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by Tom Scaletta
Even though the percentage of self-pay and uninsured patients in emergency departments (EDs) is falling—especially in states participating in Medicaid expansion—many hospitals continue to struggle with collections and bad debt as economic growth remains slow. However, healthcare organizations that pay attention to follow-up strategies that specifically target discharged ED patients may improve their ability to keep satisfied patients within the organization's network and enhance collections.
Patients and their families usually appreciate the use of a digital patient engagement system that offers the dual benefits of checking on patient well-being while also providing opportunities for satisfaction feedback. These systems typically present patients with a short, three- to six-question survey the day after discharge, delivered via text or email. Patients are normally asked how they are feeling, if they have any questions concerning their post-discharge care, and asked to rate both their providers and overall care experience.
This empathetic outreach not only helps build trust and loyalty among new and existing patients, it also creates a good business model. That's because improving the patient experience pays dividends not only clinically, but financially as well.
Consider these three areas where connecting with ED patients can have a positive impact on both the patient experience and the revenue cycle:
1) Personal financial investment
Today's consumer-minded patients bear much more responsibility for their healthcare costs, and as a result are much more discriminating about the care and service they receive. Hospitals that extend care and demonstrate concern by using next-day patient follow-up can increase their perceived value among patients.
Furthermore, a digital survey lets patients communicate a great experience or voice criticisms—both of which can be helpful to the bottom line. Take, for example, the patient who completes a great survey the day after an ED visit, but then says she received substandard care once her high-deductible bill arrives weeks later. Digital engagement allows the hospital to retrieve the patient's immediate feedback and explore the reasons for the change of heart.
But even more important is the opportunity to quickly turn any complaints into positive resolution and patient loyalty. When a complaint is left unresolved, it sometimes gets exaggerated over time and becomes an excuse not to pay the bill. By contrast, hospitals that receive negative feedback the day after a patient encounter have the chance to address it promptly—and consequently create a good experience. When the bill finally does arrive, the patient will recall the hospital's prompt attention and response, and is more likely to pay in a timely manner.
2) Social network echo
Before the days of social media, people shared experiences at dinner parties or in conversations across the neighbor's fence. Feedback, whether positive or negative, didn't reach beyond the immediate area and quickly faded as attention turned to other aspects of local life.
With today's social media explosion, however, more patients share their experiences across multiple and far-reaching communication channels. Those comments have a long shelf life, often surfacing as consumers conduct digital searches for other patients' experiences. Unfortunately, research has shown that people are more motivated to tell negative stories than positive ones, so the social network "echo effect" can materially impact a hospital's financial success.
Once again, automated patient follow-up can effectively blunt a negative "echo" by allowing hospitals to immediately address concerns—including, at times, offering an apology. In the end, patients who feel they've been heard by the hospital feel less need to share a negative story through social media.
3) Trust, loyalty and leakage
Patient satisfaction creates loyalty, which prevents leakage to competitors. Coupled with the fact that satisfaction rates drive 30 percent of Medicare incentive payments, patient satisfaction has a significant impact on downstream revenue.
It also is a key factor as payers demand greater value for their customers. From a business perspective, payers want to partner with hospitals that go beyond diagnosis and treatment. They want providers who close the gap by providing not only care, but also follow-up focused on the patient's well-being and satisfaction.
Keep in mind that top-decile organizations achieve "top box" scores of 70 to 75 percent on patient satisfaction surveys—which means that even they have opportunities for improvement. Digital engagement may help move the mark while also giving staff insight into the very narrow margin between good and great. When staff understand the substantial financial impact of a few percentage points, they are motivated to further strengthen their interactions with patients while delivering care.
Automated patient follow-up is a simple, effective and cost-efficient solution for achieving immediate and real-time feedback about care and satisfaction. But its impact goes beyond just the clinical benefits—it can also help improve the revenue cycle. In today's age of healthcare consumerism and its subsequent focus on financials, the question is no longer whether to invest in digital patient engagement. The question is: How much will it continue to cost your organization if you don't?
Tom Scaletta, M.D., is medical director of patient experience and the emergency department chair at Edward-Elmhurst Healthcare, a health system that comprises three hospitals and serves 1.7 million residents in the west and southwest suburbs of Chicago.
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