multiple payment options means that a healthcare practice provides patients with different ways to pay their medical bills. This could include credit cards, debit cards, cash, check, online payment, payment plans, etc. By offering multiple payment options, healthcare practices can make it easier for patients to pay their bills, improving patient satisfaction. It can also increase the likelihood that they will pay their bills promptly. Additionally, offering multiple payment options can help healthcare practices to streamline their revenue cycle management process by reducing the number of payment delays and denials.
Improve Patient Access To Care
Effective communication is crucial to improve patient access to care. This includes new and existing patients requiring nursing services or a physician referral and appointment. A well-designed appointment system can provide quick and seamless access to medical services, improving patient satisfaction and physician efficiency. Additionally, offering various virtual options such as phone calls, video chat, and online meetings can enhance communication between patients and providers. Experimenting with telemedicine options can also benefit elderly patients. Patient portals can facilitate secure email and electronic communication, helping patients and providers. Moreover, mobile applications can provide timely information and improve patient satisfaction. Overall, improving patient access to care is critical to successful healthcare practice.
It is vital to remember the ultimate goal of serving patients to ensure the success of your organization. If patient expectations are met, it can positively affect revenue performance. However, implementing the above strategies can help improve patient satisfaction and benefit the organization. To take patient experience and revenue cycle management to the next level, consider exploring RCM solutions that support staff workflows and meet patient expectations. Patient engagement is not just good for revenue but for patients’ well-being and the healthcare industry’s success.