Tag: identity management
When it comes to patient access, friction can lead to bad patient experiences. If patients can’t see a quick way to schedule a medical appointment when they visit their provider’s website, they’ll click away. If registration involves sitting in a waiting room with piles of paperwork, they’ll be reluctant to attend. If patients are confused by complex billing processes, they’ll put it off until they have the time and energy to engage. A recent survey by PYMNTS and Experian Health found that 61% of patients would consider switching to a provider that eliminates these pain points in patient access and offers more streamlined patient access, for example, through a patient portal. Beyond consumer satisfaction, convenient and flexible patient access makes financial sense for providers. It can help reduce no-shows, enable better use of staff time and accelerate patient collections. It also paves the way for higher quality care. After all, if patients are deterred from attending appointments and/or thinking about switching providers, it’ll take much longer for them to receive their diagnosis and treatment. What does “convenient and flexible” mean in practice? It means deploying digital patient access software that allows patients to complete intake tasks at a time and place that suits them. Self-service scheduling, automated registration, and personalized outreach around billing all help to create a friction-free consumer experience – and a more consistent cash flow. Rethinking patient access with patient-friendly digital solutions Consumer feedback in the survey by PYMNTS and Experian Health suggests there’s an opportunity to rethink patient access to meet patients’ digital expectations. Here are some examples of revenue-boosting swaps that will help create a patient access and intake experience that keeps patients coming in: 1. Instead of time-consuming queues and call center bookings → offer convenient online self-scheduling Around a fifth of patients say they’ve used digital scheduling tools, including patient portals, websites or text messages. Patients want to be able to schedule appointments when it suits them, rather than having to call within fixed hours to speak to a call center agent. Online self-scheduling allows patients to quickly find and book available appointments. Some providers may worry that these systems can’t account for their complex scheduling rules, but that’s not the case. Built-in guided search functions can factor in the provider’s scheduling rules, so patients are only offered appointments with the right providers. It’s easier for patients, and it’s far more efficient for staff. Relying on institutional knowledge and thumbing through giant binders of questionnaires can be stressful, time-consuming and error-prone. Online patient scheduling platforms eliminate these challenges. 2. Instead of patchy patient data → get accurate and complete patient identities One of the biggest challenges in patient access is capturing and utilizing accurate patient information. Typos, missing demographic details, out-of-date contact information and duplicate data all contribute to gaps and errors in patient identities. Without complete and reliable patient records, providers run the risk of delivering substandard care and suffer from preventable revenue loss. Instead of relying on manual data input processes, providers need digital systems that ensure the information added to a patient’s record is correct and complete. Experian Health’s Patient Identity Management solution pulls from the industry’s most reliable data sources to verify each patient’s information. It arms staff with automatic updates and alerts them to any potential discrepancies. Identity Verification helps improve the patient experience, minimize payment delays, and protect patients and healthcare organizations from identity theft. With more accurate data, collections are more efficient, leading to faster revenue recovery and fewer costly denials. 3. Instead of losing revenue to unnecessary write-offs → run automated coverage checks to find forgotten insurance If patients are unsure of their insurance coverage status, providers must invest time and resources to check for missing coverage. This pain point is currently in sharp focus, with the end of the COVID-19 Uninsured Program and the end of continuous Medicaid enrollment. As patients’ coverage status changes, providers must be able to run efficient checks for any potential missing or undisclosed coverage. Experian Health’s Coverage Discovery tool can run automated checks to look for billable coverage, as soon as the patient first interacts with the organization. Data-driven coverage discovery gives patients clarity about what they owe so they can plan ahead and allows more efficient use of staff time. 4. Instead of opaque pricing information → make it easy for patients to understand and pay bills Patients want transparent healthcare pricing. However, 15% of patients said they found it difficult to get accurate price estimates before coming in for care. The complaint was more frequent among the most digitally active patients – who are also more likely to switch providers based on the quality of digital services. Despite a recent push toward price transparency, there’s still a long way to go, with many providers struggling to comply with new federal price transparency requirements. Upfront pricing estimates make it easier for patients to understand and plan for their medical bills. With Patient Payment Estimates, patients get a clear, personalized breakdown of their expected financial responsibility sent directly to their mobile device. Patient Financial Advisor takes this a step further, by offering a text-to-mobile financial experience that connects patients with estimates, payment plans and contactless payment methods. Providers that offer convenient and flexible ways to pay will be best placed to protect profits. Discover how Experian Health’s digital patient access software solutions can help attract and retain satisfied consumers and bolster the bottom line.
Healthcare revenue cycle challenges exist at every stage of the patient journey, beginning with patient access and extending all the way through claims, billing, payment and collections. However, digital tools and analytics can help providers tackle their top healthcare revenue cycle challenges. “The complexity of our reimbursement structures and the complexity of billing mean a variety of aspects impact revenue cycle management,” says Tricia Ibrahim, Director, Product Management, Contract Manager, Hospital at Experian Health. “Technology, regulations, changing contractual obligations and payer policies, people, processes, billing—each of these complexities adds to the challenge.” Revenue cycle management (RCM) issues can also lead to revenue loss if not addressed. Data and analytics, digital tools and automation can help providers manage complexity and adapt to evolving patient needs. Here are seven of the top healthcare revenue cycle challenges and how providers are taking them on: 1. Problems with patient access Consumers accustomed to using mobile apps and online services to shop and do their banking look for seamless digital experiences when they’re choosing a provider, scheduling appointments and managing pre-appointment activities like registration and insurance verification. In a new consumer survey by Experian Health and PYMNTS, 77% of patients who were not currently using digital tools for healthcare said they would be interested in switching to a provider that offered a patient portal. The automated tools that make up your digital front door make a huge difference in how patients engage. Together with accurate estimates and convenient payment options, digitally focused Patient Access Solutions help providers enhance the patient journey and improve registration accuracy. Manual processes require more staff time up-front; human error can lead to claim denials or billing errors later in the cycle. Automating streamlines the process. Offering patient intake software that can be accessed online or via a mobile device provides the flexible and familiar digital experience they expect in today’s world. 2. Poor collections recovery rate As high deductible health plans have patients taking more responsibility for their healthcare costs, patients are finding it more difficult to pay. Bigger bills often translate into a greater potential for confusion, more questions about insurance coverage, and a greater need for financing options. Providers need effective collections strategies to boost revenue and lower bad debt write-offs as more focus shifts to the patient as a payer. A patient-centered payments strategy helps patients better understand their estimated costs, insurance coverage, and payment options. To help patients navigate the financial process successfully and navigate this healthcare revenue cycle challenge, providers will need to support them with: Clear, accurate estimates that show patients how much they’ll owe up-front Payment options that include multiple payment methods, including cards, Apple Pay, and e-checks Navigating payment plans to manage large balances A process that encourages payment before service or at the point of service to reduce collections down the line When providers have to collect, digital tools and analytics can help optimize the collections process by prioritizing accounts that are most likely to pay, automating billing and messaging workflows, and even tracking the effectiveness of outside collections agencies. 3. Billing errors Claim denials are a drag on workflow, sending staff into a repetitive loop of claims submission, denial, correction, and delay—and throwing a wrench into revenue flow. A denied claim typically slows reimbursement by 16 days. Worse, claim denials are on the rise: 69% of healthcare leaders in an MGMA Stat poll reported that denials increased at their organizations in 2021. Replacing manual processes with automated workflows can reduce billing errors and A/R days. Integrated claims management software reviews claims for inaccurate coding before claims are submitted, easing demands on staff time, reducing claims denials, and shortening the time between billing and payment. 4. Underpayments in payer contracts Missed payments and underpayments can add stress and volatility to your revenue cycle. Often, the source of these problems lies in payer contract issues. “Payers often know your book of business better than you do,” says Ibrahim. “When you’re negotiating contracts, you need to be able to go through large amounts of data quickly and efficiently, so you can come to the table armed with information. One of the services we provide is contract analysis to help providers evaluate contract terms in real dollars and cents.” For active contracts, Healthcare Contract Management helps providers track inaccurate payments and hold providers accountable. 5. Changes in healthcare regulatory and compliance standards New regulations are a constant in healthcare. However, this is one of the biggest healthcare revenue cycle challenges that providers need to keep up with. Failing to stay up to date with the ever-evolving compliance landscape can lead to claim denials, payment delays, and administrative and billing backlogs. Healthcare Regulatory Solutions, which includes systems for providing transparent, patient-friendly estimates, can make it easier to make regulatory compliance part of your regular business processes. A free No Surprises Act (NSA) Payer Alerts Portal keeps providers updated on how new NSA regulations are playing out. 6. Lack of data-driven metrics and insights Gaining efficiencies in RCM means using analytics to provide a big-picture view of what’s happening throughout the enterprise. This perspective is not always the default in a busy healthcare practice or hospital. Yet, “Fixing claim after claim on an individual basis isn’t going to get you the efficiency you want,” says Ibrahim. “You need to identify trends to find the biggest opportunities to improve your results.” Comprehensive data and analytics are key for providers that want to pinpoint and address areas of trouble. Here, disparate systems and siloed information can get in the way of creating the single view needed to diagnose the issues that are slowing down claims, billing, and payment. Revenue Cycle Management Analytics integrates client data with non-native standard Electronic Data Interchange sets to reveal opportunities for process improvements. By leveraging the right data, providers can optimize patient access productivity, billing efficiencies, reimbursements, and payer performance. 7. Potential security issues Patient portals engage patients and empower them to schedule their appointments, review test results, or make payments. But as providers digitalize to improve the patient experience and boost the revenue cycle, patient identities and data may be at greater risk. Cases of medical identity theft reported to the Federal Trade Commission rose more than 532% between 2017 and 2021. Medical identity data is particularly valuable to thieves, bringing 20 to 50 times more money than data from financial sources. Securely authenticating patients is critical as a safeguard for both providers and patients. Identity theft damages the patient experience and erodes trust, while dealing with the resource and reputational damage fraud can cause is a major potential liability for providers. Working with vendors that provide extensive Patient Portal Security and digital tools that protect patient identities without causing friction or frustration is essential to keeping patient data safe without alienating the patients in the process. Prevent healthcare revenue cycle challenges with automation Revenue cycle management healthcare challenges are among the great tests facing providers right now. But improvements in digital tools and analytics are helping providers keep revenue flowing while keeping both compliance and the patient experience in focus. Find out more about how Experian Health's Revenue Cycle Management Solutions can help your organization meet the challenges of modern RCM.
Solving the patient identity problem and ensuring that each patient record is accurate and airtight is a top priority. Healthcare providers want to be 100% confident in answering “yes” to the following questions: Is the patient who they say they are? Is the right medication being administered to the right person? Is the correct bill being sent to the patient’s current address? By validating patient identities, providers can secure patient trust, deliver high-quality care, and avoid losing revenue to identity errors and fraud. Unfortunately, patient identity management is only becoming more complex. While telehealth and remote patient access are opening healthcare’s digital front door to meet changing consumer needs and expectations, a mountain of sensitive patient data is piling up. This data is a gold mine for fraudsters who steal and sell patients’ personal information or use it to access services and prescriptions without paying. It’s distressing for patients and creates a major financial and administrative burden for healthcare staff. A nationwide patient identification system may still be some way off. However, providers can optimize patient matching in their own health systems by working to reduce vulnerabilities and adopting cutting-edge interoperable patient matching technology. Better patient matching means better patient care and protected profits The human cost of incorrect, incomplete or outdated patient medical records is significant. Patients could be given the wrong medication or diagnostic procedures. Allergy information can be missed. Patient test results can be mislabeled or mixed up. In Experian Health’s State of Patient Access 2.0 survey, almost half of providers said inaccurate and incomplete patient data was an obstacle to proactive follow-up, which could cause gaps in care and avoidable complications – which are critical to value-based care compensation. Duplicate and mismatched patient records also create massive inefficiencies that can threaten an organization’s financial health too. With telehealth claim lines climbing by 2817% between December 2019 and December 2020, reliably authenticating patient identities in both existing and new services will be critical to future financial performance. Resolve, protect and enrich patient identities with universal identifiers Having the right technology to resolve and secure a patient’s information when they log on to patient portals and telehealth systems is the first step. Automating patient enrollment with Experian Health’s PreciseID® ensures the patient is who they say they are. This solution utilizes best practices in identity-proofing, fraud management and device recognition. But this system only works if the records being matched are accurate. A universal patient identifier provides a single, accurate, 360° view of each patient throughout their healthcare journey. An interoperable format allows systems to talk to each other and protects against duplicates, errors, inefficiencies and fraudulent activity. Universal identifiers aren’t available nationwide yet, though there has been some encouraging movement. Congress is working to remove the ban on funding for such measures, while the Centers for Medicare and Medicaid Services are taking steps to promote data standardization. For health systems that want to maintain a golden record for each patient within the bounds of their own operations, Experian Health’s Universal Patient Identifier allows staff to connect, verify and protect patient information. Choosing the right patient matching technology Traditional matching technology relies on demographic data and uses deterministic or probabilistic methods to link records with identical identification information. However, relying on a single source of data means that previous errors are inherited by new versions of a patient’s record. Demographic data isn’t unique to individual patients, which can lead to mismatched records and create extra manual work to fix. Experian Health uses referential matching technology to build a complete view of patients from reliable health, credit, and consumer data sources. The universal patient identifier connects disparate datasets and instantly updates the master index of patient records with new data points. Referential matching can only ever be as good as the data that is being matched and Experian is a global leader in data accuracy, across numerous sources, and is continually updated. Victoria Dames, VP of Product Management at Experian Health, says, "With Experian’s reference data, we’re able to create a longitudinal record of each individual and reconcile their data as they change names, addresses and see different providers. You need to know that it’s the same person, especially with the pandemic acting as a catalyst for digital technologies such as telehealth. It also helps organizations bring data together and ensure data integrity through mergers and acquisitions. Dealing with large volumes of data is a big hill to climb, but with the right technologies it can be that much faster.” As telehealth and digital patient access services gain traction, solving the patient identity problem becomes increasingly urgent. Universal Identity Manager combines industry-leading consumer demographic information with the highest quality reference data and powerful unique patient identifiers to create a single view of each patient. With better patient identity management, providers can protect against errors and fraud, and reassure patients that their personal information is safe. Find out more about Experian Health’s identity management solutions.
No healthcare organization is immune to the problem of bad data. One in five patients has found errors when looking at their electronic health record (EHR). This includes incorrect information about their diagnosis, medications, test results and more. If the data held in patient records is incomplete, inconsistent, or inaccurate, this can lead to poor clinical decision-making, substandard patient experiences, and gaps in treatment or follow-up. In Experian Health’s State of Patient Access 2.0 survey, patient identity management emerged as a major challenge for healthcare providers, with almost half of the respondents saying that inaccurate and incomplete patient data hindered follow-up contacts and patient outreach. “Dirty” data also presents a major financial risk, costing healthcare organizations millions of dollars per year. Many providers have stepped up their digital offerings in the last few years, particularly in response to the pandemic. While digitalization offers huge advantages, it does have an unfortunate side effect. As more data is created, shared and accessed, there are more opportunities for mistakes. Some industries may accept a certain amount of rogue data as inevitable, but in healthcare, it mustn’t become the norm. Patient data needs to be consistent, complete and standardized to ensure the highest standards of care. The Centers for Medicare and Medicaid Services (CMS) recognizes the need for an easier and more secure exchange of healthcare data, and are taking steps to facilitate interoperability. As these provisions are finalized, providers can act now to embed data standardization in their digital services. Better data means better decisions, better care and lower costs. As the digital transformation continues, providers must implement strategies to eliminate inaccuracies, enable consistent identity management, and ensure data is standardized across all their systems and networks. In this article, we share three steps to help your organization ensure that patient data remains complete and consistent for better patient identity management. 1. Start with the right patient data As the saying goes: garbage in, garbage out. Reliable patient records require the right information to be added from the start, or errors will follow the patient throughout their healthcare journey. This will only continue compounding over time. A 2021 survey of Experian Health clients revealed that incomplete data arises for a variety of reasons. This ranges from patients not filling out forms correctly prior to their visit or forgetting their insurance cards, to staff having limited time to complete documentation. Typos, misspellings, duplicate data and missing information can also cause identity errors.* Providers should reduce the risk of inaccurate data from being added to a patient’s record in the first place. A standardized approach to data formatting is a good place to start. For example, if a patient is accustomed to writing their date of birth in a European format, with the day before the month, they may enter this incorrectly when filling out online patient access forms. Configuring calendar drop-down menus in such a way that prevents this will avoid these basic but costly errors. With a Universal Identity Manager (UIM), each patient’s record can be maintained in a standardized format. Probabilistic and referential matching techniques are used to check the patient’s identification information against existing databases, for a more complete view of the patient regardless of any data gaps. 2. Solve patient matching challenges with robust identity verification It doesn’t matter if patient records are accurate if staff pull up the wrong record when they speak to a patient. Providers should prioritize consistent identity management to ensure clinical and non-clinical staff see the same and correct information, regardless of where or when a patient interacts with their organization. Identity Verification validates the patient’s identification information during pre-registration and check-in by instantly accessing demographic information. This includes the patient’s name, address, Social Security number, date of birth, phone number and insurance coverage data. If there’s a mistake, it’s easily found and corrected. 3. Standardize data to maintain clean patient databases Victoria Dames, Vice President Identity Management at Experian Health explains why standardization is so important: “The increasing use of digital services means that more healthcare data is being exchanged within and between health systems than ever before. However, in order to leverage the opportunities that come with a more connected healthcare system, we need that data to be as reliable as possible. Preventing inaccuracies before they occur will be much more cost-effective than scrambling to fix them after the damage is done. With a standardized approach to data collection and management, healthcare organizations can maintain reliable records for every individual patient and stay ahead of the game as more data is generated and shared.” Unique Patient Identifier (UPI) helps providers eliminate duplicate records so there’s a “single source of truth” for each patient. After the UIM matches the patient’s information within a single and accurate patient file, a UPI is assigned to that record and maintained in a master index. This is far more secure than a traditional matching algorithm based on Social Security numbers, which can be vulnerable to errors. Together, these tools help healthcare providers create and maintain a “golden record” for each patient. Data quality will always be a challenge. However, with the right data standardization strategies, providers can make better decisions. This will create better patient experiences and better health outcomes while limiting the financial impact of dirty data. Contact Experian Health today to find opportunities to clean up your healthcare data for better patient identity management. *Survey of Experian Health clients, October 2021 Are you an Experian Health client? Then we invite you to join our Innovation Studio research community. Your ongoing input is key to driving improvements to our tools and products! Sign up here!
As patient expectations shift, providers that offer a personalized healthcare marketing experience will be more likely to attract and retain satisfied consumers. The pandemic accelerated this shift. As a result, the traditional ways of healthcare marketing are starting to fall short. For example: A healthcare marketing strategy that’s designed for an “average consumer” results in a one-size-fits-all model that doesn’t always meet a patient’s individual needs. Communication options with fixed hours and channels don’t reflect “patient first.” Outreach messages blasted to an entire patient email list miss the mark for individuals who don’t speak the language or might prefer a quick text message instead. A study by Dassault Systèmes and CITE Research found that 83% of consumers expect products and services to be personalized within moments or hours. They’re accustomed to the “one-click” digital retail experience, which offers instant access to relevant recommendations and flexibility about how and when to buy. They’re also suffering from information overload, thanks to the sheer volume of emails, messages, articles and videos flooding their digital devices. Personalized communications can remedy that and help consumers feel respected and empowered, which drives connection and loyalty. But personalization isn’t just important for patient outreach. Personalized healthcare marketing can also help ensure patients get the treatment they need, by anticipating individual needs and highlighting relevant services at the right time. With the COVID-19 pandemic continuing to influence access to care, personalized healthcare communications can also be tailored for different patient segments. This can help reassure or remind individuals to book vaccination appointments or reschedule deferred care. Improve patient engagement with personalized outreach As digital offerings grow, consumer engagement expectations evolve. Providers must keep pace and communicate accordingly. Incorporating information about patients’ lifestyles, behaviors and preferences enables providers to deliver the right message at the right time. It also helps providers select and use the most effective channel of communication. Patients are more likely to respond and are empowered to manage their healthcare journey. For example, a Gen Z patient may prefer to receive appointment reminders by text, while an older patient may prefer a physical letter. One patient may prefer to get prescriptions mailed to their home while they’re at work, while another may be content to visit a pharmacy and pick up their medication while shopping nearby. Some patients will want a text message with a payment link to clear outstanding bills immediately, while others will appreciate a customized payment plan. Experian Health’s State of Patient Access survey 2.0 found that patients welcome proactive outreach by providers, though many say this doesn’t happen. Providers recognize the value in proactive patient engagement, but many say they lack the data to reach out effectively. With reliable consumer data and analytics, providers can create holistic profiles and deliver improved marketing to better serve new and existing patients. ConsumerViewSM pools data points on core demographics, behavioral insights, psychographic information and financial data to help providers understand their patients. This data can then be analyzed using Mosaic® USA and TrueTouchSM to segment, identify and reach the target audience with the most relevant message and format, and adapt based on consumer response. ConsumerView also adheres to consumer data privacy regulations, so providers can actively engage patients and build patient loyalty while confident in the knowledge that they have permission to use the data. Reduce readmissions and improve patient outcomes with better segmentation Personalized healthcare marketing isn’t just about messaging and channels. Providers that have a holistic picture of a patient’s lifestyle, life events, geographic changes and socio-economic challenges will be in a stronger position to anticipate their evolving wants and needs. For example, social determinants of health (SDOH) data can tell providers which patients may need extra assistance when visiting a doctor’s office, so that appropriate measures can be put in place. They might help identify patients with potential comorbidities that warrant proactive reminders about preventive check-ups. Similarly, providers can segment patients according to their financial situation. This can help with creating custom payment plans and sending timely payment reminders through targeted communications channels. Effective post-admission engagement can also help patients access the support needed to adhere to care plans, thus minimizing the risk of readmission and reducing unnecessary costs. A McKinsey & Co study found that around a third of patients with unplanned, high-cost follow-up care reported reasons that were considered avoidable, such as receiving unclear post-discharge instructions. Boost retention and recruitment with patient-centric and personalized healthcare marketing As rising medical costs and pandemic-related lifestyle shifts prompt more patients to shop around for care, providers must take action to create a healthcare experience that’s truly patient-centric. With data-driven healthcare marketing tools, providers can differentiate their services from other health systems vying for the same market. Find out how Experian Health can help your organization use consumer insights to build a patient-focused, personalized health marketing strategy to attract and retain satisfied consumers.
This is the first in a series of blog posts exploring how the patient journey has transformed as a result of COVID-19. This series will take you through the changes that impacted every step of the patient journey and provide strategic recommendations to move forward. In this post, we explore the role of healthcare marketing in acquiring and re-engaging patients as they return for care. Read the full white paper here. The healthcare industry’s overnight switch to digital-first operations put marketers and patient engagement teams at the heart of the new patient-provider relationship. From helping patients navigate online services and contactless care to providing timely information about COVID-19, proactive communications became a matter of life and death. Now, the challenge has shifted again. With a growing number of patients moving locations, changing jobs, and switching health plans, healthcare providers must strengthen their marketing outreach efforts to welcome new consumers and reconnect with existing ones. Finding new strategies to communicate effectively and pointing consumers to the right services at the right time will be key to financial recovery post-pandemic. Here, we look at four opportunities that healthcare marketers and patient outreach teams can incorporate into their post-pandemic playbook. Opportunity 1: Get your records straight before investing in new healthcare marketing strategies As patients’ circumstances changed, many found their health records were out of date. Addresses were incorrect. Insurance records were incomplete. Some individuals accidentally set up duplicate accounts when registering for online services. For providers, this amplified a challenge that existed long before the pandemic – finding ways to ensure accurate patient identities. A recent survey by Experian Health found that patients welcome proactive outreach by providers, though many say their providers fail to do this. Nearly half of providers say they want to, but inaccurate or incomplete patient data gets in the way. Investing in marketing and outreach strategies is money down the drain unless providers can verify that the information they have for each patient is reliable. An identity management tool such as can confirm names, addresses and other demographic details of existing patients and those who have recently moved to the area – to correctly match their information at every digital and in-person touchpoint. Opportunity 2: Build personalized patient outreach strategies based on consumer insights Next, providers can enrich patient identities with originally sourced consumer data for a comprehensive picture of who their patients are. When providers can confirm who their patients are, what they need, how they spend their time and money, and how they like to communicate, they can build personalized outreach strategies to improve patient acquisition and retention. For example, providers have new opportunities to offer telehealth access for patients in their preferred language. Experian offers 196 language codes that can be applied based on individual patient profiles, so you can connect patients to the right physician. For patients who are new to the area, communication that reflects their lifestyles, preferred channels, and personal interests will help maintain loyalty and provide better customer experiences. The aftermath of the shift to online and digital healthcare tools has been polarizing, with some patients feeling hesitant to engage with unfamiliar tools. Others expect a more sophisticated digital experience that matches their interactions in retail and entertainment. Knowing which camp patients identify with will help your patient outreach team discern which tools and guidance to offer to which patients. With ConsumerView, you can differentiate your services from other health systems vying for the same consumers, and offer a tailored engagement experience. Opportunity 3: Reduce readmission risk with data on social determinants of health Knowing whether your new and existing patients are affected by social determinants of health (SDOH) can also help tailor outreach communications. This can help them overcome access challenges and reduce the risk of readmission. Understanding if patients are at risk of missing appointments or struggling to follow a care plan because of food insecurity, isolation, lack of transportation, cultural exclusion, or financial limitations, can help providers point them to relevant community programs and financial support. By understanding patient barriers, providers will be able to communicate more effectively with their patients. For example, a conversation with someone who is experiencing unexpected, short-term financial difficulties as a result of losing their job in the pandemic would be much different than a conversation with someone who has been unemployed and low-income for many years. Opportunity 4: Reschedule deferred care by marketing online scheduling platforms Seven in ten patients deferred or canceled treatment during the pandemic. Providers must figure out where those patients are and what their (potentially more serious) healthcare needs may be. Re-engaging and rebuilding relationships with these patients is critical to encourage them to come back for care. Marketing teams play a major role in raising the visibility of non-coronavirus health issues and the need to reschedule care and return to a pre-pandemic healthcare routine. Third-party data can fill in the gaps in patient identities, so providers can identify specific needs and worries, determine the best contact information for each patient, and re-engage effectively. Online scheduling platforms will be especially important. These platforms can help patients reschedule appointments at their convenience, connect them to telehealth services, and overcome some of the practical barriers to care. Find out how Experian Health can help your organization access new sources of data and see how your patient community has changed since March 2020, down to the individual level. By combining identity management software with accurate consumer insights, your marketing and outreach teams will be armed with everything they need to attract and retain satisfied consumers. Download our white paper to see how other steps of the patient journey have evolved since the onset of COVID-19.
Patchy patient data has plagued the healthcare industry for decades, but the pandemic opened the door to a whole new set of identity management challenges. As patients rushed to register for patient portals and book vaccines, many unwittingly created multiple accounts, having forgotten they’d already signed up. Fluctuating unemployment levels meant many individuals were forced to jump health plans, which meant their records were moved between various organizations. As a result, data errors crept in, and identity updates were omitted. Incomplete and inaccurate patient identification data leads to suboptimal clinical decision-making, poor patient experiences, and higher costs for patients and providers. A 2020 study found that one in five patients had spotted an error in their electronic health record (EHR). Many clinicians have also witnessed medical errors that stem from patient misidentification. Hospitals lose millions of dollars every year in denied claims arising from identity errors, which can easily be avoided with a standardized approach to identity management. In a recent survey conducted by Experian Health, we found that identity management emerged as a major challenge for healthcare providers. Almost half of the respondents said that having inaccurate and incomplete patient data hindered follow-up contacts and patient outreach. It matters to patients too – a 2020 survey for the Pew Charitable Trusts found that four in ten were more supportive of data-sharing efforts among providers because of the pandemic, and twice as many were open to the idea of biometric identity verification. "Patients still welcome proactive outreach by providers, but more say their providers fail to do this, and 45% of providers say inaccurate or incomplete patient data gets in the way." - Experian Health's State of Patient Access, June 2021 Providers know that a 360-view of their patients is essential for improving patient outcomes and delivering positive patient experiences; however, duplicate and incomplete data continues to thwart their efforts. With a unique patient identifier (UPI) and a robust identity verification solution, providers can achieve single, accurate, and current records, and solve for these data standardization challenges. Data standardization creates a single source of truth for each patient Despite bipartisan recognition of the need for a national standard for patient identities, statutory barriers have hampered the adoption of a nationwide UPI. In the absence of a national approach, providers must take the lead to ensure high-quality patient records and prevent duplication, gaps and errors. The first step towards data standardization is identifying the type of patient information your organization needs. What data must be collected from patients? Which form fields are required and which are optional? How should data fields be formatted when updating patient records? Standardizing data collection and ensuring content and format consistency will help create reliable records for every individual patient. Next, a Universal Identity Manager (UIM) can hold and protect that single view of each patient, creating a standardized approach when new data is added. The software assigns a unique identifier to each patient, which follows them throughout their entire healthcare journey. By drawing on referential and probabilistic matching techniques with Experian data and patient rosters, the UIM uses the unique identifier to accurately match the patient’s identification and medical history, to help both clinical and non-clinical staff offer optimal care and support. Confirming the patient is who they say they are Having an accurate picture of each patient is only the first step. Next, providers must feel confident that each record can be correctly matched to the individual who is trying to log on to the portal or sitting in the waiting room. A complete and current record is useless if clinicians are matching it to the wrong person. To solve patient matching challenges, most healthcare organizations assign employees or contractors to fix and clean up data records. Without a software-driven identity management engine, these teams are forced to rely on manual processes, which are time-consuming, costly, and still vulnerable to errors. Alongside the consistent approach to content and format mentioned above, providers should have a reliable way of checking and amending the patient’s records at every touchpoint in the healthcare journey, using cutting-edge identity proofing techniques, risk-based authentication, and knowledge-based questions. A tool like Identity Verification can easily identify every patient and help maintain a clean and accurate patient database. Each patient’s demographic data can be validated and corrected during pre-registration, so providers know that the person is who they say there. This is even more crucial as the pandemic leads more patients to opt for remote and virtual services alongside in-person care. Future-proofing patient identities as the pandemic prompts long-term change Since March 2020, many Americans have gone through major life changes. Whether it’s the loss of a loved one or loss of a job, a change of address or a change in attitude towards their health, patients’ lives are changing. The healthcare system must adapt to follow suit. Many more players are involved in delivering healthcare, with digital apps and tools growing in popularity. These developments mean more patient data is being generated and shared, and by more diverse and distributed sources. A robust identity verification system built on standardized data can help smooth out the bumps in patient records and offer better patient experiences and improved health outcomes. Providers don’t need to completely overhaul their records system, but by investing in incremental changes to improve the quality and governance of their data, they can accelerate the move towards data standardization. Talk to Experian Health about how our proven tools can help your organization deliver better patient data quality today, and build a universal identity management system fit for the future.
“Experian Health’s speed and ability to speak our business language definitely impressed us,” said ACS president, Tim Anderson. “Some of the claims were valid for only a few more weeks, and we were able to submit them in plenty of time. This is the best, fastest platform we’ve seen to reconcile duplicate and data-deficient records. It really helped us achieve the best possible resolution for our clients and our company.” Acadiana Computer Systems, Inc. (ACS) was contracted with numerous labs in Louisiana to submit billing claims, primarily to Medicare, for testing that occurred in the first months of the pandemic. Unfortunately, in the chaos and scramble to offer testing services as quickly as possible in nursing homes and testing sites, the labs struggled to collect needed information to submit valid claims – in particular the Medicare beneficiary’s MBI number, or even a Social Security number. As the pandemic response progressed, a similar challenge developed around the administration of vaccines, particularly in mass vaccination sites and other off-site vaccination centers. Providers struggled to get more than a name and maybe a birthdate, address, or phone number. This left a gap in ACS’ efforts to submit private insurance and Medicare reimbursement claims on behalf of their clients. ACS worked with Experian Health and our Universal Identity Manager (UIM) platform, delivering the Experian Single Best Record (ESBR) – the matching of records through aggregation of disparate information and delivering a single record that accurately identifies separate records that belong to one person. The platform uses multiple data sources to verify, match and consolidate disparate records into one “best record.” ACS assembled the records requiring more identifying data and prepared them for secure transfer to Experian Health. Experian Health securely accepted more than 75,000 patient records and ran them through the UIM platform in 24 hours. It was critical to assign an SSN to as many individual records as possible, and to confirm an associated MBI number for Medicare billing, if applicable. Results included: 69% assigned unique records 12% identified as duplicate records With the information delivered back from the matched records, ACS had all the necessary data needed to continue the billing process. Within a week claims were submitted, expected to exceed $20 million in collections when the process is completed. The ACS group was experienced, savvy and data ready. Their expertise enabled an elegant and efficient exchange and complemented Experian Health’s capabilities. ACS expects to continue to use Experian Health’s UIM platform throughout the pandemic and also for mitigating duplicate records and preparing claims for submission. Learn more about how our Universal Identity Manager (UIM) platform can help your organization eliminate duplicate patient records.
As Spotify and Amazon can attest, digital technology plus personalization is a winning formula. Consumers want anytime-anywhere access to the services and products they enjoy, without having to sift through irrelevant information. They want tailored recommendations that will make their life easier. More than eight in ten consumers say they’re more likely to choose businesses that treat them like a person instead of just a number. The pay-off for business—and health plans—is huge: by paving the way for better services, better relationships and a better consumer experience, personalization boosts profits, too. There’s one challenge: delivering personalization requires data. Health plans that want to offer a member-centric experience need the right insights to build a complete picture of what individual members need and want. Yet many health plans are forced to work from stale or incomplete data, notably when CMS hands over a new list of members or a new employer signs on to the plan. A system like that makes it nearly impossible to provide meaningful personalization, and consequently, the member experience suffers. With originally sourced data and consumer insights, health plans can fill in the missing links in member profiles and maximize opportunities to improve the consumer experience. Here, we look at how three specific data-driven strategies could help your health plan attract and retain satisfied members and demonstrate digital excellence by using personalization to drive improvements in communications and care. Personalize member communications for maximum engagement By looking beyond simple demographic data and clinical information, health plans can discover what really matters to members. Consumer data provides detailed insights about the kind of content that will resonate most with the member’s lifestyle, interests and health circumstances. Health plans can tailor their marketing messages accordingly, by highlighting articles about the treatment of relevant medical conditions or sending reminders ahead of annual check-ups.Health plans can also discover when and how to communicate with members so they’re most likely to respond. When member profiles reveal who prefers an email or a text and when, health plans can elicit higher levels of engagement, improve the consumer experience and see better results from targeted outreach campaigns. Make improvement decisions based on the most relevant data Consumer insights can also be used to develop improvement plans that zero in on exactly what members need for the best possible health outcomes. Combining insights on patient behavior patterns with an understanding of the challenges facing individual members means health plans can segment members, so the right support goes to the right place.For example, efforts to drive up medication adherence are going to be far more successful if based off accurate and current member profiles. Specific members can be sent automated, personalized reminders to fill out prescriptions in good time before they run out. Compare that to a “spray and pray” awareness campaign using generic messages that are likely to be ignored. Data-led improvement strategies are operationally efficient and create a better experience for members. Help members overcome social barriers to health Finally, when member profiles include a snapshot of how social and economic factors influence their ability to access healthcare, health plans can take action to offer support. Closing the gaps in care that arise when a patient fails to turn up to their appointment or ends up being readmitted to hospital, can often involve quite simple solutions. If data suggests the member has small children, but there’s no other adult in the household, it makes sense to cross-promote childcare services. Similarly, if the member isn’t known to own a car, a health plan could offer information on free transportation.Understanding these social determinants of health can help health plans offer proactive support so members enjoy better health outcomes in the long run. Experian Health’s rich datasets give health plans access to member-level insights on more than 330 million consumers, with data analysis and automation tools to help make business decisions based on the most relevant, current data. Contact us to find out how we can help provide the personalized experience members are looking for.