1 Proprietary & Confidential Creating the “Ritz-Carlton Effect” in Patient Access Maryland AAHAM ANI 2015 Daniel V. Hobbs, CRCE.

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Presentation transcript:

1 Proprietary & Confidential Creating the “Ritz-Carlton Effect” in Patient Access Maryland AAHAM ANI 2015 Daniel V. Hobbs, CRCE

2 Proprietary & Confidential So... How different are we?

3 Proprietary & Confidential Why?... Market Drivers  14 million access insurance through new exchanges or expanded Medicaid*  $1,200 is the average annual deductible under job-based health plans  $2,563 average Silver plan deductibles  $5,300 average Bronze plan deductibles  $6,600 per individual, $13,200 per family additional copays and coinsurance in 2015** In short, consumer-driven healthcare is here *Source: What to Expect in Round Two of the Health Insurance Exchanges, HFMA.org, Sept 2014 **Source: Kaiser Family Foundation, Medical Debt Among Insured Consumers: Role of Cost Sharing, Transparency, and Consumer Assistance, Jan. 2015

4 Proprietary & Confidential Why can’t we have in health care what we have in other sectors?  GasBuddy: 121,000 gas stations and 160,000 places that vend fuel o 4 types of fuel  Health care: o 8,000 CPT codes, 12,000 ICD-9 codes, 1,000,000 providers/suppliers, 100,000’s plan designs, 430 MAS’s or 44,000 zip codes – Demand for both price and quality information Why? Price Transparency

5 Proprietary & Confidential Pre-Service Collections Pre-Service: Scheduling and Pre-Registration (Collected: $870,000) Patient Arrives Registered or Checked-In (Collected: $880,000) Before Patient Goes to Service Area there was a total Collected of $1.7 million (one year) This is money collected during the Pre-Reg call)

6 Proprietary & Confidential Processes Improved Cash Collection Performance and Customer Service ED Financial Clearance Improvements Per-Service Collection Scheduling Process Improvement PreRegistration

7 Proprietary & Confidential Pekin Hospital Experience

8 Proprietary & Confidential Patient Access System wide Scheduling Order Checking Medicaid Roles checking Charity Guide Financial Assistance Screening Doctor Checker NOA/Precert Patient Identity Verification Patient Payment Estimator Patient Payment Portal Registration Quality Assurance Patient Satisfaction Press Ganey Scores Healthgrades Payer Web Sites Communication Management System  Recording and scripting Tools

9 Proprietary & Confidential “Why bother… we are a community Hospital and have to treat everyone!” “I like giving my customers the convenience of coming directly from the Doctors office for those small Outpatient tests!” “I’d like to preregister more patients but we have trouble catching them before they arrive for their appointment!” “We cant have the patient self-schedule, the doctor needs to know the test got scheduled!” “I cannot ask for money in the ER!” Common Concerns

10 Proprietary & Confidential The experience begins before the front door Benefits of a centralized model Patient financial communication best practices Recording and scripting promotes more valuable communications Monitoring and measure the impact of change Conclusion

11 Proprietary & Confidential Contact Us | (615) Daniel V. Hobbs, CRCE Senior Consultant Quorum Consulting Services

12 Proprietary & Confidential

13 Proprietary & Confidential