As the front-line “face” of health care, staff members in patient access (PA) play a vital role in the success of any health care organization, both clinically and financially.
For patients of all kinds – especially those who are anxious, stressed or depressed – PA staff members represent the entire clinical team, providing an initial source of attention, empathy and support to enhance a patient’s overall experience. This is vitally important as patient satisfaction scores increasingly factor into provider reimbursement levels. From a personnel and process perspective, PA is the starting point for delivering expedient access to compassionate, quality care.
Due to their multiple financial service roles, including benefit verification, pre-certification, point-of-service collections, and even financial counseling, PA staff members can critically impact an organization’s revenue cycle. About 80 cents of every dollar collected in a health care facility is handled by PA representatives, according to the National Association of Healthcare Access Management.
A major California health system wanted to expand the service offerings and efficiency of its PA department while also reducing costs. These efforts included operational enhancements, financial improvement projects, position control development, and department expansions/acquisitions. The health system engaged Freed Associates (Freed) to coordinate and oversee this effort.
Strategy and Goals
After significantly growing in recent years to meet the expansion of the health system, the PA department required external insight to address its administrative, scheduling and operational needs.
Through Freed’s counsel and guidance, the health system sought PA enhancements in three crucial ways:
1: Staffing – Ensured PA staffing levels met current and future system requirements and patient expectations, given the health systems planned growth.
2: Finance – Improved the department’s copayment and point-of-service collection rate organization-wide, including within the system’s ambulatory, cancer center and cardiovascular clinics.
3: Acquisitions/Expansions – Assessed opportunities for PA to expand into health system facilities and departments not currently part of or aligned with PA.
Through quantitative analysis and first-hand, qualitative assessments of PA operations, Freed partnered with the client to create and execute strategies to address all of these objectives.
Freed and the client collaboratively achieved the following results:
• Developed a customized and multi-functional PA staffing model – This model needed to reflect the staffing needs of a rapidly growing department with more than 150 employees spread across 25 unique registration areas. Based on several key data inputs going far beyond patient registration volumes, Freed designed a dynamic staffing model fulfilling both everyday staffing needs and providing robust predictive staffing capabilities.
• Created a new dedicated float pool team – Increased demand for the PA team to support additional clinics resulted in a high use of overtime and contracted hours. Freed created a new, dedicated PA float pool team. The float pool initiative increased PA operational efficiency and substantially decreased operating costs – up to $100,000 annually in savings.
• Transferred enterprise-wide co-payment responsibility to PA – To achieve an 85%+ copayment collection rate enterprise-wide, all co-payment responsibilities were transferred to PA. Freed developed the work plan to guide all required Epic system enhancements, copayment collection accountability across 40+ clinics, reporting enhancements and patient experience standards (e.g., signage, front desk staff training, etc.).
• Enhanced point-of-service collection – Freed led the strategy for PA point-of-service collections, including establishing goals and methodologies, increasing transparency and accountability and standardizing the patient experience. As a result, the health system accelerated its cash collections and improved its finances.
• Identified PA acquisition/expansion opportunities – Freed assessed and analyzed opportunities for PA to oversee patient registration and front desk workflows at additional system-affiliated facilities, providing PA with multiple expansion opportunities. Through expansion, PA can provide more consistent and enhanced PA services system-wide.
“Freed Associates are professional, reliable, timely and thorough professionals with every expected deliverable. I continue to benefit from their work that helped create a robust staffing model and float pool for my department. Their work is exceptional and I would bring them in again for any other strategic work effort.”
The client achieved multiple cost-saving operational enhancements and workflow improvements with this engagement. They also have newly identified opportunities for expansion of these benefits within the health system. Throughout the engagement, Freed worked with the client to ensure continued maintenance and sustainability of all realized results.
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