Presentation on theme: "Joe Liszak, MBA Fremont Community Health Center Fremont, Ohio"— Presentation transcript:
1Joe Liszak, MBA Fremont Community Health Center Fremont, Ohio Improving Productivity by Reducing No-Shows One Community Health Center’s StoryJoe Liszak, MBAFremont Community Health CenterFremont, Ohio
2In the beginning........ No show rate ran between 21-36% daily “We are not saints, but we have kept our appointment. How many people can boast as much?” Samuel BeckettIn the beginningNo show rate ran between 21-36% dailyRevenue and expenses loss > $200,000 per yearDouble/triple bookings = schedule backupsPatient satisfaction = Poor due to wait timesStaff overtime issuesPolicy was weak and ineffective
3Formed an internal committee of eight employee representatives “If you can find a path with no obstacles, it probably doesn't lead anywhere.” Frank A. ClarkProblem Identification......Formed an internal committee of eight employee representativesMonthly “brainstorming” meetingsWorked through many emotions and feelings, especially regarding children and parent responsibility
4“You can have data without information, but you cannot have information without data.” Daniel K. MoranScope of the problem...Health center patients opted to use ER at a very high rate.Our health center was the only health care resource accepting Medicaid or self-pay in a 3 county areaDental program was the only program in a 5 county area accepting MedicaidDismissal of patient from health center left no other health care option.
5“I have found that the greatest help in meeting any problem is to know where you yourself stand. That is, to have in words what you believe and are acting from.” William FaulknerDeveloping the policy....No patient dismissal; suspension after three no show appointments in one yearWritten notification of each no-show; third notification- Certified letter of suspensionNo-show algorithmNo-show Appeals ProcessRequired education class for patients to be reinstated
6“If we get it right, there need not be losers.” John Anderson Four years later....the fruits of our labor....9% overall no show rateIncreased revenueMuch better patient flowBetter patient outcomes due to complianceHigh patient satisfactionMuch higher educated patient base
7Our Education Approach “Education is an ornament in prosperityand a refuge in adversity.” AristotleThe next slides present an overview ofthe reinstatement class given to patientswho no-show three times in one year.
8Knowing the Facts…… True or False StatementOffice hours are from 8 a.m. to 5 p.m.An appointment must be cancelled 24 in advance.Fremont CHC operates medical and dental officesCHC was founded over 30 years ago as a migrant clinicCHC sees patients even if they can not pay.CHC has four other officesTo cancel an appointment a person can call 24 hours per dayPatients who keep their appointments, prevent health problemsMost ER visits are not emergenciesAll patients are required to pay a minimum fee at the time of service.
9Brief History of CHC Started in 1972 in Tiffin Moved to Fremont in 1978Started dental office in 1981Built a large addition in 1992 in order to have more doctorsAdded 3 other offices in the 1990sBecame JCAHO accredited in 2000Added Pediatric office in 2005
10Health Professional Shortage Area (HPSA) Designation What is this?A HPSA area is an area that does not have enough doctors to serve the population. Sandusky County has a special populations HPSA which means not enough doctors to take care of the migrant population.What does this mean?This federal designation allows CHS to offer doctors and dentists positions with our organization and in turn, they can receive school loan repayment.
11Other Service Providers Question:Other than CHS, where else can I go for medical and dental services if I have a Medicaid card, or I am paying the bill myself?Answer:Very few other providers accept Medicaid or patients who are self-pay, this is why it is so important that you remain a part of our system, so that you will always have a place for you and your family to receive care.
12What Keeps People From Getting To Their Appointment. What are some reasons patients miss their appointments?Cannot get off workCannot find transportationForget appointmentNo babysitterAn emergency came upThe weather was badNo phone to be able to contact the officeOthers??
13How Can We Help You?Community Health Services employs a full-time Patient Care Coordinator to assist you. We have put together a list for you to take with you so that you can use one of these services in the future to help you keep your appointments. Here are some of those programs that may help.
14How Do I Schedule an Appointment? By calling one of our offices from 8:30 am - 5:00 pmCommunity Health Services-MedicalCommunity Health Service-DentalFremont Family PracticeBirchard Medical CenterWest Side Pediatrics
15How Do I Cancel an Appointment? You can cancel an appointment with our office 24 hours a day by calling your doctor’s office number. The Memorial Hospital answering service will take a message and pass it along to your office.With our new computer system, you will have an option to cancel your appointment when you receive your courtesy reminder call.
16Late for an Appointment? CHS policy states that all patients who arrive to an office more than 10 minutes late may be rescheduled. After that time, each office can determine if you can still be seen or not, depending upon appointment availability in that office.Please try to arrive at least 10 minutes early for your appointment.
17Transportation Assistance TRIPSFremont Taxi ServiceCare-A-VanHart’s AmbuletteBellevue Four County Wheelchair VanVeterans Service Office
18Social Services Assistance Catholic CharitiesWSOSWICShare and CareFood PantryFirelands Counseling and Recovery Services
19Medication Access Assistance Patient Assistance ProgramsSome drug companies have programs for those in need. The Patient Care Coordinator at CHS can assist you with the paperwork.Samples given by CHS doctors when available.Share the Care ProgramFree medications for people who qualify. Distributed by CHS doctors when available.
20Financial Assistance All CHS offices offer a sliding fee scale The local hospitals have Patient Care Assurance Programs
21Cost of No Show – THEN. . . In 2004 there were 28 no shows in the CHS medical and dental offices resultingin:Medical office losses - $79,534 annually Dental office losses - $134,241 annually
22Cost of No Show – NOW!!Everyday there are 9 patients who no show in the CHS medical officesEveryday there are 4 patients who no show in the CHS dental officeCHS medical areas lose $54,288 annually due to no show appointmentsCHS dental office loses $53,244 annually due to no show appointments
23Ways the losses are made up. Increase in the chargesOverbook patientsLay people offAll of this causes1. Longer wait times for patients who keep their appointmentsAdditional time away from work for those people seeing the doctor during work hoursMore ER visits which are costly
24Following the Doctors Orders…. Keeps you and your children healthyCuts down on the time you spend in our officeSaves you moneyCreates more appointment time for othersReduces emergency situations
25What You Can Do To Help? Call ahead to cancel an appointment: This allows us to give your appointment tosomeone elseCreates more appointment availabilityFrees our schedule so people can get appointments soonerEmergency patients can be seen quicker
26Keep Us Up-to-DateYour current phone number and address will help us remind you of your appointmentHelps us contact a family member in case of an emergencyCurrent insurance helps us bill you correctly
27What Have I Learned?How do you cancel an appointment? When can it be cancelled?What happens if I arrive late for an appointment?Can someone assist me with medication costs?Can someone help me with any other barriers?How does no showing for an appointment affect me?How does it affect CHS and other patients?Are there other Medicaid/self pay providers that I can go to?
28SUMMARY Men who do things without being told draw the most wages. Edwin H. Stuart
29THANK YOU FOR COMING! ANY QUESTIONS? For More Information contact: Joseph Liszak, MBAChief Executive OfficerCommunity Health Services410 Birchard AvenueFremont, Ohio 43420TF