Understanding the patient journey means setting aside the preconceived notion that the patient is traveling along a healthcare path alone. A successful patient journey also involves payers and providers that are pursuing their own clinical and financial journeys, which interact and interweave with the patient’s.
In the previous two articles on this topic (1, 2), we have focused on the pre-visit and visit stages of the patient journey. This article examines the post-visit period and the priorities present for each stakeholder.
Preserving loyalty is essential
Depending on where you sit in the healthcare ecosystem, the goal of the post- visit is to engender loyalty. For this article, loyalty is broadly defined as when consumer decision-making aligns with the objectives an entity is trying to realize. For example, will a patient choose to seek care at the same facility again? Will they meet their financial responsibilities? Will they take the next steps to continue their care? Will they remain members of a health plan year over year?
It has been shown that a 5% increase in customer retention can increase a company’s profitability between 25% and 95%. Consequently, ensuring post-visit processes and procedures are designed to cultivate loyalty is crucial for long-term financial viability and success.
Remain vigilant about the patient experience
As the patient journey winds down, it may be tempting to shift focus away from the patient experience and toward processes for collecting reimbursement and mitigating revenue loss. However, organizations should not take their foot off the gas here. There have been a lot of well-documented friction points with patients regarding their healthcare bills and wrapping up their financial obligations during this stage. Payers and providers need to provide easy-to-read statements, patient-friendly communications, and responsive customer service. This is the last opportunity payers and providers have to interact with a patient, and it is important to leave a lasting, positive impression. Patient loyalty and treatment compliance can be swayed by a good or bad post-visit experience, and many financial and clinical outcomes are determined by the effectiveness of post-visit processes.
The critical part that payers play
From a financial standpoint, payers assume an outsized role during the post-visit phase as the onus falls on them to efficiently review claims and associated documentation, and render payment decisions and reimbursement. When payers and providers collaborate to streamline documentation submission, enable electronic information exchange, and minimize the sending and receiving of unnecessary information, payers can become more efficient in adjudication. Better processes yield more consistent decisions, reduce risk, and allow the payer to get payments out faster.
From a clinical perspective, both payers and providers must be able to promptly and effectively share patient health information during this stage without sacrificing privacy and security. Whether it’s connecting clinical decision makers who aren’t necessarily within the same institution or sending attachments between payers and providers to justify medical necessity, it is vital that information exchange be smooth and efficient—and ideally embedded into existing workflow. Payers and providers must also readily share information with post-acute providers to get them the information they need to continue care without lapses or miscommunications.
Creating an infrastructure that encompasses diverse viewpoints
As with the other stops along the patient journey, it is critical for providers and payers to work with innovative technology that sits at the juncture of patient, provider, and payer perspectives. These tools can enable a smooth post-visit experience for all stakeholders. The interdependencies at this stage are substantial, yet if the different entities operate in siloes, they can miss key opportunities to preserve loyalty, reduce risk, and ensure financial viability. When organizations use smart technologies like artificial intelligence and blockchain, they can make processes in this phase more efficient, data-driven, and accurate, removing tedious manual components and freeing staff to focus more directly on value-added activities.
Don’t get left behind: the time for innovation is now
Across the three articles in this series we’ve demonstrated that optimizing the patient journey requires more than just enhancing patient engagement. Providers and payers must elevate and enrich their own clinical and financial journeys while determining how they impact and influence the patient. Delivering a high level of performance given the various interconnected and interwoven processes can be a tall order. But it is necessary for organizations to pursue a new way of thinking and acting to compete in today’s competitive healthcare marketplace. To hold onto market share and remain competitive, traditional providers and payers must commit to transformation and seek comprehensive and future-facing solutions that span all perspectives, incorporate emerging technologies, and are designed to help healthcare entities make meaningful progress toward a new standard of healthcare delivery during the pre-visit, visit, and post-visit phases of the journey.