By Lisa E Monteleone, RN-BC, BSN, MHA
Mixed use centralized patient access centers are an important investment for medical groups and health systems as they provide an access point for current and prospective patients. A decentralized or splintered patient access design or a poorly performing centralized center can result in patient frustration and lost revenue.
Effective implementation and management of a mixed use centralized patient access center is key to attracting and retaining patients. What is “patient access?” It’s everything that affects a patient’s ability to get to the right care, at the right time, for the right reasons, at the right location. Patient access most often includes the operational functions of referrals, scheduling, insurance, registration and payment collections. It also includes IT systems, facility and workflow design, staff training and management, the right mix and number of providers, as well as the coordination of care and services between multiple sites across the full continuum of care.
When it goes wrong
In the recent past you have likely been subject to a poorly performing patient access workflow that resulted in multiple calls, repetitive requests for information, long hold times and inadvertent disconnects. It’s likely this experience left you frustrated and questioning your choice in care provider. In today’s healthcare environment this experience can be detrimental to the success of the healthcare provider. To be successful, providers must focus their patient access efforts on the complete patient experience. Overlooking steps adds to the risk of losing the patient to another group or system or generating a less than desirable patient outcome.
When it goes right
I had a recent experience during peak hours with a patient-centered provider of health care services. During the call the representative was alerted via their IT system that there was a financial hold on my account. The hold did not allow the appointment to be scheduled. I thought to myself, here we go, this is going to take FOREVER! Boy was I surprised! In one call that lasted less than 15 minutes, touched three departments, and had minimal repetition of patient information:
- An outstanding payment – rectified
- An appointment – scheduled
- A non-urgent medical request – triaged by a nurse
Mixed use centralized patient access centers accomplish many things for a medical group or health system, not the least of which is call demand management and appropriate routing. In addition to improved efficiencies and operational savings the centers create multi-practice, provider, and service line visibility. The centers reduce voicemail and email related frustration and eliminate the need for multiple calls. Mixed use centralized patient access centers are a one-stop-shop for the patient and a command center for the provider:
- Appointment scheduling & reminders
- Physician & service referrals
- Pre-registration functions
- Follow-up calls / patient outreach
- Prescription refills
- Test result communication
- Symptom based nurse triage
- Revenue cycle management
Which shape and size fits your need?
Mixed use patient access centers come in all shapes and sizes. The centers can be centralized in a single location or virtually though IT applications and systems. They can be operational during business hours or 24-hours a day 7 days a week. The centers can be staffed in-house by the medical group or health system or they can be outsourced to regional or national call centers. And lastly, the centers can be brick and mortar based or deployed remotely. Larger medical groups and health systems are likely to use more than one of these models to effectively manage the needs of the patient population and their providers.
Meeting the challenge head on
Health care providers are faced with several challenges at once: an aging and more consumer-oriented patient population alongside reduced payments and a more competitive marketplace. Investing in top notch people, policies, and processes are key to health care provider survival. Mixed use centralized patient access centers allow medical group and hospital based staff to focus on face-to-face patient management needs at their facilities and offices and as a result improve operational efficiencies, patient satisfaction, and patient outcomes. How does your patient access measure up?