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  1. 1. 2/25/2015 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential. 1 Help Increase Patient Collections and Improve Patient Satisfaction Best Practices for Keeping Patients Financially Engaged
  2. 2. 2 2/25/2015 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential. Our Speakers Today Travis Mendenhall, FHFMA, MFA Sr. Systems Analyst, Gwinnett Hospital System David Dyke Vice President, Revenue Cycle RelayHealth
  3. 3. 3 2/25/2015 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential. Part 1: Market Dynamics Patient Market Quality Part 2: Case Study: Gwinnett Hospital System About Gwinnett Hospital System Strategies for Change Results & Best Practices Discussion & Questions Agenda: Doing the Impossible
  4. 4. 4 2/25/2015 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential. Part 1: Market Dynamics The Patients World View The Market is Shifting at an Alarming Rate Qulaity Madters
  5. 5. Concept % of People who THINK they understand the concept % of those that THINK they do, and ACTUALLY understand % of People (Total) who ACTUALLY understand Co-Pay 100% 72% 72% Deductible 97% 81% 78% Coinsurance 57% 59% 34% Max Out Of Pocket 93% 59% 55% Training: Patients Source: Consumers Misunderstanding of Health Insurance, Journal of Health Economics & Washington Post, August 2013 http://www.washingtonpost.com/blogs/wonkblog/wp/2013/08/08/do-you-understand-health-insurance-most-people-dont/
  6. 6. 6 2/25/2015 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential. Broad Consumer Mobile Internet Access Trending Americans 90% Have Cell Phones 58% Have Smart Phones 83% : Age 18-29 49% : Age 50-64 47% : In < $30k Households 81% : > $75k+ Activities 82% : Pictures 81% : Texting 50% : Email 49% : Location 31% : Health 29% : Banking & Payments Source: Pew Internet & American Life, January 2014
  7. 7. 7 2/25/2015 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential. Technology Adoption and Usage 0% 25% 50% 75% 100% Cell Phone Internet Broadband Internet & Mobile Phone Adoption All Adults Adults +65 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 18-29 30-49 50-64 64+ Internet Use Frequency: By Age Daily 3-5x Week Source: Pew Internet Project, Older Adults and Technology Use Report 4/3/2014
  8. 8. 8 2/25/2015 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential. Seniors with annual household income of $75,000 or more, 90% go online and 82% have broadband Seniors with annual household income $30,000 or less, 39% go online and 25% have broadband 27% of Seniors own a tablet, e-book reader or both 18% of Seniors own a Smart Phone On the Topic of Seniors and Technology Source: Pew Internet Project, Older Adults and Technology Use Report 4/3/2014
  9. 9. 9 2/25/2015 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential. Online account management is growing across all demographics for all markets Online Account Management Source: Pew Internet & American Life Project, Generations 2010, 12/2010 0% 10% 20% 30% 40% 50% 60% 70% 18-33 34-45 45-55 55-64 65-73 74+ Regularly Paying Bills Online By Age Group Growing 10-14% per year Continued steady usage
  10. 10. 1 in 5 Employer Sponsored Patients in HDHP 10 0% 20% 40% 60% 80% 100% 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 0% 4% 5% 8% 8% 13% 17% 19% 20% 29% Conventional HMO PPO POS HDHP 30% Growth 62% Growth 12% Growth Source: Kaiser Francis Family Foundation, 2013 HEBS 5% Growth ACA Impact?
  11. 11. 11 2/25/2015 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential. Collecting Critical Financial Information Helps improve efficiency Helps reduce risk Assists in increasing Patient Satisfaction See Patient Here Take Payment Here Take Payment Here
  12. 12. Your Past, Present and Future 2011 2012 2013 2014 2015 2016 2017 Standard: 5010 Operating Rules: Claims Operating Rules: Remittance Operating Rules: Eligibility Operating Rules: Claim Status Operating Rules: EFT Op. Rule: Referral/Auth. Standard: EFT Standard: Claim Attachment Standard: ICD10Standard: ICD10
  13. 13. 13 2/25/2015 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential. Operating Rules Operating rules included in the ACA Defines common USAGE and CONTENT for HIPAA transactions Most obligations on health plans provide specific data If ANSI 4010/5010 defined HOW to communicate Then operating rules define WHAT to communicate
  14. 14. 14 2/25/2015 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential. Operating Rules for Eligibility CMS Adopted CAQH CORE Phase 1 & 2 Rule Areas Goals System Up Time 86% availability per week (24 hours of down time per month) Publish scheduled maintenance 1 week advance notice for non-routine maintenance 1 hour notice of emergency downtime System Response Time Real Time - Maximum 20 second round trip Batch - In by 9PM, out by 7AM 90% adherence Benefit Response Support 48 Service Types Example: Medical, Physician , Hospital, Urgent Care, Mental Health Static Financial Co-Pay, Co-Insurance, Base Deductible for most service types Return In & Out-of-Network when different Variable Financials Return accumulators (Year to date) Remaining Deductible, Out-of-Pocket
  15. 15. 15 2/25/2015 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential. Alerts Drive Action and Quality Alerts Quick Confirmation Other coverage alerts Real-time alerts within the HIS Registration Quality Drive process accountability Patient has Medicare but its actually an HMO! The HMO is Super Duper Health DO SOMETHING
  16. 16. 16 2/25/2015 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential. Monitoring the Team Team 74% Registration QA Scorecard Alice91% (A) Brett77% (C) David45% (F) Chris82% (B)
  17. 17. 17 2/25/2015 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential. Coaching the Individual David Registration QA Scorecard Pre-Admit88% Lab24% ER45% Clinic31%
  18. 18. 18 2/25/2015 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential. Part 2: About Gwinnett Hospital System Strategies for Change: New Processes Strategies for Change: New Technologies Results & Best Practices Questions & Discussion
  19. 19. 19 2/25/2015 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential. Process and Technology Using process and technology to empower staff to collect payments earlier and more often while ensuring patient satisfaction
  20. 20. 20 2/25/2015 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential. About Gwinnett Hospital System Lawrenceville Campus Acute Care 89 Bed Extended Care Center Outpatient Centers Neuroscience/Stroke Center Open Heart Trauma Level 2 Pain Management Clinics FY14 Duluth Campus Acute Care Inpatient Rehab Center Outpatient Centers Bariatrics Orthopedics Orthopedic ASC Concussion Institute Clinics 553 Beds
  21. 21. 21 2/25/2015 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential. About Gwinnett Hospital System Employees 4964 Affiliated Physicians 850 Discharges 28570 ER Visits 140,308 Ambulatory Surgery 25,505 OP Diagnostics 217,057 Gross Revenue $2 Billion Net Revenue $624 Million FY 2014
  22. 22. 22 2/25/2015 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential.
  23. 23. 23 2/25/2015 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential. Our Challenges A need to increase overall POS collections - High deductibles are the new normal Lost revenue/difficulty estimating patient bills Confusing patient statements High call center volume Manual posting of credit card payments Web savvy population expects consumer-friendly payment options
  24. 24. 24 2/25/2015 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential. Our Goals Break down barriers to payment - Inform patients of financial responsibility upfront - Help patients understand their bills - Provide convenient ways to pay - Collect at multiple points during care process Reduce call center volume Increase cash posting efficiency Increase patient satisfaction and loyalty
  25. 25. 25 2/25/2015 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential. Strategies for Change New Technology New Processes Staff is empowered to collect payments earlier and more often
  26. 26. 26 2/25/2015 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential. Process Strategies Patient Loyalty Program Pre-Visit Calls with Estimates FC Visits for All Self-Pay Scheduled Patients Presumptive Charity Screening Increase Collections and Patient Satisfaction
  27. 27. 27 2/25/2015 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential. Patient Loyalty Program
  28. 28. 28 2/25/2015 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential. Process Metrics Financial Counselor Bedside Visits: 1673 Patients who made a payment: 23% Patients who declined to pay: 58% Requests for a payment plan: 17% Requests for financial assistance: 2% January 1 June 30, 2013 *With 2 financial counselors 23% 58% 17% 2%
  29. 29. 29 2/25/2015 RelayHealth and/or its affiliates. All Rights Reserved. Proprietary and Confidential. Process Metrics Average collection per patient at the

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