Staying ahead of healthcare’s top trends

Aug. 21, 2015

Several years ago, Business Insider published a list of 21 things that became obsolete in the first decade of the 21st century. From video rental stores to phone booths, these products and services were rendered unnecessary because they didn’t keep pace with innovation and technology. The smart companies, however, survived.

How?

Among other things, they asked the right questions and conducted the necessary research and development to fuel change. The video rental store turned into an on-demand video streaming service. The dial-up connection became a DSL or wireless offering.

Staying relevant in a highly competitive, quickly changing environment such as healthcare requires leaders to ask the tough questions. What trends must we address? How can we stay relevant and meet demands? We face new challenges and regulatory demands every day in healthcare, which makes our environment particularly difficult. Our reward is much greater than just financial success, though – it is also our ability to provide better patient care than ever before.

As you’re evaluating your organization’s growth strategy, here are four key questions to ask: 

1. As we treat increasingly savvy patients, do we have a strategy to address healthcare consumerism?

Healthcare consumerism is growing by leaps and bounds, and patients have become more research oriented about every decision – from selecting a landscaper to selecting a surgeon. A survey of more than 4,500 patients revealed Americans primarily use Healthgrades and Yelp for physician reviews. In the category of care quality, patients are most concerned with accurate diagnoses. In the administrative category, patients are most concerned with waiting times, followed closely by billing and payment.1

As patients adjust to high-deductible and consumer-driven health plans, they’ll want more information about their financial responsibility, and they may decide to comparison shop once they have an estimate. This attitude shift makes it important for practices to provide price transparency. Tools to generate a fast and credible estimate before services are rendered can give patients the information they demand, all while keeping your staff efficient, ready to respond to payment questions, and able to proactively collect at the time of service.

While patients will likely welcome this new level of transparency, they may be surprised by it. Likewise, staff will need training in regards to how to present patients with cost estimates and explaining their organization’s collections protocols. Healthcare is one of the rare situations where you traditionally don’t pay at the time of service. Breaking this long-term habit will require an extra dose of confidence and assertiveness from your staff.

In addition to price transparency, technology to fuel automated payment plans, online bill payment, and other convenient billing solutions provides options that the billing staff can leverage to direct patients to the optimal payment method. As patients increasingly are responsible for paying for more and more of the healthcare they consume, it’s important for staff to feel comfortable reviewing estimates and saying, “How can we set up a payment plan that will make this amount comfortable for you?”

2. Are we poised for the best and broadest interoperability based on our current strategy?

Most healthcare clinicians and staff immediately think of electronic health record (EHR) integration when they hear the term “interoperability.” While EHR interoperability is crucial, we shouldn’t lose sight of the true, widespread vision for interoperability. This vision encompasses medical devices, hospital equipment, clinical, and revenue cycle software – a broad array of technology – all talking seamlessly to each other across the continuum of care.

Keeping this vision top of mind is important, because it can help you keep an important perspective: No one vendor can fulfill all of your needs exceptionally well. Consequently, hospital leaders should pick the best-of-breed components that meet their organization’s needs. It’s the vendors’ job, nudged by the government through Meaningful Use, to ensure interoperability.

The bottom line: Providers shouldn’t feel pigeonholed into buying a certain vendor’s solution to achieve interoperability. Providers should, on the other hand, be vocal to vendors and ask for the interfaces and interoperability they need. Most likely, countless other providers are asking the vendor for the same thing.

3. Does our patient engagement strategy include a financial component?

Numerous surveys by organizations such as the National eHealth Collaborative cite patient engagement as a top priority among healthcare executives.2 In many cases, though, the survey’s focus is clinical engagement. With patients shouldering a great deal of their rising care costs, a patient engagement strategy should ideally include a financial component as well.

Financially engaging the patient can begin as early as pre-service, when staff makes the appointment reminder phone call. During the call, staff can inform the patient that the financial policy is changing; at the point of care, the patient will be asked to review an estimate and then leave a credit or debit card on file to be charged up to the estimated amount. At time of service, staff can engage with patients by reviewing their financial responsibility and determining the best way to pay. Should they set up a payment plan? What’s a reasonable per-month payment amount? By acting as a counselor, providing information and guidance about what the charges will likely be, as well as providing options for paying the bill, the billing staff can connect and engage with patients in ways that will increase collections and provide for better patient relationships.

We all know that billing patients after the visit can be expensive and difficult. Automated payment plans, which charge a pre-determined amount to the patient’s card until the bill is paid in full, can keep patients financially engaged on autopilot. In other words, they’ve agreed to pay the bill, but they don’t have to take any action. This is a different type of engagement, but it’s one that busy patients often appreciate.

4. Is our organization ready for ICD-10 and all the changes it represents?

While there is still a small chance the government will delay the ICD-10 implementation date, the likelihood that a delay will occur diminishes with each passing day. Organizations that are not engaging in ICD-10 preparatory plans earnestly for ICD-10 implementation on Oct. 1 are exposing their practices to significant financial harm.

That’s really only part of the story, though, as ICD-10 represents a big step toward population health, prevention, and wellness care. The greater specificity and detail required by clinical documentation and coding will enable providers to establish population health programs. The new level of documentation detail will also help providers meet the necessary requirements for claims payment under value-based reimbursement. And, perhaps most importantly, primary care physicians will have the data they need to establish wellness programs for their patients. As ICD-10 fosters both broader and deeper data collection, primary care physicians will not only have more informed discussions and develop better treatment plans, but also have more comprehensive data to send with referrals.

Conclusion

Although ICD-10’s transition date is a month away, we’re approaching many other milestones: Meaningful Use Stage 3, a larger percentage of value-based reimbursements, and the next round of HIPAA Office for Civil Rights (OCR) audits are just a few changes on the horizon. Amid this uncharted territory, healthcare leaders can prepare their organizations by asking these difficult questions, evaluating technology and processes, and keeping their team focused on their most important mission: to provide the highest quality care.

References:
  1. “How Patients Use Online Reviews,” IndustryReview, Software Advice, 2013, accessible online at http://www.softwareadvice.com/medical/industryview/how-patients-use-online-reviews/
  2. “Survey Find Consumer Engagement Top HIE Priority,” National eHealth Collaborative, August 2012, accessible online at http://www.hitechanswers.net/survey-finds-consumer-engagement-top-hie-priority/

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