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The growing shift from inpatient to outpatient care continues. The U.S. ambulatory services market was estimated at USD 289.5 billion in 2023 and is projected to grow at a CAGR of 5.38% from 2024 to 2030. A Deloitte study notes that the gap between inpatient and outpatient revenue has been closing for two decades. But what's driving this boom? Clinical advances, patient demand for lower-risk and lower-cost options and payer pressure all play a role. New technologies, like advances in orthopedics, allow more procedures to be performed at outpatient service centers instead of costly hospital settings. Free-standing ambulatory surgery sites are expected to see a 14% volume boost over the next decade as more service lines, like cardiovascular and neurosciences, begin to shift procedures from inpatient to outpatient facilities. The ongoing growth in outpatient services presents a unique opportunity for revenue cycle leaders to use technology to improve outpatient revenue—and the overall patient experience. Grow outpatient revenue with more digital care Patients want a better experience at every step of the patient journey. They want to see their doctor faster, manage appointments online and understand how much it costs—with as little red tape as possible. A lack of streamlined patient access and transparency often results in no-shows, a rise in claims denials, wasted staff time and patient complaints. However, by opening the digital front door, providers can give patients the self-service tools they crave, improve the care experience, keep outpatient schedules full and increase revenue. Additionally, providers can use technology like artificial intelligence (AI) to lower claim denial rates. Here are five strategies to increase outpatient revenue in 2025. 1. Make patient access simple Patients want to see their doctor faster. In Experian Health's latest State of Patient Access survey, eight in ten patients who reported being unhappy with their provider experience cited waiting for an appointment as a top complaint. When trying to schedule, patients are also frustrated by the friction that comes with complex processes, clunky technology systems and sparse provider communication. Outdated manual workflows, staffing shortages and lack of staff training often result in challenges for both patients and providers. Improved patient access is at the heart of patient-centered healthcare. Technology designed to put the patient in control, like online patient scheduling and digital patient intake tools, offer continuous patient engagement, optimized scheduling, and streamlined administrative processes. By leveraging modern patient access solutions, providers can improve patient experiences and alleviate the impact of staffing shortages. 2. Reduce appointment no-shows Missed appointments cause headaches for patients, providers, and revenue cycle managers. Online scheduling and mobile registration are also top of mind for patients. In Experian Health's State of Patient Access 2024 survey, 89% of patients said they wanted self-service scheduling and 85% reported a dislike for filling out repetitive intake paperwork. Online patient scheduling software puts patients in the driver's seat, providing convenient and secure 24/7 access to book, reschedule, and cancel appointments on their own time. Solutions like Patient Schedule sync seamlessly to an organization's scheduling rules, and patients receive automated appointment reminders by text or IVR. On average, providers that use Experian Health's scheduling solution experience an 89% show rate, a 50% reduction in scheduling time, and a 32% increase in patients per month. Patient intake tools like Registration Accelerator simplify mobile registration with a streamlined text-to-mobile experience. Once registration is complete, automated returns of forms, patient-check-ins and demographic information ease the burden on staff. 3. Help patients prepare for outpatient costs Patients need a clear breakdown of their financial responsibility before receiving care. Without it, they may be unable to prepare for care costs appropriately. While hospitals are now required to share detailed pricing for at least 300 common procedures, confusion around a patient's actual financial responsibility still persists. More than half of patients report turning to their provider for help understanding what insurance covers. Digital solutions that provide accurate, upfront estimates empower patients. More than eight in ten patients say pre-service estimates help them prepare for the cost of care. Patient Payment Estimates provide upfront, real-time estimates of what a patient will owe. Providers can offer convenient and secure payment links, and allow patients to pay their bills online or see customized payment plans. Outpatient providers can further maximize the chance of reimbursement by running health insurance coverage checks across the entire revenue cycle. This can help find billable coverage that may have been forgotten and give patients greater certainty about what they'll owe. 4. Automate healthcare collections Collections are often a major challenge in the outpatient revenue cycle. Outpatient procedures can be costly, even with insurance, leaving patients responsible for potentially large bills. Automating healthcare collections allows for faster, more efficient, and more compassionate collections. Tools like Collections Optimization Manager helped Novant Health achieve an overall recovery rate of 6.5% and increase revenue and cost savings to a rolling average return on investment of 8.5:1. With automated tools like Patient Financial Clearance, providers can assess patients' ability to pay and assign them to an appropriate financial pathway. This allows patients to quickly get the assistance they need while freeing up valuable staff time. 5. Streamline claims to increase outpatient revenue Denied claims continue to be problematic for providers. In Experian Health's State of Claims 2024 report, which surveyed 210 healthcare revenue cycle leaders, nearly three-quarters of providers feel claims denials are increasing, while 67% feel getting paid is taking longer. Claims management software can help end the cycle of denials. However, around half of providers still use a manual claims review process, and only 28% feel confident in their understanding of automation, machine learning and AI. Adopting automated and integrated healthcare claims management solutions can reduce errors, prevent undercharges, and ensure a higher first-pass payment rate. Tools like Experian Health's ClaimsSource® simplify the entire claims process, while Claim Scrubber helps providers submit more accurate claims. Digital solutions can also automate claim status monitoring and eliminate manual denial processes. Implementing AI tools to interpret past claims data and recommend next steps can improve outpatient claim denial statistics. Tools like AI AdvantageTM look at past payer behavior and historical claims data to predict and prevent denials. AI Advantage's two components, Predict Denials and Denial Triage, help providers respond to growing denial challenges by identifying claims with a high likelihood of denial before submission, and focus on remits that have the most impact. See how: Find out more about how Experian Health's revenue cycle management solutions can help healthcare organizations increase outpatient revenue, keep pace with growing patient volumes, improve patient satisfaction and boost their bottom lines. Learn more Contact us

Published: December 2, 2024 by Experian Health

Convenience, speed, and control are the triad of better patient experiences. Experian Health's 2024 State of Patient Access survey showed that 89% of patients want to schedule their appointments online or on a mobile device. Today, patients expect provider scheduling, registration, and other administrative tasks to match the convenience of their typical online shopping experience. However, too many patients face obstacles when booking appointments and accessing care. With more than 6 out of 10 patients saying they would switch to a provider that offers a patient portal, making digital channels available is now a baseline requirement for providers seeking to improve care delivery. Patients want a digital front door that circumvents the inconvenience of traditional call center booking systems. Self-service patient scheduling software helps providers keep pace with patients' digital demands. But the case for scheduling software goes beyond these expectations, offering real benefits for patients and their doctors. Here are 8 reasons to use online scheduling to benefit both patients and providers: The benefits for patients 1. Patients enjoy the convenience and accessibility of online scheduling Online appointment scheduling provides unparalleled convenience and accessibility for patients. These solutions allow them to schedule their appointments anytime, without being constrained by office hours. This flexibility benefits individuals with demanding work schedules, family responsibilities, or other commitments. The user-friendly interface of online scheduling platforms enables patients to quickly navigate the system, select their desired service, and book an appointment without any hassle. Additionally, remote access means that patients can schedule their appointments from any device with internet connectivity, whether at home, work, or on the go, eliminating the need for physical visits or phone calls. 2. Patients can experience reduced wait times and greater access to care Nearly 8 in 10 patients who say they're unhappy with their provider experience cite the speed at which they see their doctor as a big frustration. By using online appointment scheduling, patients can significantly reduce their wait times. They have immediate access to the real-time availability of appointment slots, allowing them to choose the most convenient times without waiting for a receptionist to check the calendar. The streamlined booking process minimizes the back-and-forth communication typically required when scheduling via phone, leading to quicker confirmation and less time spent coordinating. Patients who need to reschedule can easily do so online, viewing available slots and selecting a new time without delays. 3. Patients can schedule anytime and from anywhere One of the most significant advantages of online appointment scheduling is its 24/7 availability. Patients can book appointments anytime, including evenings, weekends, and holidays. This flexibility primarily benefits those who find making calls during standard office hours challenging. With the ability to address their scheduling needs instantly, patients can book or change appointments whenever it is most convenient for them. Additionally, for practices serving patients in multiple time zones, online scheduling ensures everyone can book appointments at a time that suits them best. 4. Online scheduling provides immediate confirmation, reducing uncertainty and the need for follow-up Online scheduling provides patients with instant confirmation of their appointments, offering real-time updates that reduce uncertainty. Once an appointment is booked, patients receive immediate confirmation, often via email or SMS, which helps to alleviate anxiety and ensure they know their appointment is secured. Many online scheduling systems also offer automated reminders via email, SMS, or app notifications to help patients remember their appointments and reduce the likelihood of missed visits. This instant confirmation and reminder system also reduces the need for administrative staff to follow up with patients to confirm appointments, freeing up their time for other tasks. The benefits for providers 5. 24/7 self-scheduling increases appointment bookings and reduces no-shows One of the major challenges healthcare providers face is the issue of patient no-shows. According to the Medical Group Management Association (MGMA), the average provider no-show rate is 5% to 7%. The cost to healthcare providers is around $150 billion annually. Yet there is growing evidence that allowing patients to conveniently and quickly schedule, cancel and reschedule appointments decreases no-shows, which is money in the bank for providers. Studies at the Mayo Clinic and Johns Hopkins showed that the percentage of appointments kept increased when patients scheduled their visits online. Automated reminders and confirmations are integral features of online scheduling systems that help mitigate this problem. By sending reminders via email, SMS or app notifications, these systems ensure that patients know about their upcoming appointments. These reminders reduce the likelihood of patients forgetting their scheduled visits, decreasing missed appointments. Fewer no-shows translate to more consistent patient flow and better utilization of the provider's time and resources. 6. Digital scheduling reduces pressure on staff The convenience factor extends beyond patients. Self-scheduling platforms also improve efficiency and ease the burden on call center staff. Experian Health's “Short-staffed for the long term” report showed that 73% of providers say finding staff is challenging. As the chronic staffing crisis continues, providers should look to automated solutions to remove bottlenecks, increase capacity and improve the experience for call center staff. After partnering with Experian Health, Indiana University (IU) Health found that automated self-scheduling helped them do more with fewer staff while engaging patients. They stated, “Self-scheduling does the work of two full-time schedulers.” Of the patients who used the online scheduling tool, 87% arrived for their visit. Patient appointment scheduling software offloads call volumes and cuts call times in half. It also gives providers control over their calendars while integrating seamlessly with electronic medical records and practice management systems. Providers can also use these solutions in parallel to patient intake software to help accelerate registration, saving even more valuable time and resources. 7. Embracing digital scheduling gives providers a competitive edge Getting patient scheduling right is crucial to patient acquisition and retention strategies and is increasingly vital as patient volumes fluctuate. Making a strong first impression with easy self-scheduling is more likely to attract new patients and gives providers a competitive edge. Online appointment scheduling systems allow healthcare providers to manage their schedules more effectively. Providers can easily view and optimize appointment slots, ensuring effective time utilization. These features improve workflows and productivity as providers can balance their schedules to avoid overbooking or underutilization. Additionally, the ability to analyze scheduling data can help providers identify peak times and adjust their staffing and resources accordingly, further enhancing operational efficiency. In a competitive healthcare market, staying ahead of the curve with advanced technology solutions like online scheduling is crucial. Providers who embrace digital scheduling not only improve their operational efficiency and patient satisfaction but also position themselves as leaders in the industry, attracting tech-savvy patients who seek modern and convenient healthcare services. 8. Patient scheduling software can protect against the unexpected A final reason to embrace patient scheduling software is to future-proof scheduling capacity against unforeseen events. During the COVID-19 pandemic, flexible self-scheduling tools helped providers maintain operational stability as patient numbers surged with each new wave of infections. In a climate of chronic staff shortages, augmenting employee numbers is challenging and can be impractical to manage during periods when patient volumes subside. Patient self-service software is a DIY solution patients want, and providers need to stretch staff efficiency and work smarter. Today, these tools continue to improve, and providers increasingly rely on them to meet patient needs. A 2024 survey showed that 60% of patients want more digital tools to manage their health. Patient scheduling software gives patients the self-service experience they're accustomed to with 24/7/365 online appointment scheduling. New uncertainties will always be on the horizon, but with the right digital patient scheduling software, providers will be well-positioned to face whatever's next. Learn how Experian Health's patient scheduling software can help healthcare organizations meet patient expectations, improve operational efficiency and prepare for future patient scheduling demands.

Published: August 22, 2024 by Experian Health

Patient expectations of their healthcare providers have changed. Today, patients expect providers to offer the same convenience as their favorite e-commerce site, with intuitive self-service options that put them in the driver's seat. It's a brave new world for healthcare providers, who know the patient experience is about more than providing quality care—it's also about opening a digital front door with patient access technology. What do patients want from their healthcare providers? Experian Health's State of Patient Access 2023 survey shed light on what healthcare customers want: 76% want online scheduling from their favorite mobile device. 72% want an online payment option that is mobile-friendly. 56% want more (not fewer) digital options for managing their health. Outdated manual workflows do more than bog down backend healthcare teams; there's evidence this also frustrates patients. One study showed that 85% of patients believe technology can improve communication with their providers. Beyond the convenience of self-scheduling and improved communication, there is also evidence that patient access technology improves patient safety. Most people hate paperwork, and patients are no exception. Providers can digitize many of these manual tasks. Streamlining the patient access experience online could include: Online self-service appointment scheduling. Pre-registration via a patient portal. Real-time insurance eligibility verification. Automated, accurate out-of-pocket estimates. Text and email reminders to reduce no-shows. Online bill payments with personalized payment plans. Today's patients have grown accustomed to the immediacy of online shopping thanks to vendors like Amazon. That expectation transfers to healthcare, where administrative and financial tasks can be repetitious and frustrating. Technology can improve engagement with healthcare consumers, from patient intake to bill payment, while lowering the administrative burden on medical staff. How can patient access technology make healthcare convenient? Digital technology can transform the healthcare experience into a more accessible and patient-centric model. For example, 24/7 online scheduling lets patients book appointments at their convenience from their favorite online device without lengthy phone calls or complex scheduling processes. These solutions reduce wait times and patient frustration. Providers benefit from improved call center efficiency, lower no-show rates, and higher patient satisfaction. Digital patient portals are an easy conduit to better communication and faster access to healthcare information. Patients can fill out forms, get price estimates, check test results, and update insurance details. Providers benefit from more accurate patient data, not to mention more satisfied patients. Mobile-friendly tools enable on-the-go access to patient health information. From viewing test results to communicating with healthcare providers, mobile apps empower patients to actively engage in their healthcare journey. Secure messaging platforms enable patients to interact with healthcare providers by email and text, when they want, on their chosen device. Patient access technology also streamlines labor-intensive administrative processes with digital registration systems. Patients experience reduced wait times, as these technologies expedite check-in, contributing to a more efficient and hassle-free healthcare experience. Ultimately, these tools make life for patients and providers easier. Manual healthcare workflows cause bottlenecks and mistakes that lead to increasing claims denials. Patient access technology automates many labor-intensive tasks for patients and providers, including prior authorizations, which, if declined, can delay care and negatively affect patient outcomes. Tools like Experian Health's Patient Access Curator can check patient coverage within just a few seconds, speeding up reimbursement workflows from registration through payment. The software is particularly helpful for self-pay patients, helping providers identify a clear path towards financial accountability at the beginning of the encounter. Can automation improve patient engagement? Automation technology does more than improve human workflows in the complex service delivery world. These tools engage patients across their healthcare journey, a crucial component of effective, patient-centered care. Patient engagement refers to the active involvement of individuals in their healthcare journey, and automation can play a pivotal role in facilitating this process. Patient data allows technology to personalize each encounter. Automated systems can deliver timely and tailored messages to patients, reminding them of appointments, medication schedules, and preventive care. Automated patient access technology lets patients know that their chosen healthcare provider is looking out for their well-being. These solutions help patients stay informed and create accountability for adhering to treatment plans. Behind the scenes, sophisticated analytics provide valuable insights into the health of various patient populations. Healthcare providers make data-driven decisions that can guide any intervention before issues escalate. Automation can streamline administrative tasks, allowing healthcare providers to focus more on direct patient care. Digital platforms handle appointment scheduling, prescription refills, and routine inquiries, reducing the burden on healthcare staff and patients. Automating routine processes allows healthcare professionals to spend more time on meaningful patient interactions that build stronger long-term relationships. Improve patient access technology and improve patient experiences A recent Accenture study shows healthcare consumers are willing to switch providers if their needs and preferences are not met. Millennial and Gen Z populations are six times more likely to switch providers. The study also showed patient access was the top factor when choosing to stay or leave their healthcare provider. The increasing level of consumerism in healthcare should be incentive to change for any provider with legacy technology and outdated administrative processes. Experian Health’s automated patient access solutions improve the patient's experience at each point in their encounter with their provider. To find out more, speak to the Experian Health team.

Published: March 18, 2024 by Experian Health

Is the digitalization of patient access services losing momentum? Experian Health’s State of Patient Access 2023 survey suggests that both patients and providers feel there’s still work to do to open healthcare’s digital front door. Where are the gaps? And how can providers fulfill patients’ digital expectations? This article looks at the advantages of offering a digital patient access experience and three technologies that can help providers stay competitive and give patients what they need and want. What is healthcare’s digital front door? The term “digital front door” refers to the virtual gateway through which patients access healthcare services and information. It has become a synonym for patient access, encompassing the digital touchpoints patients interact with when they’re booking appointments, registering for care, verifying insurance eligibility, paying for services and checking their medical records. This can include a hospital’s website, mobile apps for registration and payment, patient portals, telemedicine platforms and online appointment scheduling systems. Digital services have become an integral part of daily life, and healthcare should be no different. Patients and providers alike are seeking streamlined ways to connect and engage. What are the benefits of opening healthcare’s digital front door?  According to the State of Patient Access survey, patients want one thing above all else: to see their doctor as soon as possible. More than three-quarters said online scheduling was a top priority. Being able to book appointments online sidesteps geographical and practical barriers to care, reduces wait times, and prevents more serious and costly health situations from arising. For providers, this is an effective route to patient loyalty as well as better health outcomes. Opening healthcare’s digital front door unlocks financial advantages, too. Registration forms can be pre-filled with verified patient data, eliminating the errors that can occur through manual processes. This saves time, effort and expense for patients and providers later. CAQH estimates that the efficiencies gained through automated processes across the entire revenue cycle, including patient access, could allow the medical industry to release savings of as much as $22.3 billion each year. As healthcare labor challenges continue, a third of providers also noted that digital technology can help offset staff shortages, easing pressure on staff by automating repetitive tasks. Clarissa Riggins, Chief Product Officer at Experian Health, says, "For those in the healthcare industry who have been hesitant about implementing technology due to fears about replacing workers, the current staffing shortage may be the catalyst they need to change." And with a wealth of insights about service utilization and staff workflows now at their fingertips, data-driven digital services can facilitate continuous operational improvements. Why has the digital momentum slowed? Despite these benefits, patients report a slowdown in the digitalization of patient access. While the acceleration of the adoption of digital services seen during the pandemic could be expected to level off, survey responses from patients and providers hint at a more significant dip. Only 17% of patients think patient access has improved over the last two years, and 47% of providers say it’s gotten worse. Riggins says, "Patients have increasingly high expectations for easy and efficient tech-enabled solutions when it comes to accessing healthcare services...The bottom line is providers must prioritize updating their technology to avoid being left behind. Patients, especially younger generations, are demanding a better 'digital front door' experience or they could look elsewhere for care. In fact, Experian Health's survey found that 56% of patients who believed the access experience was worse said they would switch providers because of it." How can healthcare providers improve their digital front door? Fulfilling patients’ digital expectations comes down to three things: 1. Quick and convenient self-scheduling Survey results show that 76% of patients want to schedule appointments online or via a mobile device. With Experian Health’s patient scheduling software, providers can offer patients the option to book, cancel and reschedule appointments from any device, at any time. This omnichannel platform acts as the central scheduling hub across an entire health system. Self-service scheduling and integrated text and IVR outreach campaigns reduce the number of calls to agents. And for those calls that are needed, guided search makes scheduling quicker and easier. 2. Mobile-enabled patient registration Data from Experian Health and PYMNTS found that a third of patients chose to fill out registration forms for their most recent healthcare visit using digital methods, while 61% said they’d consider switching providers to one that could let them manage care through a patient portal. Aside from boosting patient engagement, automated registration also reduces the risk of denied claims, by preventing data entry errors that occur during patient registration. With Experian Health’s patient intake software, providers can simplify registration for a better patient experience, reduced administrative costs and fewer denied claims. 3. Anytime, anywhere payments More than seven in ten patients say they want to be able to pay for healthcare using online or mobile methods. But before that, they also want to know in advance how much their bill is likely to be. The survey suggests that providers still struggle to deliver accurate, upfront cost estimates to patients. With tools like Patient Financial Advisor, Patient Estimates and self-service payment options, providers can help patients navigate the financial side of their healthcare journey, resulting in prompter payments and more positive reviews. Implementing new systems and tools can be daunting, but with the support of an expert vendor, providers can deliver the convenience and choice that patients demand in the most efficient and cost-effective way. As labor costs continue to rise, now is the time to invest in digital technology to ease pressure on staff, increase patient engagement and safeguard revenue going forward. Discover how Experian Health is helping to open healthcare’s digital front door with comprehensive patient access solutions.

Published: July 19, 2023 by Experian Health

With 2023 just around the corner, healthcare executives are teasing out their strategic priorities for the next 12 months. Where should they be focusing their attention? Here are the top 3 healthcare predictions to watch in 2023 and the actions needed to help providers prepare. Prediction 1: AI and automation will continue to gain traction “The time is now for providers to get ready, prepare and implement these technologies.” - ­Jason Considine, Chief Commercial Officer at Experian Health Automation came to the forefront during the pandemic, enabling essential access to care and filling in gaps created by staffing shortages. By now, the use of remote and digital tools is pretty well-established. Automation is the norm, but there’s room to leverage these solutions for an even greater ROI. As Jason Considine says, investing in technology that makes it easier for providers to get paid will be a particularly effective use of digital tools. One such example is in the digitalization of healthcare claims. Healthcare claims management processes have typically relied on manual systems. These can be slow and error-prone, creating avoidable extra work for staff and friction for patients. In the State of Claims 2022, 78% of executives said their organization would be likely to replace their existing claims management solution if convinced something else can deliver better ROI. Eliminating inefficiencies and optimizing reimbursement would certainly check that box. Tools like Denials Workflow Manager, Enhanced Claim Status and ClaimSource® use automation and detailed analytics to improve claims management performance. More claims can be processed more accurately, resulting in fewer denials and faster reimbursement. With denials increasing by 10–15%, claims automation is likely to be a top priority for many providers in 2023. Prediction 2: Patients will increasingly choose providers that offer a user-friendly financial experience  “The immediate path to better billing and payment processes may escalate pressures on providers right now, but it will yield better financial outcomes in the future for patients.” - Victoria Dames, Vice President of Product Management at Experian Health The economic downturn has put pressure on providers and patients, which we can expect to last into 2023. Patients are concerned about healthcare costs, but they’ve also come to expect a more transparent and compassionate financial experience. Experian Health's top healthcare predictions finds that reliable pricing estimates, support to find the right payment plan, and convenient and flexible payment options will be table stakes in 2023. For providers, implementing digital payment options to meet these needs may be challenging, but it’s an investment that will yield positive long-term results. More than 6 in 10 patients who have received an unexpected bill or inaccurate estimate would switch healthcare providers for a better experience in future, placing transparent medical billing at the core of attraction and retention strategies. The medical billing software outsourcing market is already experiencing historic growth as providers respond to patient demand for a digital financial experience: the market’s value is expected to grow over the next decade, from $11.1 billion in 2021 to $55.6 billion in 2032. Experian Health leads the way when it comes to creating a patient-friendly billing and payment experience, with solutions such as Patient Financial Advisor and Patient Estimates. Giving patients greater control over their financial journey with upfront estimates and tailored payment plans makes it easier for them to prepare for payments. Prediction 3: Providers that fail to create a welcoming digital front door could be closing off revenue opportunities  “Deliver convenience. People are consumers before they are patients.” - Tom Cox, President at Experian Health Automation offers opportunities for optimization throughout the revenue cycle, but one of the most crucial points is in patient access. Making patient access easier is on the list of top healthcare predictions, and for good reason - a frictionless first impression can have a powerful lasting effect. What should this look like? Cox advises that providers should “anticipate the needs of digital-first customers.” Patients expect the same personalized service they are accustomed to in other sectors, with convenience, choice and control at the center. Administrative “relics” such as the traditional waiting room clipboards and repetitive forms must be minimized where possible. A report from Experian Health and PYMNTS found that a third of patients chose to fill out registration forms for their most recent healthcare visit using digital methods. 61% of patients even said they’d consider changing healthcare providers to one that offers a patient portal. Online scheduling software and self-service registration makes it easy for patients to complete these tasks in advance. Providers can then round out a user-friendly patient experience with Patient Payment Solutions. This gives patients a choice of payment methods, leading to faster payments. Providers have realized that many patient access functions can be achieved more efficiently and cost-effectively using self-service and remote digital tools. By streamlining intake operations, organizations can make better use of staff time, reduce errors and increase productivity, while improving the patient experience simultaneously. As revenue cycle technology continues to develop in 2023 and beyond, providers need to ensure they are capitalizing on the latest software to improve their bottom line, deliver on patients’ service expectations, and keep pace with healthcare predictions. Learn more about Experian Health's revenue cycle management solutions and contact us to find out how these solutions can help healthcare organizations open their digital front door and prepare for 2023.

Published: December 15, 2022 by Experian Health

On July 28, the US House of Representatives voted in favor of extending Medicare telehealth flexibilities after the COVID-19 public health emergency ends. If enacted, the Advancing Telehealth Beyond COVID-19 Act will allow beneficiaries to continue to access telehealth services at any site, including their home, until December 31, 2024. Coverage for a wider list of telehealth practitioners, delivery at specific clinics, audio-only telehealth, and remote behavioral health and hospice care would also continue. After a quick implementation period at the start of the pandemic, providers spent the last two years refining telehealth delivery. However, a question mark remained about telehealth’s post-pandemic prospects. The new legislation offers welcome certainty around reimbursement, at least until December 2024. More significantly, it’s further confirmation that telehealth is likely to become a permanent fixture in modern healthcare delivery. What does that mean for providers? Telehealth is here to stay Throughout the pandemic, remote and virtual care proved an effective way for providers to maintain relatively stable service delivery and limit gaps in care. It even helped to tackle inequitable access to care by making it easier for rural and underserved communities to speak to their doctor. Now, patients and providers alike are familiar with the benefits of telehealth. It’s an expected component of the overall healthcare experience. For the American Telehealth Association, the vote is “a significant step forward in providing much-needed stability in access to care for millions of Americans… We cannot allow patients to lose access to telehealth post-pandemic, and this bill will provide stability through 2024, while giving Congress time to address how to make the policies permanent.” As telehealth is gradually stitched into the fabric of the US healthcare system, providers should consider the following three actions to maximize the opportunities that come with delivering virtual and remote care: 1) Review the digital patient journey and increase telehealth access Telehealth is more than just a video visit – a truly virtual patient care experience starts from the moment the patient books their appointment all the way through to patient billing. Recent data from Experian Health and PYMNTS found that a third of patients chose to fill out registration forms for their most recent healthcare visit using digital methods, while 61% of patients said they’d consider changing healthcare providers to one that offers a patient portal. Prioritizing the use of digital channels could therefore boost patient attraction and retention, as well as efficiency and productivity. Integrating telehealth platforms with online scheduling software means patients can choose how and when to book their appointment, and appointment options are synced with physician calendars for maximum efficiency. Similarly, providers can ease friction when patients are registering for a telehealth visit by offering digital, automated and mobile-friendly registration. 2) Prioritize personalized patient outreach and engagement While many patients are now familiar with telehealth services, many may not be aware that it’s an option or may be unsure of how it works. Patient engagement strategies are essential in communicating to patients that telehealth services are available. By providing clear information about how the visit will work, how to use the technology and how to prepare, providers can help patients understand the process more clearly so they get the most out of their visit. This is especially important for patients who may be unable to attend in-person visits (e.g., due to location, disability, or lack of transportation or childcare). Telemedicine helps these patients take a more active role in their health and healthcare journey, in turn closing gaps in care. It also creates opportunities for remote patients to access experts that they’d otherwise be unable to see. Consumer data helps providers build patient engagement and outreach strategies based on reliable demographic, behavioral, psychographic and financial information. As telehealth services grow, a tool like ConsumerView enables providers to segment, identify and communicate with different audiences so that patients receive the most relevant message at the most useful time. 3) Explore automation for efficient telehealth billing Keeping track of telehealth reimbursement regulations has been one of the key challenges for providers as telehealth services have expanded. Flexibility reduced some of the barriers to scaling telehealth services, but did leave the door open to variation in payer requirements, coding changes and geographical coverage. The new legislation would maintain the status quo for a while longer. But looking ahead, any further changes to telehealth reimbursement rules, combined with greater telehealth utilization, could leave providers with an administrative mess to clear up if they don’t have robust processes in place. Those that utilize claims management and billing tools now will be best placed to manage what may follow. Automation can ease the burden in several ways. For example, with Coverage Discovery and eligibility verification solutions, providers and patients can confirm coverage eligibility early, which will speed up collections further down the line. Another option is to use automated healthcare claims management software to ensure every telehealth claim is submitted correctly the first time. With Experian Health’s customization function, telehealth alerts can be automatically checked so providers know whether the patient is covered for virtual care. As telehealth services gain a permanent place in the healthcare ecosystem, providers should act now to optimize patient-facing services and back-end processes. Failure to do so could cause patients to look elsewhere for the healthcare experience they desire and lead to lost revenue opportunities. Contact Experian Health today to discover how data-driven insights and automation can help providers bolster their telehealth offerings to maximize reimbursements.

Published: September 14, 2022 by Experian Health

The U.S. is currently struggling with a critical healthcare labor shortage that is impacting every part of the revenue cycle. In fact, the American Hospital Association has deemed this challenge a “national emergency” that is only expected to worsen. Staffing shortages leave healthcare providers vulnerable to reimbursement delays, low morale and negative patient experiences.  As a result, many healthcare providers are leveraging automation to tackle this staffing crisis. Revenue cycle management (RCM) software and analytics can help providers navigate labor shortages by relieving staff of repetitive, process-driven manual tasks and improving operational efficiency. As healthcare labor shortages continue, how can providers maximize the return on their investment in automation? The snowball effect of healthcare labor shortages The first quarter of 2022 ended with a peak of 11.9 million open vacancies in the United States. Just about every industry is feeling the impact of the Great Resignation, driven largely by the fact that more people are reaching retirement age than are entering the labor market. In healthcare, the challenge of attracting and retaining top talent is felt even more acutely - in May 2022, the healthcare vacancy rate was 8.8%, second only to hospitality services. While the pandemic created greater pressures on healthcare staff, chronic understaffing and burnout were already a problem. Now, healthcare workers are contending with the snowball effect of increasing stress, sickness absences, lack of time to train new staff and loss of morale. Potential recruits may be tempted away to industries touting fewer COVID regulations, competitive pay, and more flexible and remote positions. Healthcare providers need smart and creative staffing strategies to close the gaps. Automation should be at the heart of HR contingency planning Providers may look to traditional market forces to solve the staffing challenge. Reducing services, increasing wages, improving working conditions and partnering with local education facilities to attract new staff are all on the table. But tight margins and inflationary pressures limit the options available, and policy changes can take time to be implemented. Automation can help mitigate healthcare labor shortages in three main ways. It can reduce the workload and increase staff capacity, improve operational performance and free up resources that can be reinvested in the workforce, and create better experiences for staff (and patients). Using automation to increase staff capacity Repetitive tasks that follow the same process every time are perfect for automated programs. Shifting the load from staff to software means that fewer team members are needed for those activities, and available staff can focus on more complex issues. Patient access is a good place to start. Many hospitals have already started to scale back care due to severe staffing shortages. Online scheduling and automated registration can ease the burden as patient volumes increase. These self-service tools cut down call center queues and eliminate labor-intensive data entry. With automated pre-registration, the correct information for each patient can be pre-filled and follow them throughout their healthcare journey, so staff no longer lose entire days spent resolving data input errors. Automation can improve operational efficiency, even with labor shortages Automation is more than replacing human effort with software programs: it also strengthens operational performance. Automated revenue cycle tools can complete tasks such as data entry, coverage checks, pre-authorizations and eligibility verifications much faster – and with fewer errors – than staff. If data-driven tasks can be completed with greater accuracy and efficiency, then the entire revenue cycle will move more quickly, leading to faster reimbursement. This is especially obvious when using automation to streamline collections. It doesn’t make sense for staff to pursue all past-due accounts, but with automation and advanced analytics, they can identify the patients most likely to pay and focus their efforts accordingly. Collections Optimization Manager uses multiple data sources to automatically screen and segment accounts, so staff doesn’t waste time chasing the wrong ones. Accounts are then distributed to appropriate collections channels using specific routing and recall rules. With a better understanding of each patient’s financial situation, staff can engage with patients in a more compassionate way and resolve issues without repeated calls and emails. Alongside this, automated patient outreach can provide personalized and convenient communications about patient collections. PatientDial frees up staff from time-consuming calls by providing automated inbound, outbound and blended calls with live agents or automated interactive voice response (IVR) services. “Queue callback” automatically calls patients back when a suitable agent becomes available, maximizing staff time while improving the patient experience. PatientDial also monitors agent performance so managers can make strategic decisions to improve workflow. Using automation to create better user experiences Existing staff may worry that increasing the use of automation could lead to their jobs becoming redundant. This isn’t really the case: while automation and artificial intelligence (AI) allow RCM teams to “do more with less” and reduce the need to recruit additional staff, they should be seen as complementary to rather than replacing staff. By removing time-consuming and tedious tasks, automation creates a better experience for staff. User-friendly interfaces give patient access, claims and billing teams all the information they need to help patients quickly and accurately. And as prior authorizations and payer policy changes change ever more frequently, staff will be relieved to hand over the task of checking each payer’s website to a software program that can complete the job quickly and accurately. Shifting to online and mobile options gives patients a more convenient and satisfying user experience, too. For example, automated self-service tools can be used to give patients upfront estimates about their expected cost of care, and link to convenient payment methods. It’s a quick win for providers who will find it easier to comply with new price transparency rules and makes it easier for patients to clear their bills faster. And the result? A happier workforce, a better patient experience and a healthier revenue cycle. Find out more about how Experian Health’s automated revenue cycle management solutions can help healthcare organizations build resilience and thrive in the face of healthcare labor shortages.

Published: August 17, 2022 by Experian Health

COVID-19 provided an unexpected use case for patient portals. In a matter of weeks, the benefits of remote patient access were undeniable. Patient portals allowed patients to schedule, register and pay for care from the comfort and safety of home. Now, as the latest omicron sub-variant triggers another surge in case numbers, providers are again reminded of the value in making digital channels available to minimize face-to-face interaction. With staffing shortages continuing and patient numbers rising, it’s worth recapping the benefits of patient portals. Why should healthcare providers prioritize patient portals? Here are 7 reasons: 1. Patient portals can be used to communicate safely with patients as Covid-19 cases rise Health officials may be cautious about reinstating extreme measures in response to the latest wave of infections. However, they can’t afford to be complacent about an uptick in hospital admissions. Patient portals can mitigate the risks associated with increasing foot traffic by allowing patients to schedule and register for care without attending in person. Completing paperwork from home eliminates the need for patients to share clipboards or sit in stuffy waiting rooms, while online scheduling platforms enable staff to manage the flow of patients safely and efficiently. Remote patient monitoring, secure messaging and online prescription refill requests can also be managed via portals, further reducing the need for in-person visits. 2. They can ease pressure on understaffed teams Providers need to find efficient ways to handle the administrative workload that comes with higher patient volumes. It’s even tougher given increasing retirement and resignation figures. More nurses are embracing the occupational benefits of remote and virtual care and are opting to switch from high-stress facilities to telehealth positions. While this speaks to the growth and impact of remote healthcare, it leaves a gap to be filled in hospitals. Patient portals can alleviate some of the burdens by reducing the need for staff input at various points in the patient journey. For example, online scheduling reduces the number of calls to call centers. Pre-filled data and automated registration can reduce the risk of errors during patient intake, which are time-consuming to fix. Portals can also be used to help patients navigate the payments process, speeding up collections and reducing the time staff spend chasing payments. 3. Patient portals can address inefficient patient access workflows Because patient portals are tethered to the patient’s electronic health record (EHR), they provide a hub for every piece of data relating to the patient. Patients can access that golden record at any time. They get an engaging and transparent experience, and are less likely to call up to ask questions – they already have the answers. They can also check data to make sure that it's accurate, which helps avoid the delays and misunderstandings that cause friction for patient access teams. It's important to ensure that the portal itself doesn’t introduce friction. Patients need to be able to enroll in the portal without too much trouble. Automating the patient enrollment process and implementing a multi-layered identity-proofing solution can create a secure and efficient way for patients to get the most out of their portal, without compromising safety or efficiency. 4. To improve patient engagement and meet consumer expectations One of the biggest reasons to invest in patient portals is because patients say they want them. Research from Experian Health and PYMNTS found that 44.1% of patients have obtained test results through patient portals, while 18% used patient portals to fill out forms for their most recent healthcare visit. Overall, two-thirds said they use patient portals. Beyond offering a convenient patient experience, this is also a matter of patient loyalty and retention: 61% of patients say they’d consider switching providers to one that offered a patient portal, which could have a significant impact on revenue. 5. They can boost revenue by offering easy ways to pay Experian and PYMNTS research shows that around a fifth of patients uses their portal to make payments. Unfortunately, 16% of those patients said they’d faced difficulty viewing invoices, setting up payment plans and making payments through their portal, which suggests some room for improvement. Experian Health’s Patient Payment Solutions solves these challenges. A range of self-service, mobile-optimized tools simplify the patient financial journey by giving patients upfront pricing estimates, personalized payment plans and easy ways to pay. 6. Using patient portals can improve health outcomes (especially for “frequent flyers”) Patient portals also play an important role in promoting better health outcomes for patients. Research shows that when patients have access to their medical information, they feel empowered and prepared to speak to their doctor and adhere to care strategies. Multiple providers can engage with the patient through the same platform, and see what other treatments are being prescribed. This helps improve communication between the patient and provider and helps improve care management. It’s especially useful for older patients and those with chronic conditions. In this way, portals support effective care coordination, helping value-based care providers achieve their goals of reducing healthcare costs, promoting population health and closing the gaps in care that have widened over the last few years. 7. Patient portals can support compliance with price transparency regulations Finally, portals offer a route to ensuring compliance with new regulatory requirements around price transparency. The No Surprises Act and hospital price transparency rule call on providers to give patients accurate, upfront cost estimates so they can plan for their financial responsibility more easily. Patient Payment Estimates can be delivered in several ways, including through patient portals. And as noted, once the patient has their estimate, they can also be directed to easy and convenient payment methods, including through their portal. Whether it’s a surge in COVID-19 cases, rising inflation, or labor shortages, providers must find ways to build resilience, stay competitive, and continue to offer patients the flexible and transparent healthcare experience they desire. Patient portals should be part of the plan to open the digital front door. Contact us to find out how Experian Health helps healthcare organizations deliver a reliable and secure patient portal experience.

Published: August 11, 2022 by Experian Health

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.

Published: July 27, 2022 by Experian Health

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