What are the priorities for patient access?
Hospital leaders struggling to increase revenue are looking to patient access for solutions.
"In the 1990s, the focus was largely on the performance of the back end of the revenue cycle. This has largely paid off, and hospital leaders have turned to the front end for further improvements," according to Ronnie Dail, managing director of Huron Healthcare in Chicago. Dail says patient access requires an increasingly integrated approach for scheduling of appointments, sharing information with clinicians, and validating coverage. Here are three processes Dail says are top priorities for patient access:
• Estimating the cost of services.
"Hospitals will need to be more transparent about pricing. Many patient access departments lack tools to address the needs of cost-conscious patients," Dail says.
In addition to investing in more tools, hospitals need to develop the appropriate communication pathways to provide cost information to patients prior to service where possible, he adds.
• Integrating scheduling and health information systems.
"Automation will help eliminate unnecessary touches and rework within patient access," Dail says. "Hospitals are not as integrated today as they would like to be."
For example, an integrated system will tell an insurance verification representative that a patient has previous bad debt. "Having more timely access to data in an integrated system will lead to more collectable revenue and decreased overall cost to collect," Dail says.
• Ensuring that coverage is identified for patients.
"Health reform will provide access to care to a large portion of the uninsured population," Dail says. "These new entrants to the healthcare market will present a huge challenge to hospitals."
Patient access needs more robust financial counseling programs to help patients navigate healthcare insurance exchanges, he advises. "Hospitals will need to bear the burden of educating patients about their various insurance options in a confusing and evolving marketplace," Dail says.