Patient Engagement

According to the most recent figures from the Centers for Disease Control and Prevention, around 8.8% of Americans are without health insurance. While this has dipped since the pandemic high of 10.3% towards the end of 2020, it still leaves nearly 30 million people facing the often-difficult decision of what to do when they need healthcare. A further 40 million underinsured individuals could find themselves in the same position.  Do they pay for it themselves, avoid care altogether or seek financial assistance? With inflation on the rise and government pandemic support coming to an end, even those with coverage may need additional charity care support. Several regulatory efforts have been made to address healthcare affordability and increase transparency around charity care, particularly at the state level. For providers, the challenge is to find efficient ways to screen for charity care eligibility as more patients become eligible for support, and remain compliant as these new regulations come into effect. Why screen for presumptive charity? Eligibility for charity care depends on a hospital's financial assistance policy and relevant state regulations. Uninsured patients may be offered a full or partial discount on their medical bill, while insured patients may be awarded a discount on the cost of care. Without charity care, these unpaid bills would be tagged as bad debt, which could lead to patients being chased for payments they're unable to make and affect the provider's cash flow. To qualify for charity care, patients are often asked to share their household size and income, among other details. Often a provider will ask patients if they'd like to fill out financial assistance forms during patient intake, but many patients decline or are unable to provide the necessary information. Some may feel embarrassed about needing support or worry about how the information will be used. There may be language or literacy barriers. Some may assume they're not entitled to support and decline the forms. To get around this, providers use automated screening software to identify patients who may be eligible for charity care. This pulls together credit information, demographic data and financial details to determine whether the patient qualifies. Patients get the support – and thus the care – they need, and providers can focus their collections efforts on those who are most likely to be able to pay. Regulation 501(r) permits this type of presumptive screening by a reputable third party. What does the legislation say about charity care? As the use of presumptive eligibility screening has grown, several federal and state regulations have been introduced to encourage clarity, consistency and best practice. Providers must keep pace with changes to charity care policy or risk civil penalties or the loss of tax-exempt status. Under the Affordable Care Act, Regulation 501(r) requires hospitals that offer charity care to have a written financial assistance policy, specify maximum amounts that eligible patients can be charged, and determine a patient's eligibility before sending their bill to collections. Again, it allows for this process to be automated using a third-party vendor. Individual states also have their own requirements around eligibility screening, for example: In Washington, the legislature has recently voted to expand charity care eligibility as of July 1 2022 for patients who meet federal poverty level thresholds and have exhausted third-party coverage options. The new rules require hospitals to identify patients that might be eligible for retroactive Medicaid support and support them in applying for coverage. In California, the AB 1020 rule raises the income level for charity care eligibility to 400% of the federal poverty level. Hospitals must display online notices explaining their policy for financially qualified and self-pay patients. They must also wait 180 days before assigning unpaid patient bills to collections, and provide information to patients before doing so. AB 532 requires hospitals to give patients written details of patient charity care and discount policies at the time of service or at least before they are discharged. How can providers streamline the presumptive screening process? Automated presumptive screening can help providers comply with these new rules and implement their own financial assistance policies in the most efficient way. For example, Experian Health's Patient Financial Clearance uses current financial data to screen patients for Medicaid, charity care and other financial assistance programs in line with the provider's unique charity policies. It incorporates customizable logic that helps providers adhere to regulatory requirements and internal rules around charity care and billing. Screening happens automatically prior to or at the point of service, generating an estimated Federal Poverty Level (FPL) percentage for each guarantor.  A healthcare-based propensity to pay score can also be calculated, giving providers a further data point to work best with patients. This makes it easy for patient advocates to connect patients with the most appropriate financial assistance program, and even auto-enroll them. If the patient does have an amount to pay, they can be guided to the optimal payment plan for their individual circumstances. Patients can get direct access to screening qualification tools too, with solutions like Patient Financial Clearance. They can check their qualification status and upload documentation to qualify for discounted or free care via text to their mobile device. In addition to helping providers ensure regulatory compliance and document charitable services, this tool helps maximize collections and deliver a patient-centered financial experience. Providers should also check that their collections partners are aware of their obligations under charity care law, and ensure they're compliant, too. Keeping patients in the loop during charity care eligibility screening Clear communication is at the heart of a compassionate patient experience, fostering loyalty and trust. In the context of charity care screening, this means making sure that patients know that financial assistance may be available (now also a requirement under charity care regulations). In the past, some patients were not informed about how to apply for financial assistance and struggled with bills they couldn't afford. Others were assigned to charity care without their knowledge and spent months worrying unnecessarily about bills that would never arrive. Automated charity care checks solve both situations, by ensuring that no patient misses out on support to which they're entitled and by making it easy for providers to notify them. Patient Financial Clearance generates scripts for patient advocates to use during financial counseling discussions, to help patients navigate the financial process with greater ease. And with mobile text charity screening, the patient gets the information they need, right in the palm of their hand, so they can engage with the process more easily. Patient Outreach solutions can complement these activities by providing timely and personalized prompts and reminders through the patients' preferred communication channels. Not only will this enhance the patient experience and support compliance with charity screening rules, but it also helps improve patient outcomes by keeping patients on track with their care plans and driving down unnecessary readmissions. And for patients who do have an amount to pay, a payment experience that's tailored to their financial circumstances will further boost patient satisfaction and collections. The ROI on these tools can be significant. Let's say a hospital treats 1,460 uninsured patients per month. If just 10% of those patients qualify for Medicaid, at an average reimbursement rate of $1000, the hospital could claim $146,000 per month by ensuring those patients are enrolled – and avoid writing off nearly $1.8 million per year. As economic uncertainty continues to weigh on providers and patients alike, the pressure's on to streamline patient collections and prevent avoidable missteps such as non-compliance with charity care rules. Find out how using an automated financial assistance process with Patient Financial Clearance can create a safety net for providers and patients, increase collections and reduce bad debt as patient financial responsibility increases.

Consumer-centric digital technology struggled to disrupt healthcare as it had in other sectors – until the pandemic made it non-negotiable. Now, healthcare providers must double down on their commitment to digital patient access or risk losing patients to competitors. In a recent interview with PYMNTS CEO Karen Webster, Experian Health's President Tom Cox reflected on the findings of joint research conducted by the two organizations, which looked at how consumers are using digital tools to access care. He recommends five strategies to transform the patient journey in line with consumer expectations. 1. “Think like your kids and your parents.” Cox says the first strategy is for healthcare leaders to put themselves in the shoes of both "digital-first" and "digital-necessary" generations (with the "digital-first" persona referring to individuals who prefer using digital methods for at least five healthcare activities). Millenials and Gen Z generations lean toward a digital-first approach, having grown up with the ability to access information at the touch of a button. But Cox notes that older generations with multiple health conditions are also embracing digital tools for more convenient access to healthcare. "If you're a frequent user of the healthcare system, then you most likely will invest in using an app or digital tools. Younger generations have grown up with digital access, so that's just where they go first... They're both driving [healthcare organizations] to digital solutions, which are clearly where the future in healthcare is headed from a convenience and access perspective." Healthcare providers must recognize the needs and preferences of both ends of the demographic spectrum and identify ways to deliver convenience and choice to all consumers. 2. "Anticipate the needs of digital-first customers." Overall, one-third of patients chose to fill out forms for their most recent healthcare visit using digital methods. Cox observes that “digital-first consumers are digital-first patients.” They gravitate toward convenient digital solutions that allow them to skip administrative “relics,” such as waiting room clipboards and filling out paperwork online before they attend. Providers should consider offering online scheduling software and self-service registration so consumers can complete these tasks from home. Cox notes that enabling self-service in patient access is a win for providers too, particularly as the Great Resignation puts pressure on understaffed teams. 3. "Outsource payments to the patient." The third strategy continues the self-service theme, with the ability to pay for medical care online before a visit. Cox says there is still a “great divide between what people want and what they can actually experience.” Digital-first patients want to be able to pay online, but not a lot of patients do so currently.Cox says it's all about removing friction.  He says, “I will just tell you for myself as a patient, I much prefer to pay before I get there. Or I'd like to pay when I leave so that I don't have to get the bill. If I do get the bill, I want to be able to pay online. What I don't want is to fill out the slip with a check — the worst — or my credit card information and mail it to someone.”Moving payments to the front end of the process is not only more convenient for patients, it can also speed up collection rates for providers. Experian Health's patient payment tools help providers offer patients the 24/7, self-service, mobile-optimized payment experience they're looking for. These tools allow payments to be collected anytime, anywhere and connect patients to information about financial assistance and personalized payment plans. 4. “Provide accurate and timely estimates.” A fourth way to transform the patient experience is to provide upfront, clear and accurate estimates of the patients' likely out-of-pocket expenses. According to the research, nearly 85% of patients are highly satisfied with their care experience, but that satisfaction dropped among patients who did not know cost estimates in advance of treatment. 15% percent of patients said they run into difficulty when trying to get accurate cost estimates before coming in for care. Cox says that price transparency should top the agenda for healthcare providers: “Before we ask anyone to commit to a purchase, we should give them [an idea of] how much it's going to cost… In healthcare, oftentimes you make the purchase decision without any knowledge of how much it's going to cost. And then a lot of times people end up in tough situations. ”Determining accurate estimates is a complicated process, but consumer demand and regulatory change are increasing pressure on providers to find better solutions. Effective price transparency improves patient engagement, increases collections before and at the point of service, and reduces the total cost to collect. One way to achieve this is with Experian Health's Patient Estimates and Patient Financial Advisor tools, which generate accurate estimates of patient responsibility and communicates to them in a quick and convenient manner, so they can start to plan for their bills. 5. "Use digital tools to foster patient loyalty." Finally, providers must pay attention to the fact that patient loyalty is increasingly tied to the availability of digital healthcare solutions. According to the research, 61% of patients with an interest in using patient portals said they’d consider switching to a provider that makes one available.Cox says that for patients, “the easiest thing to measure in healthcare is convenience, so we're seeing people use convenience as the key criteria in decision making.” He says that if providers want to engage with commercially insured consumers, they’ll need to embrace digital tools that prioritize convenience for patients and ease friction throughout the patient journey. Download the full report for more insights into healthcare's digital transformation and opportunities to make better use of digital tools to improve patient engagement.

Telehealth adoption has been a bumpy ride. Remote and virtual healthcare services struggled to gain traction pre-pandemic, only to become a life raft for safe access to care when infection rates began to climb. After that initial surge, telehealth usage leveled off at around 38 times pre-pandemic levels for much of 2021. Now, while uptake has dipped slightly as patients return to in-person care, the way healthcare is delivered has changed forever. Having seen what digital healthcare solutions can do, providers are continuing to embrace telehealth and digital tools as a route to improve equity, access and efficiency. According to a new report by Grand View Research, the telehealth market is expected to reach $787.4 billion by 2028 – a compound annual growth rate of 36.5% from 2022. Research from Experian Health and PYMNTS confirms that patients similarly expect digital tools to remain on their healthcare menu, with two-thirds using patient portals. Healthcare providers must keep patients' digital demands firmly in their sights, to improve patient engagement and secure a competitive edge. For providers thinking about their next digital steps, where are the emerging opportunities and pitfalls? How to harness the benefits of digital healthcare solutions: 1. Satisfy consumer demand with hybrid models Research shows that digital-first patients prefer using online tools to schedule appointments, obtain test results and make payments. Providers can satisfy consumer demand by offering hybrid models that include in-person and digital tools. Experian Health's suite of patient access solutions allows patients to choose when and where they engage with their provider and reduces friction around booking and billing. Clean data and reliable patient matching can give patients a seamless experience as they move between online and in-person interactions. 2. Connect with diverse communities to increase access to care Adoption of telehealth and digital opportunities goes beyond consumer satisfaction. Opening healthcare's digital front door enables communities that often find it challenging to access care, such as rural and lower-income communities, to overcome obstacles. Online scheduling tools can give busy families and those who may be juggling multiple jobs opportunities to book appointments at a time and place that suits them best. Data on the social determinants of health and patients' financial circumstances can be used to direct those in need to financial assistance, so patients don't miss care out of concerns about cost. Digital healthcare solutions can also be a better fit for younger patients who automatically reach for their mobile devices to interact with services. 3. Automate to save resources and mitigate rising inflation Automated and self-service digital healthcare tools that eliminate the need for manual input are also far more efficient than analog alternatives. Providers can save valuable staff time and resources and redirect them to where they're most needed. A more efficient and adaptive approach to healthcare delivery can help combat rising inflation and ride out economic shocks. Pitfalls to avoid when implementing digital health solutions: 1. Close the expectation gap – especially around payments Despite these advantages, a gap remains between how patients say they want to use digital tools, and whether they can actually use them. For example, in The Digital Healthcare Gap report by Experian Health and PYMNTS, 32% of patients who don't currently use patient portals said they'd be interested in doing so if one was available. There's a similarly stark gap between the number of patients seeking upfront cost estimates and those who get them. Only 24% of patients said they had access to a patient portal that offered pricing estimates. To increase patient satisfaction (and bump up collections rates), providers must expand portal capabilities to include cost estimates, payment plans and other services that patients repeatedly say they need.Closing the expectation gap will be particularly relevant to providers that want to attract new and younger consumers, who are more likely to expect and use digital healthcare solutions. 2. Eliminate disjointed data with interoperabiliy Digital and data-driven tools are only as powerful as the data they’re built on. If patient information is inaccurate or incomplete, the convenience and ease expected of digital healthcare solutions start to break down. Providers must find digital healthcare solutions that are convenient for patients to use, but also compatible and easily integrated with the wider information ecosystem. A unique patient identifier is one way to ensure that these innovative tools and apps work together and ensure staff have access to up-to-the-minute patient information. Getting the back-end setup right will ease friction in the patient journey. 3. Avoid missed opportunities to scale with actionable analytics As the pandemic has shown, telehealth and digital healthcare solutions have the power to open access to care, but only if they are made available to the right patients at the right time. Experian Health's data and analytics solutions allow providers to identify gaps in digital strategy delivery, understand and segment patients, and adopt a flexible and responsive approach to create a frictionless patient journey. Find out more about how Experian Health can support healthcare organizations to maximize the opportunities in implementing digital healthcare solutions and secure the digital advantage.

Dayton Children’s Hospital is a pediatric hospital in Ohio with over 300,000 annual patient visits. Ranked by U.S News & World Report as one of the top 50 pediatric facilities in the United States, the facility’s mission centers around providing “optimal health for every child.”  Challenges The Patient Accounts department, led by Richard Gonzales, wanted to reduce his team’s reliance on third-party collections agencies and avoid associated fees. This meant that his in-house team needed to further scale its operations and processes to reach their in-house collections goals. The Pre-Service Operations department, managed by Jason Schenck, pursued efficiencies for resources within the centralized scheduling team, including the goal to quickly respond to referrals and turning those referrals into scheduled appointments within 24 hours. Throughout the pandemic, both teams experienced staffing shortages and pandemic-related absences. Because their dialing methodologies were manual, these disruptions in personnel prohibited them from growing in-house collections and reaching the turnaround times Schenck's team wanted to achieve for scheduling referrals. As Dayton Children’s strived to achieve these ambitious goals, they decided to proactively provide a better patient experience through convenience, connection and an effective communication experience. Resolution Dayton Children’s launched Experian Health’s PatientDial solution in the Patient Accounts department to scale their in-house collections efforts, thereby reducing dependency on their outside collections agencies. The solution was also adopted in the Pre-Service Operations department to automate dialing and conversation readiness so that the team could expedite the scheduling of referred patients. The expertise of a dedicated Experian Health consultant provided unwavering support to the two departmental heads and also gave them full control over the operations to best match their expectations. Streamlining patient payment collections with PatientDial  The Patient Accounts department’s operations revolve around billing a claim, reducing bad debt, increasing patient collections and providing effective customer service. They devised a two-pronged approach when it came to contacting patients for payments. The outbound campaign focused on collections, whereas the inbound customer service team handled the large volume of incoming calls from customers and rerouted them to the correct department. When it comes to collections, the Patient Accounts department found that making phone calls was the most effective medium to support their collections efforts. Billing is a complex process and taking the time to connect with patient guarantors to explain those bills paid off. To refine the communication approach, patient accounts were segmented based on outstanding balance amounts and where they were on the statement cycle. Calls were then made to the accounts with the highest propensity to pay. Waiting on hold not only wastes a patient’s time but also leads to a frustrating patient experience. Many even abandon calls, to call again later, which makes phone lines even busier. To provide a better patient experience, the department was also able to try out an innovative recall campaign, enabled by the queue callback feature. Patients were called back automatically the moment an agent became available, thereby reducing call hold time. By providing patients with this callback option, Dayton Children’s is empowered to accept more inbound calls per day along with having empathetic conversations with guarantors around payment plans to sustain its collections goals. Patient scheduling and preregistration powered through automation The Pre-Service Operations department leveraged PatientDial to improve outbound call efficiency and optimize existing staff resources to schedule appointments rather than leave voicemails. The productivity for scheduling a new patient visit from an outbound call was about 30%. With the centralized team supporting more than 40 specialty clinics, the team needed to improve the number of new patient visits scheduled daily, which meant opening resources to receive inbound calls. The mighty team of 10 was able to strategically use the autodialer feature to make new appointments, send appointment reminders and schedule referrals. Time is of the essence in a healthcare setting, and swift access to pertinent patient information enabled the staff to start their work even before greeting the callers when an inbound call came. Powered by the agent pop feature, staff had immediate access to key patient identifiers such as name, date of birth and specialty clinic from referral. Additionally, the feature enabled the team to reinvest time in creating a positive patient experience through improved hold and talk times, both of which reduce the risk of call abandonment. Results of incorporating PatientDial With PatientDial, the Patient Accounts department has been able to successfully align revenue goals with employee productivity. Previously, the staff was able to make only 50–60 calls per day, out of which 70% went unanswered. By automating dialing, the staff is now able to make 600 calls per day, resulting in a corresponding uptick in collections. The recall campaign, used for following up with patient guarantors, was a new endeavor for the department and has reduced the staff’s burden of making 300 manual calls per day and has also reduced call abandonment rates. The Pre-Service Operations department, has seen a 50% increase in patient appointments scheduled, powered by 600–800 automated calls made per day. The referral-to-scheduled appointment timeline has gone down from 4 days to under 1 day. Two hundred patients can now be reached via text daily and the speed to answer calls has been reduced from 60 seconds to 30 seconds. Lastly, PatientDial has positively challenged the Pre-Service Operations department to rethink productivity and daily operational efficiency. Dayton Children’s investment in dialing automation has streamlined their patient communications around scheduling and far exceeded initial goals. Because of the resulting high volumes of new patients scheduled and improved efficiency and effectiveness the team realized, there’s a strategic plan specific to central scheduling and to implement standard processes for managing new patient referrals across the organization. What’s next for Dayton Children’s? Empowered by their stellar results, both the Patient Accounts and Pre-Service Operations departments want to further explore how PatientDial could help other departments achieve greater productivity and further deliver a positive patient experience. The Patient Accounts department wants to maintain its focus on productivity gains and employee experience through PatientDial, with the ultimate goal of bringing in more collections. The Pre-Service Operations department plans to take on additional scheduling responsibilities across departments, creating time to reinvest in direct patient care and improving patient outcomes. Initial plans are for establishing patient scheduling and improving processes to identify and schedule follow-up visits. Both the teams at Dayton Children's recognize Experian Health’s expertise in revenue cycle solutions, which has made this a successful partnership. Learn more about how PatientDial uses patient outreach and patient engagement processes and workflows to increase your bottom line.  

When it comes to the patient journey, knowledge is power. That's where targeted patient outreach comes in. Informed patients can make better and faster decisions about their healthcare. By arming patients with answers and easy access, they’ll be less likely to miss appointments or fall behind on payments. Instead, they’ll enjoy better health outcomes and a more satisfying healthcare experience. As digital services evolve, healthcare providers need to find new ways to engage patients. That means embracing digital tools and data analytics to make sure patients get the information they need through their preferred channels, and at a time that makes them most likely to act. Knowing what patients need gives providers the power to communicate with more patients, more effectively, and deliver outstanding patient experiences. This article looks at three specific use cases for targeted patient outreach. These include reducing pressure on staff, closing gaps in care and streamlining patient collections. Use case 1: Targeted patient outreach can help reduce pressure on call center teams and increase appointment bookings One of the biggest pain points for patients is having to schedule appointments by calling a specific number at a specific time, and then being put on hold until an agent is available to help. A recent survey by Experian Health and PYMNTS found that over the last year, one out of every five patients chose to skip this option and have booked their appointments through digital channels instead. Instead of just providing patients with a number to call during office hours, providers can make it even easier for patients to book appointments by deploying a patient outreach solution that connects patients to an online scheduler. Automated text message (SMS) and interactive voice response (IVR) campaigns can be used to send patients a link to schedule their appointment immediately. Waitlists can also be managed with this technology, by sending automated messages that enable patients to accept earlier appointments that may become available and cancel their existing appointments to make the slot available to others. Reminders are useful, but the ability to make an appointment is far more likely to result in bookings. Not only is this convenient for patients and enables them to see their doctor sooner, but it also helps offload call volumes for busy call center staff. Automated outreach capabilities can reach many more patients than a traditional call center setup. It can also process thousands of calls and messages per day without agent input. Use case 2: Targeting at-risk patients to close gaps in care Targeted patient outreach also plays an important role in closing gaps in care, so patients get preventative and follow-up treatment without delay. Historical patient data and data on the social determinants of health (SDOH) can be leveraged to identify at-risk patients and ensure they get timely, relevant and actionable information about their care options. For example, researchers in Pennsylvania found that patients with lung cancer were more likely to attend screening appointments after receiving some form of outreach, compared to those receiving standard care. Similar prevention-focused approaches have been suggested to identify patients at risk of chronic kidney disease, to address gaps in screening and early intervention. SDOH data and targeted patient outreach solutions can also be used to support populations that typically struggle with access to care, such as immigrant, minority and lower income communities. Outreach messages can include information about health education, local resources, links to book wellness visits and details of screening programs. Use case 3: Streamline patient collections and avoid lost revenue with targeted patient outreach In addition to tailored messaging around scheduling and health education, automated patient outreach solutions can be used to streamline patient collections with bill reminders and self-pay options. For example, PatientDial is a cloud-based dialing platform providing inbound and outbound automated calls. This speeds up collections by giving patients self-service options, such as balance retrieval, bill requests and pay-by-phone. Similarly, PatientText sends automated text messages with a link to a provider’s patient portal and contact center phone number. Frequency and content can be customized, and since there’s no send limit, providers can scale their campaign to as many messages as needed. Both tools reduce the need for agent involvement and provide insights to help improve performance. PatientDial in practice: Sanford Health used PatientDial in combination with Collections Optimization Manager to route collections calls to the appropriate agents based on the patient’s ability to pay. This led to increased collection rates. The system also generated $2.5 million in patient payments by verifying billing information, and an additional $60k was found through better management of accounts for deceased patients. Targeted patient outreach should be personalized, proactive and process-driven The key to success in each of these use cases is to be proactive. With the right data and patient outreach solutions, providers can anticipate the information that patients will need and deliver the must-know details in a tailored and timely format. Patients will be empowered to manage their own healthcare journey, while providers will lighten the administrative load and see higher collection rates. Find out more about Experian Health’s patient outreach solutions.

Healthcare staffing shortages are patients' biggest safety concern, according to a new study by ECRI. Pandemic pressures led many healthcare workers – clinical and non-clinical – to join the “Great Resignation,” causing a significant drop in hospital employment since February 2020. Insufficient staffing can lead to longer wait times and clinical and administrative errors, which can present a real threat to patient safety. Critical shortages also erode financial performance through wage inflation, recruitment and training costs, and hampered productivity. As the problem persists, providers are seeking effective solutions to alleviate the burden on their existing workforce and solve for healthcare staffing shortages. Digital tools and automation should be top of the list to help improve efficiency, increase staff satisfaction, and corral the resources needed to deliver high-quality care in a cost-effective way for non-clinical jobs. Creating the conditions for a thriving healthcare workforce The pandemic exacerbated longstanding issues with understaffing and burnout that led to healthcare staffing shortages, but it also expedited several digital innovations that may be part of the solution. An aging population coupled with increasing public health concerns aren't going to make the situation any easier, so healthcare leaders should leverage these digital advances to build a resilient workforce. For non-clinical roles, advanced data analytics and automation can complement wider workforce strategies – by making it easier for downsized teams to do more with less. This can help reduce time-consuming manual work, eliminate frustrating and unnecessary rework, and streamline workflows to increase efficiency and job satisfaction. By handing off repetitive and rule-based tasks to intelligent software, administrative and billing teams will be able to manage the growing workload with less staff and focus their efforts on the tasks that really need a human touch. How digital tools can fill in the gaps created by healthcare staffing shortages 1. Streamline non-clinical workflows with advanced analytics Analytics can capture organization-wide insights to inform planning and optimize staff resources on a day-to-day basis. By taking a deep dive into existing processes, providers can better understand what tasks are really necessary. Eliminating superfluous activities and automating those that don't need a human touch means that available staff can be deployed more efficiently. This is more than simply digitizing existing workflows. The real power lies in combining updated technology with strategic process improvements. For example, automated patient outreach allows providers to send automated messages and appointment and bill reminders to patients, so fewer staff members are needed to manage calls. It can also be used alongside consumer data to segment patients according to their needs, so providers can identify and reach out to those that may need to reschedule care. This can help forecast future demand with greater accuracy. 2. Facilitate self-service patient access with automation Equipping patients with the digital tools to complete more administrative tasks themselves is another effective way to reduce the need for staff input. Self-service patient scheduling and registration solutions give patients the convenience and choice they desire (as revealed in Experian Health's State of Patient Access survey 2.0). They also minimize the manual tasks and call volumes that put pressure on understaffed patient access teams. Digital scheduling also plays a role in patient care. Online scheduling reduces the risk of no-shows because it's easy for patients to book and reschedule appointments at a time they know they can attend, thus avoiding diagnostic and treatment delays that could lead to poorer health outcomes. And unlike manual registration processes, data errors are far less likely, which helps avoid delays and rework later. Automated self-scheduling and registration platforms allow small teams to handle more complex work, which improves staff satisfaction and increases the likelihood of positive patient outcomes. 3. Let better data minimize staff time spent on revenue cycle tasks Understaffed teams must allocate their time carefully. Significant amounts of staff time can be saved throughout the revenue cycle with more accurate and timely data. For example, Kootenai Health in Idaho saved 60 hours of staff time in two months by automating patient financial clearance. More patients were assigned to the correct financial pathway, and reliable data insights helped reduce manual work and guesswork, leading to fewer bills being written off. A particular challenge for busy teams is managing frequent changes to prior authorization requirements. Prior authorization software pulls information from multiple health plan websites to give staff real-time visibility into current requirements and generates an exception-based workflow so they can focus on high-priority tasks. Ease workforce pressures and enhance the patient experience with automation Automation is not a substitute for the care and attention provided by expert healthcare workers. However, new digital and data-driven technologies can complement person-to-person interactions and ease pressure on busy teams. Integrating reliable data sources, analytics and responsive workflows can help providers manage current shortages and future workforce challenges by removing unnecessary manual tasks, reducing errors, and offering insights to improve patient-facing and back-office systems. Contact us to find out how Experian Health's data-driven insights and automation can help solve for healthcare staffing shortages, protect the revenue cycle and maintain high-quality standards of care.

As the digital healthcare revolution takes hold, do assumptions about a generation gap still hold true? Do Millennials and Gen Z have different expectations of healthcare providers compared to Baby Boomers and Gen X? In today’s hyper-connected world, the differences are a matter of degree. We’re all Gen C now. Futurist Brian Solis coined the term “Gen C” in 2012 to describe the rise of the “connected consumer,” a generation of active participants in the digital-first economy. Recently, the term has come to be associated with everyone living through the age of COVID-19. This includes pandemic babies whose early months have been shaped by quarantines and virtual playdates, and consumers of all ages who have reimagined their lives through digital tools and services. Gen C transcends the usual generational divides. Experian Health’s State of Patient Access 2.0 survey shows that patients of all ages embraced self-service technology and virtual care during the pandemic. Younger groups may be in the majority, but demand for a consumer-centric digital patient experience crosses demographic lines. Forget Millennials and Gen Z – it’s Generation COVID that’s driving the healthcare revolution. In this article, we look at what healthcare providers need to know about the attitudes and expectations of Gen C consumers. How does healthcare need to adapt to successfully engage the connected generation? Gen C: it’s an attitude, not an age Think With Google describes Gen C as a “powerful new force in consumer culture… people who care deeply about creation, curation, connection, and community. It's not an age group; it's an attitude and mindset defined by key characteristics.” Understanding the Gen C mindset will give providers the competitive edge when it comes to patient engagement. What might that look like? Gen C is constantly connected. Nearly nine in ten have a social media profile, with two-thirds updating it daily. They’re accustomed to organizing their life through apps and digital technology. Younger Millennials and Gen Z have grown up with the digital world in the palm of their hand, and have come to expect quick, flexible, and convenient app-like access to real-life services. Gen C values authenticity and transparency. Recent political, economic, and environmental turbulence has created a group of consumers who choose brands and services according to their personal values. There is also a greater emphasis on convenience and price. Instant access to information means they may be more likely to question healthcare advice and compare services. And news reports of data breaches and corporate scandals mean providers may need to work harder to gain their trust. Gen C chooses brands that embrace the power of personalization and community. Gen C expects personalized patient experiences. However, they’re also looking for community. Health and wellness brands that facilitated connection through online groups grew in popularity during the pandemic, especially when people were unable to work out together. As influencer culture continues to evolve, more brands are inviting real consumers to act as brand advocates. This includes utilizing social media to give consumers an opportunity to engage directly in product development. Healthcare services that can offer ways for consumers to connect with like-minded communities will be particularly attractive to Gen C. How does Gen C feel about health? It’s no surprise that the pandemic has made consumers more health-conscious. Gen C takes a more holistic view of health than previous generations and is more likely to use wearables and fitness apps to track their health goals. They’re also more comfortable talking about previously taboo topics, such as mental health or sexual wellness. Digitally fluent consumers are also more comfortable seeking answers to health questions online. A study by Gartner found that 41% of consumers with a health issue would talk to friends or family, and 38% would search for information on their own, before contacting a physician. There’s an opportunity for providers to position themselves as the first and best resource for reliable, engaging and accessible health information. As Gen C’s influence grows, it pays for providers to invest in understanding their needs and expectations. How should providers adapt the healthcare experience for Gen C? Offer convenient, flexible and self-service access to care Flexibility, speed and convenience are woven into Gen C’s expectations of the healthcare experience. The State of Patient Access 2.0 survey found that around seven in ten consumers said they wanted to be able to schedule their own appointments online, and a similar number wanted the option to contact their provider through a patient portal. Gen C is less likely to use a desktop computer or make a phone call, so enabling mobile-friendly apps is key. Online self-scheduling allows patients to find and book available appointments using their mobile devices. Integrations with scheduling rules and up-to-the-minute calendar checks mean patients are only shown the most relevant provider booking information. It’s a closer match to their other consumer experiences, as opposed to long phone calls and wait times with a call center representative. Similarly, automated registration tools can simplify patient intake and give consumers the option to check their details on their mobile devices. Rather than filling out multiple paper forms that are labor-intensive and error-prone, patients can simply complete the process on their phone or tablet. And for the 39% of patients who worry they’ll catch an infection at their doctor’s office, being able to complete intake tasks without sharing clipboards and pens in the waiting room will be a huge relief. In a recent podcast interview with Beckers Hospital Review, Jason Considine, Chief Business Development Officer with Experian Health, said: “With COVID-19, digital tools and data-driven solutions introduced more streamlined processes into our healthcare system. The expectation is that they’ll remain. Providers must embrace this digital transformation. Invite patients to self-schedule online, leverage digital outreach tools, simplify the registration process, and provide a transparent cost of care with flexible payment options… We need to create a simple consumer experience that matches what patients have in other facets of their lives.” Use consumer data to offer personalized outreach and boost patient loyalty Understanding Gen C requires providers to rethink patient loyalty. In the past, patients might choose a physician and stick with them for much of their adult life. Now, they’re more likely to shop around. Research published just before the pandemic showed that 73% of consumers expect companies to understand their needs and expectations, and 62% expect those companies to adapt according to the consumer’s actions. Experian Health’s survey also showed that patients welcome proactive outreach by providers, though many providers fail to do so. Nearly half of providers said that inaccurate or incomplete data prevented this. Providers know that a personalized healthcare experience is good for their bottom line, but without reliable data about each patient’s needs, preferences, and lifestyle, delivering this is a challenge. Consumer healthcare marketing data can pull together reliable data sources to allow providers to communicate the right message in the right channel for different patient segments. For an even richer view of patients’ individual non-clinical needs, providers should consider including social determinants of health (SDOH) data. COVID-19 revealed gaps in healthcare providers’ capacity to leverage data to support economically and socially vulnerable groups. With this type of data, providers can personalize their outreach strategies in a way that truly supports individual patients and underserved communities. Make it easy to pay with upfront estimates, coverage clarity, and digital payment methods Household financial concerns were felt even more acutely over the last two years. Younger generations say they’re more likely to consider cost when it comes to making healthcare decisions, with almost 60% saying it’s now the main consideration. Gen C expects upfront, transparent cost estimates, with two-thirds of younger consumers saying they’re more likely to seek out medical care if they know the cost beforehand. The State of Patient Access 2.0 survey confirms that price transparency remains high on the list of patient demands. To this end, there has been a major regulatory push toward price transparency at the federal and state levels. Many providers are deploying transparent pricing strategies and payment estimate tools to make it easier for patients to navigate the costs of care. Demonstrating a commitment to price transparency can be a powerful marketing strategy to attract and retain loyal consumers – especially for those who are most affected by fluctuating employment and financial circumstances. Watch our interview with Dan Wiens, Product Director for Patient Estimates at Experian Health, in which he describes how price transparency and patient estimates will evolve in 2022. Patient payment estimates give patients clear, accessible, and easy-to-understand estimates before they come in for care. A cost breakdown is delivered straight to their mobile device, with the option to pay right away. In addition to payment estimates, Gen C is looking for payment plans and payment mechanisms to be available at their fingertips, anytime, anywhere. In a world where they can order food and pay household bills at the tap of a button, it can be frustrating to have to wait a month for a medical bill. In fact, 70% of consumers say healthcare is the industry that makes it hardest to pay. Providers that can offer a choice of simple payment methods, pre-and post-service, will be likely to attract more Gen C patients. An integrated solution such as Patient Financial Advisor can help these tech-savvy consumers see their estimated cost of care, and make payments right from their mobile device. For providers, the benefits of making it easier for patients to pay are clear. As demand for transparent and contactless payment methods continues to grow, investing in these digital innovations could be an effective route to recouping some of the financial shortfall experienced during the pandemic. Don’t forget – more healthcare staff are Gen C, too Digital transformation isn’t just a consumer issue. Many of the digital tools and services that enable providers to meet the needs of connected consumers will offer benefits at the organizational level too. Automation and advanced analytics lead to more efficient processes, better use of staff resources, fewer errors and more meaningful workflow insights. Time and money are saved, profits increase and staff enjoy a more satisfying working experience. Investing in incremental innovations on back-end systems is even more relevant, given that growing numbers of healthcare staff are Gen C themselves. Just like consumers, they are accustomed to using digital apps and tools to run their lives, and they’re looking for similar efficiencies while at work. Failure to provide staff with the tools they need to do their jobs in the digital age could lead to wasted time, revenue loss, and the adoption of less reliable and secure workarounds. With the right digital tools and systems, providers can equip staff to fulfill their roles safely and effectively -- attracting and retaining a high-performing workforce. Providers must open their digital front door to secure patient loyalty now and in the future The pandemic has cemented a cultural and practical shift in the way healthcare is delivered. Now that more patients have had a taste of a digital patient experience, they expect it to continue. Gen C is pushing the healthcare industry to catch up to convenient, connected, consumer-centric services that are the norm elsewhere. Providers that can engage with Gen C in their digital language now will attract more satisfied consumers over the long term. Contact us to find out how we can support your organization bring together all the digital tools at your disposal, to create a healthcare experience that’s in line with Gen C’s evolving expectations.

COVID-19 transformed the patient journey, and it's clear when we evaluate every step. Data and technology gave patients the convenience, flexibility, and control to get care on their terms, and these changes will be here to stay. From marketing to scheduling to payments and more - providers and payers have ample opportunities to respond to these changes and will need to adapt their future strategies accordingly. Self-scheduling, mobile registrations, and automated authorizations are a few examples of tools and technologies that are more than likely to remain prominent in healthcare. What other changes are here to stay? In this new infographic, we take a dive into each of the 7 steps to see how data and technology has impacted the patient journey, and provide strategic recommendations on how providers and payers can adjust post-pandemic: The use of data and digital tools opened up new doors for greater patient access, engagement, transparency, and control. The post-COVID-19 patient journey is going to continue to evolve - payers and providers will need to adapt to keep up with the changes, to ensure that patients experience the best outcomes. To get a deep dive into all of the changes to the patient journey, download our white paper.

This is the fourth in a series of blog posts that will highlight how the patient journey has evolved since the onset of COVID-19. In this post, we address the fourth step – prior authorizations, and helping your patients get the approved care they need. This series will take you through the changes that impacted every step of the patient journey and provide strategic recommendations to move forward. To read the full white paper, download it here. Ask ten physicians how to improve healthcare administration, and they are likely to share dozens of conflicting answers. But if there’s one thing almost all of them can agree on, it’s the need to dramatically overhaul the processes around prior authorizations (PAs) for patient care. Prior authorizations for specific procedures, tests, and medications are designed to reduce financial surprises for patients and providers - while encouraging evidence-based care. The challenge is that criteria for authorizations changes frequently and can be complicated. Unfortunately, due to the COVID-19 pandemic, frequent change and complexity are difficult to manage. After months of avoiding in-person interactions, patients are now flooding back to their providers to catch up on deferred care. In many ways, the increase in volume is to be celebrated: providers are recouping lost revenue and patients are once again receiving necessary services. But with the return of patients comes the return of onerous paperwork, and providers are not entirely prepared to play catch up. In 2021, two-thirds of providers told Experian that they are finding it difficult to keep track of complicated criteria that keep changing during the pandemic. The same number expect to see ongoing challenges with securing authorizations for scheduled elective procedures, a marked increase from just over half of those surveyed last year. As providers, payers, and patients adjust to the new normal of COVID-19, it’s time for providers to streamline operations, increase efficiency, and improve revenue cycle predictability with automated prior authorizations. Coping with the multiplying burdens of prior authorizations Faxes and phone calls dominate the pre-authorization process. Practice staff – or even patients themselves – might spend hours working with multiple payer organizations trying to fill out forms, get more information, or appeal decisions. Without going through this tedious procedure, practices risk claim denials that can significantly impact their revenue cycles and patients may end up with unexpectedly large out-of-pocket bills. Over 80 percent of providers have seen an uptick in prior authorizations since 2020, building on a multi-year trend of increasingly complex PA requirements. In a recent survey from the American Medical Association (AMA), 85 percent of physicians confirmed that the burdens from prior authorizations are “high” or “extremely high,” and are affecting their practice operations. With an average of 40 prior authorizations per week per physician, some practices are spending more than two full working days each week on paperwork, the AMA says. Practices that want to get ahead of PAs will need to take a new approach to preapprovals and health plan relations. Fortunately, innovative automation technologies are available to help. Leveraging automation tools to streamline prior authorizations Prior authorization software can significantly decrease the cognitive burdens and person-power involved in completing PAs. With key features, such as an always-up-to-date knowledge base of current requirements for multiple health plans, staff members don’t have to search for obscure rule changes or the right payer portal to make sure their submissions are accepted the first time around. Exception-based workflows with dynamic work queues can easily guide staff members through convoluted requirements. Advanced status tracking, flags for manual review requirements, and procedure reconciliation tools also ensure that staff are always informed and prepared to take action. As a result, providers and physician groups gain the ability to complete more PAs in less time with a lower risk of errors, resubmissions, or claims denials. Meanwhile, patients can get the timely, evidence-based care they need and are less likely to find unpleasant surprises in their next medical bill. Integrating proactive preapprovals into the patient journey Providers can even take these newfound capabilities one step further to create a fully coordinated, cost-effective administrative experience for their patients. For example, automated Notice of Care tools are the perfect complement to digital prior authorization solutions. With these solutions, providers can send timely and accurate patient admission, observation, and discharge notifications while simultaneously gaining visibility into pending encounters. Uniting Notice of Care tools with data-driven PA strategies will make it simpler to proactively and holistically manage patient flow, anticipate resource allocation, and provide patients with timely and accurate information. As consumers begin to return to their pre-pandemic healthcare habits, it will be more important than ever for providers to get a handle on their administrative requirements and ensure they have the bandwidth to focus on reestablishing strong relationships with patients. With a combination of prior authorization tools and Notice of Care solutions, practices can complete necessary administrative tasks quickly and easily to support efficient, effective, and engaging patient journeys through the continuum of care. Learn more about how Experian Health can help your organization streamline patient access and improve revenue cycle predictability with automated prior authorizations. Download the white paper to learn more about how the prior authorizations process is changing post-pandemic.   Missed the other blogs in the series? Check them out: 4 data driven healthcare marketing strategies to re-engage patients after COVID-19 How 24/7 self-scheduling can improve the post-pandemic patient experience COVID-19 highlights an acute need for digital patient intake solutions