Management Tools & Technology to improve Out of Pocket Collections

Transcription

1 Management Tools & Technology to improve Out of Pocket Collections Dr. Michael Rawdan, Ph.D, MBA, BSM, CRCR & CPR (PMP TBD) System Director Revenue Cycle & Patient Experience

2 Objectives: 1. Approach Patient Collections with different lens. 2. Experience matters, ensure processes reflect as such. 3. We re not in Kansas anymore with record Patient OOP moving forward.

3 Disclaimer: My background is atypical for healthcare. Experience includes: 15+ years in Banking, Credit Cards with BOA and Capital One. 10+ years in e-commerce with Hewlett-Packard. 23 months at St. Luke s Heath System.

4 Revenues of $2+ billion 8 hospitals; 1,000 staffed beds; 150+ clinics 1,300 aligned physicians 14,000 employees 80% on Resolute HB / PB St. Luke s Health System at a Glance Mission: improve the health of people in our region

5 Audience Participation Time! As a Health System, we have decided to take a different approach What makes my title different from other Healthcare Systems? Dr. Michael Rawdan, Ph.D, MBA, BSM, CRCR & CPR (PMP TBD) System Director Revenue Cycle & Patient Experience Tackling two traditionally contradictory objectives: Revenue Cycle & Financial Experience.

6 Financial Experience OOP Collections Is balancing Experience and Collections really a zero-sum game?

7 Why does St. Luke s care about Financial Experience? Two simple reasons: 1. Sets foundation for better clinical care. 2. Our hypothesis: Strong experience improves payment performance.

8 Revenue Cycle cares because it matters financially: Among respondents giving billing processes a top score: 82% would recommend the hospital, 95% would return to the same hospital for a future elective service, and 74% paid their bills in full. Respondents giving billing processes less than satisfied scores: 15% would recommend the hospital, 58% would return to the same hospital for a future elective service, and 33% paid their bills in full. * 2014 Connance Consumer Impact Study Shows Link Between Business Office, Patient Payment Behaviors and Patient Satisfaction;

9 Three approaches we use to improve patient collections: 1. Data is your friend, use it wisely. 2. Vendors are your partners, treat them well. 3. Be as flexible with your patients as your CFO & board of directors allow.

10 1. Data is your friend, use it wisely.

11 Non-Emergent Patient (PA/Clinic or HB) D a t a OOP is estimated & scored Alpha Beta Charlie Highest Scores: POS Prompt-Pay discounts Moderate PTP: Monthly payments Low PTP: Medicaid County/State Funding Presumptive Charity

12 Day 0 Day 20 Day 22 Day 140 Day 160 Day 50 Day 80 Day 110 Patient initiated Charity Care processed Presumptive Charity processed Manual Charity and Indigent Programs High Score Do nothing High Score, no pay = Out Bad Debt: Scoring drives actions Mid Scores - contact early and often Low Scores - Prep for Presumptive Charity & Forecast Charity Care

13 1. Data is your friend, use it wisely. Benefits: Helps SLHS segment and treat accordingly. Charity identified early in patient care cycle. Reduces internal operational costs. Provides clean accounts to Vendors.

14 2. Vendors are your partners, treat them well.

15 E/O Vendor #1 E/O Vendor #2 PBD Vendor #1 PBD Vendor #1 SBD Vendor #1 SBD Vendor #1 Warehouse Vendor network structure: Current & SKIM accounts Primary BD Secondary BD In-House Servicing Current AR Day 180 Day 360 Day 700

16 Vendors directly influence Happy or Unhappy Patients

17 What we have done: 1. We call vendors Partners. 2. We provide on location training & support. 3. Scrub accounts before placement so they can focus on collectables. 4. Update regular performance and make them compete.

18 One outcome: Patient Cash FY14 FY15 20% Y/Y

19 3. Be as flexible with your patients as your CFO & board allow.

20 Continuum to improving PTs overall performance & experience Reference Material & Education Positive clinic interactions Simple EOB explanations Simple statement view Flexible options Presumptive Charity Digital experience Estimator Digital Bill Pay Prompt pay discounts Estimator Simpler paper Statements 12 MO SAC exception 24 MO with 5% INT 36 MO with 8% INT Develop Education content

21 Only 20% use long term pay plans

22 Liquidation of traditional paper & digital Digital +22% Y/Y

23 Financial Experience OOP Collections Is this a zero-sum game? We do not think so (with early data)

24 Key Summary Points: 1. Data is your friend, use it wisely. 2. Vendors are your partners, treat them well. 3. Be as flexible with your patients as your CFO & board of directors allow.

25 Final thoughts: Patient collections only getting more difficult and complex. St. Luke s believes in cooperation and best practice sharing. Always looking for partners to share best practices & test.

26 Thank you Dr. Michael Rawdan, PhD. St. Luke s Health System