The challenge: Poor patient finance experience impacting bottom line revenues
Montefiore St. Luke’s Cornwall Hospital (MSLC), a 250-bed not-for-profit hospital, treats 270K patients every year and is ranked amongst the top 5% of America’s 250 best hospitals by Healthgrades. The hospital’s payer mix comprises a high mix of government and self-pay patients, making it imperative to improve collection of patient financial responsibility – more so in the post-pandemic era where patients are increasingly accountable for a larger portion of their medical bills.
As patients’ out-of-pocket healthcare expenses skyrocketed, MSLC wanted to take a comprehensive approach – one that focuses on enhancing the patient financial experience to improve revenue and collections.
MSLC’s patient registration and financial services varied greatly across its facilities and service lines. The inconsistencies significantly impacted the patient financial experience as well as its bottom line:
- Poor cash collection and long collection cycles
- Lack of patient experience benchmark data for key indicators
- Lack of Point-of-service (POS) collection goals for individual staff and groups
- Inaccurate or missing bill estimates
- Registration data collection prone to errors due to highly manual registration processes
- Low “clean claims” rate
- Payment delays
Additional challenges included prolonged patient wait-times, high no-show and cancellation rates across various clinical departments, and low staff productivity.
The hospital needed a comprehensive patient experience solution to restructure its patient access model. It partnered with Firstsource to identify and implement the right-fit strategies and solutions.
The solution: Implementing a patient centric pre-access model
We offered our Pre-Service Solutions that transform patient onboarding into a stable, reliable operation by integrating Patient Advocacy, Registration and Revenue Cycle Management into an accurate and unified process. The solution leverages automated workflows, training, and on-site expertise to ensure comprehensive patient onboarding and financial engagement.
MSLC’s patient access and revenue cycle leaders sought buy-in from its top leadership and involved employees across clinical financial, IT, marketing teams in the planning and implementation. Firstsource collaborated with MSLC’s patient access, revenue cycle and leadership teams to design and implement a patient-centric pre-access model that engages patients ahead of receiving healthcare services.
Firstsource leveraged its proprietary IntelliAdvisor solution to centralize scheduling, streamline workflows across departments, develop custom financial guidance and planning, and expand staff roles to cover pre-registration and financial services responsibilities. To drive overall patient satisfaction and hospital performance, the model design included optimized and customizable cross-functional workflows, comprising six steps, to financially clear patients before their arrival at the hospital.
Using patient access technology, the Firstsource team integrated traditionally disconnected pillars of work, including order management, scheduling, prior authorization, pre-registration, payment collection, and patient navigation. Firstsource experts then provided training and development support – educating referring physicians, conducting workshops for the registration staff and coaching staff, benchmarking performance and providing feedback to managers on staff strengths and challenges.
To ensure the adoption of pre-access procedures and staff accountability, managers and department leaders were equipped to capture and monitor productivity reports that measure individual and team performance. The pre-access workflow processes all patient visits by segmenting them into three groups – no-stop, quick-stop and full-stop status – to reduce lobby wait times, appointment cancellations, and swiftly and effectively guide patients to their clinical destination.
The result: Enhanced patient experience and better revenues
The patient-centric pre-access model improved operational patient flow and reduced processing times for MSLC by empowering staff and patients with accurate, timely information that drives payment even before services are rendered. The hospital saw a 95% personalized bill estimate accuracy rate and a 25% reduction in registration time and no-show/cancellation rates.
The solution created an environment where the patient’s clinical and financial experience work in sync to provide a positive patient healthcare journey from beginning to end. This translated into revenue enhancement with a 125% increase in POS collections within six months from go-live.