Simple Ways to Improve the Patient Experience – Are You Leaving Opportunity on the Table? - Alorica - ContactCenterWorld.com Blog
In today’s service industry–and Healthcare is no exception—consumers expect, even demand, transparency and simplicity. Patients want their experiences to match the service they get from other industries. In a 2012 survey on healthcare, “30% of respondents wanted their patient experience to be the same as any other customer experience they have—such as shopping, hotel and travel.”i There is also ample published material suggesting that improving patient experience directly impacts a company’s ability to retain and grow market share. Certainly, that provides some justification to invest in experience improvements, but those impacts can be difficult to quantify. A 2016 article from McKinsey indicates that many “experience improvement” initiatives fail simply because the owner of the program can’t prove the value of the improved experience to their business. The authors noted that “At a recent roundtable, fewer than half of the customer-experience leaders present could say what ten points of net promoter score would be worth to their businesses.”ii Perhaps the most compelling business reason to address your experience drainers is dollars and cents.
Improve Patient Experience, Reduce Costs
Often, the things that drive poor patient experience in Healthcare also drive costs for providers, payers, employers and patients. Eliminating noise and waste allows organizations to self-fund their improvement initiatives and increases the likelihood they will succeed. One of the best ways you can ensure a successful transformation initiative is to ensure you understand what impacts costs and experience in detail.
Many causes of costly contact volume, claims appeals and adjustments, complaint investigations and outstanding medical debts can be minimized through better education for patients and the people who serve them along their journey.
Education and Communication
When it comes to patient education and communication, simplicity really matters. Healthcare and insurance are complicated topics for the majority of U.S. consumers to grasp. In The Washington Post reported on a CDC study from 2007 that found 36% (more than 90 million) of U.S. adults had only basic or below basic skills for dealing with health material.iii Patients with that level of health literacy would only be able to understand discharge instructions written at a fifth grade level or lower. While there have been initiatives across the industry to simplify health communications since then, the number of insured patients has also grown significantly, introducing a base of customers into the system who are insured for the first time. A 2015 CDC survey indicated that for the first time in 50 years the number of uninsured dropped below 10%, which has flooded the entire system with new users.iv
Despite efforts to improve the clarity of information and meet expectations, a survey from 2013 indicated the industry still has a long way to go to get there. The survey revealed that two-thirds of consumers say it is important for insurers to provide clear and easy-to-understand information on their policies—yet only 27% say they were satisfied with their insurers’ efforts to do so.
Confusion Increases Contact
When patients have trouble understanding, or are misinformed about their care and coverage, they reach out for help—sometimes multiple times and to multiple places. Millions of administrative labor dollars are wasted each year by providers, payers, and benefits administrators alike, trying to rectify the confusion after the fact. Patients are often passed back and forth between these groups, increasing the effort they have to expend to get resolution and diminishing their opinion of the experience they have received. Often, nobody is happy in these scenarios, least of all the patient who is amassing medical bills, some of which may never get paid. Additionally, poorly informed patients are at greater risk for poor medication compliance, a problem that costs the U.S. economy an estimated $283B per year.vi
In our business, we see the downstream impacts of poor information sharing first hand. We handle thousands of contacts a year with patients, providers and insurance companies trying to navigate broken communication in a very complex system. Let’s look at a few examples from around the Healthcare industry of how education and communication impacts cost and experience in Healthcare.
Readmissions represent a huge challenge for the Healthcare industry. They are both dangerous and costly to patients, providers and insurance companies. Customers who misunderstand their discharge instructions are at greater risk for complications, poor outcomes and readmissions. A study conducted by the University of California’s School of Pharmacy showed that placing an outbound call to patients after receiving hospital care to ensure they understood important discharge instructions, helped proactively address problems or questions related to medications in 19% of patients. In addition, this helped uncover new medical problems or concerns that could be addressed by the medical team in 15% of patients. The group receiving calls had a 10% 30-day readmission rate compared to 24% with no phone calls, and reported higher patient satisfaction rates.vii In this case, a proactive approach was able to prevent further, more expensive touch points and interactions down the line, and provided better care outcomes for the patients involved.
- Claims Processing and Collection Multiplies Administrative Drag
Claims processing and revenue collection are a huge source of administrative costs in the Healthcare system. They are often emotionally charged scenarios and are highly likely to result in repeat contacts, escalations, complaints and appeals. An EGS review of contact patterns and satisfaction rates related to claims calls showed a claim unresolved after 85 days produces three times more contacts to the insurance company compared to claims closed in 28 days or less—and the more contacts involved to resolve it, the least likely it is to produce a satisfied customer. We also know that claims involving disputes and errors drive longer processing times and more contacts. A Kaiser Family Foundation survey on surprise medical costs found that “among insured, non-elderly adults struggling with medical bill problems, charges from out-of-network medical bills were a contributing factor one-third of the time. Further, nearly seven in 10 of individuals with unaffordable out-of-network medical bills did not know the healthcare provider was not in their plan’s network at the time they received care.”viii More often than not, these surprises are due to emergency care. This is just one of the ways communication can break down. There could be issues with the customer-facing tools to check in and out of network providers, but more often it is because the hospital where the patient was seen is in-network, but the doctor or radiologist or anesthesiologist is not. The average user, particularly if they are new to the system, does not understand nuances that impact their out-of-pocket costs. These are often gaps in pre-treatment communication and the legalese they receive at enrollment are seldom relevant to the patient until they start using them.
Simple Ways to Improve the Patient Experience
What do these examples tell us about how to attack the problem? What are your lines of defense against costly problems impacting your patients and your business?
- Know your drivers of volume and noise and what impact they have on your cost model
- Have a systematic process to collect, dissect and understand root causes of each driver so they can be addressed before they drive cost and experience
- Use clear, easy-to-access, easy-to-understand and multimodal communications to educate patients proactively about what impacts their care outcomes and costs
- Prepare anyone who interacts with your patients to explain and educate in clear, simple terms and with empathy and communication appropriate to the patient and the situation
Improving the lives of the patients we serve, and driving value back to your business and business partners should be reason enough to look at the experience you are providing today and determine if there are ways to improve upon it. And if it’s not, there are cold hard dollars on the table, too.
iWolters Kluwer Health. “Americans Want Greater Control Over Their Own Health Care.” Nov. 2012.
iiJoel Maynes and Alex Rawson. McKinsey. “Linking the customer experience to value.” March 2016.
iiiSandra G. Boodman. The Washington Post. “Many Americans have poor health literacy.” Feb. 28, 2011. http://www.washingtonpost.com/wp-dyn/content/article/2011/02/28/AR2011022805957.html
ivCohen, Robin A., Ph.D., and Martinez, Michael E., M.P.H., M.H.S.A. “National Health Interview Survey Early Release Program.” U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, and the National Center for Health Statistics. Aug. 2015.
vThe Digital Insurer: Delivering Exceptional Customer Experiences.” Accenture. 2013
viSandra G. Boodman. The Washington Post. “Many Americans have poor health literacy.” Feb. 28, 2011. http://www.washingtonpost.com/wp-dyn/content/article/2011/02/28/AR2011022805957.html
viiDudas V, Bookwalter T, Kerr KM, Pantilat SZ. “The impact of follow-up telephone calls to patients after hospitalization.” http://www.ncbi.nlm.nih.gov/pubmed/11790365
viiiPollitz, Karen. Kaiser Family Foundation. “Surprise Medical Bills.” March 17, 2016. http://kff.org/private-insurance/issue-brief/surprise-medical-bills/
Publish Date: April 12, 2016 5:00 AM
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