The Advisory Board Company Reports 90% of Denials are Preventable1
As patients take on increasingly heavy financial burdens1 for their healthcare through burgeoning premiums, copays, and deductibles, their tolerance for subpar service diminishes. And the standard to which today’s healthcare consumers hold their physicians—not surprisingly—is the quality they experience when purchasing services from any business.
The call to action for physician practices, therefore, is to elevate their own standards for service, convenience, transparency, and communication—keeping in mind that in the internet age, positive or negative word of mouth can spread instantly and be far-reaching.
“Patients are making their decisions behind the scenes before they ever call you,” says Judy Capko, practice management consultant and author of Secrets of the Best-Run Practices.
Invest in an Online Presence
In fact, 80 percent of consumers have used the internet to make a healthcare-related search in the past year, according to a 2018 survey2 from Doctor.com, and 60 percent will not book an appointment if they don’t like what they see. Moreover, 81 percent of consumers will still check out a doctor online after being given a strong referral from their primary care doctor, the survey found, while 90 percent reported they frequently change their mind about a referral if the provider has poor or weak reviews. More than 80 percent said excluding quality care, customer service is the most important factor influencing their loyalty to a provider.
As a result, Capko recommends practices take the following steps to manage their online presence:
- Keep practice websites updated with latest practice news and offerings
- Enhance features (e.g., online scheduling, patient portal) as new technology becomes available
- Review and update clinician directories twice per year
- Conduct an online search of the practice to evaluate web presence and reputation, but refrain from responding to negative feedback in a public forum
- Use a 3x5" card to gather feedback from patients at the time of the visit—before they have the opportunity
Capko says these tasks should be included in staff's job descriptions. "Whenever it's everybody's job, nobody does it," she explains.
If administrative employees don't have enough downtime to keep up with the effort, Capko recommends staffing up.
"The cost/benefit ration is tremendous," she says, "even if you add another employee."
Prevent Sticker Shock
A fundamental way to promote patient satisfaction upfront is by providing early and accurate price transparency.
“We like to say, ‘the patient is the new payer,’” says Eric Arnson, a senior vice president of product management with Change Healthcare. “We need to think of patients as consumers. We don’t want a poor billing and payment experience to cloud what was otherwise a very positive clinical experience.”
A leading frustration among healthcare consumers is having no idea how much they will owe until after care is rendered and they receive a bill. According to Arnson, patients don’t resent the fact that they have to pay for care, per se; what upsets them is sticker shock.
“Let’s say a patient will owe $1,500 for a test or procedure. The same bill, for the same amount, is thought of differently if a conversation is had with the patient before anything takes place,” Arnson says. “It’s about setting proper expectations with patients and taking on an educational, rather than adversarial, role.”
With information in hand that provides not just a cost estimate but also a breakdown of the total, patients can make an informed decision about whether to proceed, shop around, or seek alternative treatment options. And with proper insight about a practice’s payment options and policies, patients can decide early on whether they will pay upfront or arrange a payment plan. “The key is having those conversations up front, while the patient has an opportunity to consider all of the facts,” Arnson says.
While obtaining good cost estimates for healthcare has historically been elusive for physicians, patientestimation tools are now more abundant than many practices realize, says Arnson.
“This is no longer an emerging technology; there are plenty of good estimation tools and services available,” he says. The tools come in many different forms, he adds, many of which practices may not realize are already included in their practice management or revenue cycle management packages.
Some of these products use payer contracts to estimate payments, Arnson explains, while others use historical data. Ideally, a tool will also account for patients’ eligibility and where they stand in terms of their annual deductible, co-pay, and outof- pocket limits.
The ideal tool would also include even more layers of decision support, says Gregory Weidner, M.D., FACP, medical director of primary care innovation and proactive health at Atrium Health (formerly Carolinas Healthcare System) in Charlotte, N.C.
“We have to evolve to a point where the physician and patient together can determine not only what’s most clinically relevant and appropriate, but also the financial upside and downside,” he says. “If we ignore that part of the equation, there’s a risk of care avoidance or financial toxicity.”
Foster Practice-Patient Partnership
In addition to obtaining or activating costestimation modules, practice staff and physicians need education in how to use them and explain the benefits to patients. For example, patients don’t always understand the difference between preventive (fully covered) and diagnostic services, notes Kathy Nieder, M.D., a primary care physician with Baptist Health Medical Group in Louisville, Ky. “We’re seeing movement toward better information, but many patients are not empowered or knowledgeable enough to understand it.”
“We need to think of patients as consumers. We don’t want a poor billing and payment experience to cloud what was otherwise a very positive clinical experience.”
- Eric Arnson, Senior Vice President of Product Management Change Healthcare