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Connance Presents "Customer Satisfaction and Self-Pay: The Hidden Opportunity"

C
Connance

These slides focus on a recent study proving the link between patient satisfaction, billing experiences and clinical satisfaction and how it affects self-pay collections. We know that patient loyalty is influenced by how patients are treated during the billing process, post-care. Viewers of these slides will learn the details of this recent study, including: • 23% of hospital patients who received bills for services expressed discontent with the billing process • Among these patients who were dissatisfied with their hospital billing experience, only 63% of them were satisfied with the clinical treatment they received. By comparison, among patients who were satisfied with the billing experience, 93% were satisfied with their clinical treatment • Among uninsured patients, 76% thought the amount they owed the hospital was incorrect; while 55% of patients with responsibility after insurance said they were uncertain that the amount owed was correct Billing issues appear to directly impact customer satisfaction with the hospital and affect a patient’s willingness to refer the hospital to a friend – a measure proven to be connected to customer loyalty and correlated to customer lifecycle profitability. There is a major opportunity to improve the total patient experience by improving the billing process. With the rapid growth in lives covered by high deductible health plans and health savings accounts, the short term cash at risk and long term customer loyalty issues suggested by this research are only going to increase. Providers should to start now to build their organizational competencies to ultimately increase self-pay collections.

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Customer Satisfaction and Self-Pay:
The Hidden Opportunity


April 2011




Intelligence for the Business Office
Customer Satisfaction and Self-Pay: The Hidden Opportunity



        The following information is not intended as legal
        advice and may not be used as legal advice. Legal
        advice must be tailored to the specific facts and
        circumstances of each case or inquiry. Every effort has
        been made to assure that the information contained in
        this presentation is up-to-date as of the date of
        publication. It is not intended to be a full and
        exhaustive explanation of the law in any area, nor
        should it be used to replace the advice of your own
        legal counsel.




 Proprietary and Confidential ©2011 Connance, Inc.
Presenter


                         Steve Levin is Chief Executive Officer of Connance.
                         Steve has worked extensively with leading healthcare
                         providers, health insurers, and revenue cycle services
                         companies and is a frequent speaker at industry events
                         and author of industry articles. He is a graduate of
                         Dartmouth College and Harvard Business School.




 Proprietary and Confidential ©2011 Connance, Inc.
Customer Satisfaction Increasingly A Concern




 Outsiders Now Tracking                               Consumer Groups and   Satisfaction and Loyalty Link
Healthcare Satisfaction and                           Government Watching    to Engagement, Critical for
       Experience                                      Quality and Choice     Outcomes and Utilization
                                                                                    Management




  Proprietary and Confidential ©2011 Connance, Inc.
Customer Satisfaction…and Dissatisfaction


 •     Customers who rate satisfaction “5” are six   times more
       likely to buy again
 •     Twice as many people are told about a bad experience as a
       good one
 •     1-5% of customers will escalate their complaint to a local
       manager or headquarters
       — 50-75% will complain to the front-line personnel

 •     It takes 10 good experience to make up for a bad one

                                                        ….and so on




 Proprietary and Confidential ©2011 Connance, Inc.
Healthcare is Different




Proprietary and Confidential ©2011 Connance, Inc.

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Connance Presents "Customer Satisfaction and Self-Pay: The Hidden Opportunity"

  • 1. Customer Satisfaction and Self-Pay: The Hidden Opportunity April 2011 Intelligence for the Business Office
  • 2. Customer Satisfaction and Self-Pay: The Hidden Opportunity The following information is not intended as legal advice and may not be used as legal advice. Legal advice must be tailored to the specific facts and circumstances of each case or inquiry. Every effort has been made to assure that the information contained in this presentation is up-to-date as of the date of publication. It is not intended to be a full and exhaustive explanation of the law in any area, nor should it be used to replace the advice of your own legal counsel. Proprietary and Confidential ©2011 Connance, Inc.
  • 3. Presenter Steve Levin is Chief Executive Officer of Connance. Steve has worked extensively with leading healthcare providers, health insurers, and revenue cycle services companies and is a frequent speaker at industry events and author of industry articles. He is a graduate of Dartmouth College and Harvard Business School. Proprietary and Confidential ©2011 Connance, Inc.
  • 4. Customer Satisfaction Increasingly A Concern Outsiders Now Tracking Consumer Groups and Satisfaction and Loyalty Link Healthcare Satisfaction and Government Watching to Engagement, Critical for Experience Quality and Choice Outcomes and Utilization Management Proprietary and Confidential ©2011 Connance, Inc.
  • 5. Customer Satisfaction…and Dissatisfaction • Customers who rate satisfaction “5” are six times more likely to buy again • Twice as many people are told about a bad experience as a good one • 1-5% of customers will escalate their complaint to a local manager or headquarters — 50-75% will complain to the front-line personnel • It takes 10 good experience to make up for a bad one ….and so on Proprietary and Confidential ©2011 Connance, Inc.
  • 6. Healthcare is Different Proprietary and Confidential ©2011 Connance, Inc.
  • 7. Connance Customer Satisfaction Survey • Executed Nov. 2010 • Hospital experience within last year • Insurance coverage at time • 500 respondents • Understanding of the hospital bill — 13.5% uninsured • Satisfaction with billing process — 86.5% insured • Use of and usefulness of billing question support • Satisfaction with clinical experience • 47 different states • Likelihood to recommend hospital • Likelihood to recommend physician Proprietary and Confidential ©2011 Connance, Inc.
  • 8. Customer Satisfaction with the Billing Process 20% rank “5” and 23% rank 3 or less All Patients (n=500) Very Satisfied (5) More than Satisfied Satisfied (3) Less than Satisfied Dissatisfied (1) Connance Consumer Survey, Nov 2010; n=500 Proprietary and Confidential ©2011 Connance, Inc.
  • 9. Customer Satisfaction with the Billing Process Billing Process is significantly less satisfying than clinical process Satisfaction With Billing Process Satisfaction with Clinicians Very Satisfied (5) More than Satisfied Satisfied (3) Less than Satisfied Dissatisfied (1) Connance Consumer Survey, Nov 2010; n=500 Proprietary and Confidential ©2011 Connance, Inc.
  • 10. Customer Satisfaction with the Billing Process The issue is similar among uninsured and insured with BAI • BAI: 22% rank “5” and 60% are 3 or less • 81% of uninsured are 3 or less Uninsured Balance After Insurance (n=67) (n=433) Very Satisfied (5) More than Satisfied Satisfied (3) Less than Satisfied Dissatisfied (1) Connance Consumer Survey, Nov 2010; n=500 Proprietary and Confidential ©2011 Connance, Inc.
  • 11. Customer Expectation of Receiving A Bill Customers expect to have to pay something for service Uninsured Balance After Insurance (n=67) (n=433) Expected to Pay Did Not Expect to Pay Did Not Have To Pay Connance Consumer Survey, Nov 2010; n=500 Proprietary and Confidential ©2011 Connance, Inc.
  • 12. Customer Satisfaction with Bill Only 25% are very certain bills are accurate • Hospital bills less understandable than other bills 60% Very Certain Accurate 40% Yes, Correct Hospital More 20% Understandable Think Correct 0% -20% Not Certain Correct -40% Hospital Less Very Certain Not -60% Understandable Correct Don't Know -80% Cell Credit Utility Connance Consumer Survey, Nov 2010; n=500 Phone Card Bill Proprietary and Confidential ©2011 Connance, Inc.
  • 13. Hospital Satisfaction Connected Billing satisfaction appears directly tied to hospital satisfaction Satisfaction of Billing and Satisfaction with Hospital 100% 80% Less than Satisfied with Hospital (1,2) 60% 40% Middling on Hospital (3,4) 20% Very Satisfied with 0% Hospital (5) Very Satisfied No Opinion on Negative Opinion with Billing (5) Billing (3,4) on Billing (1,2) Connance Consumer Survey, Nov 2010; n=500 Proprietary and Confidential ©2011 Connance, Inc.
  • 14. Overall Recommendation Pattern For every 3 customers who would recommend the hospital, 1 would not (e.g. 3:1). By contrast, it is 5:1 for clinicians 50% Would You Recommend To A Friend? 40% 30% 20% Recommend 10% 0% Negative Opinion -10% Go Elsewhere -20% Clinician Hospital Connance Consumer Survey, Nov 2010; n=500 Proprietary and Confidential ©2011 Connance, Inc.
  • 15. Billing Experience and Hospital Recommendation When billing is unsatisfying, recommendation level falls precipitously for both hospital and clinical Of Those Fully Satisfied Of Those Dissatisfied with Billing (5) with Billing (1,2) 100% 100% 80% 80% 60% 60% 40% 40% 20% 20% Recommend 0% 0% Negative Opinion -20% -20% -40% Go Elsewhere -40% -60% -60% Clinician Hospital Clinician Hospital Connance Consumer Survey, Nov 2010; n=500 Proprietary and Confidential ©2011 Connance, Inc.
  • 16. High Cost Low Value Situation • Disappointing patient-to- prospect referral • Strains with physicians • Motivation for follow-up elsewhere • Cash later • Lower yield rates • More letters, postage cost • More inbound calls • More accounts to bad debt • Higher vendor fees • More compliance risks • More customers with “attitude” • More first-time patients / fewer repeat users Proprietary and Confidential ©2011 Connance, Inc.
  • 17. Turning the Cycle Positive To deliver a more satisfying billing process … 1. Patients are not all healthcare billing experts 2. Deliver billing support that meets the unique needs of the patient, e.g. segment and focus 3. Root out process breakdowns, ensure basic process integrity 4. Close the loop between business office and clinical events Proprietary and Confidential ©2011 Connance, Inc.
  • 18. 1. Patients Not Healthcare Experts • Language — What’s an EOB? • Communications — How visually attractive are you bills? — Can someone not in healthcare understand them? — How many different bills will a patient receive for a single visit? Proprietary and Confidential ©2011 Connance, Inc.
  • 19. 2. Billing Process Segmentation • Consumers have different familiarity and attitudes toward healthcare and healthcare bills — Experienced vs. New — Proactive vs. Reactive • A few predictable payment patterns • Approach should balance needs of consumer and hospital Proprietary and Confidential ©2011 Connance, Inc.
  • 20. 2. Billing Process Segmentation • Segmentation makes sure that each process feels different to the patient, consistent with their needs and hospital interest − What activity, when, with what message − Deliver 20-30% more cash for same budgets Segment-Tailored Segment-Tailored Process Messages Segmentation Grid Segment Four Day Activity Self-Directed 0-10 LTR – A2 Patient 10-20 Repayment Behavior 20-30 Reminder Msg 30-40 Reluctant 40-50 LTR – A4 Payor Low High 50-60 60-70 PT Dialer 70-80 LTR – A7 Proprietary and Confidential ©2011 Connance, Inc.
  • 21. 3. Process Integrity • Multiple handoffs over Hospital Billing Pinball Machine many weeks, months… or years Biz. Collection Office — Single guarantor Agency with bills in different locations Eligibility • Breakdowns, confusion common and accepted — 13% of inventory with vendors has reconciliation issue with hospital Proprietary and Confidential ©2011 Connance, Inc.
  • 22. 3. Process Integrity Deliver more consistent patient experience end-to-end, resulting in more cash while improving process integrity • Data flowing both ways — Account-level Business Office — Financial and activity • Integrity in information across vendors Database of Placed — Common definitions Inventory Business Reporting — Retained Rules — Reconciled • Accessible — Reporting functions Early Out Collection Small Balance Eligibility — Analysis platform Agencies Agencies MC Follow-Up Agents • Exception-driven — Rule driven — Push up breakdowns, concerns — Uncovers gaps Proprietary and Confidential ©2011 Connance, Inc. Proprietary and Confidential ©2011 Connance
  • 23. 4. Closing the Loop • “Relationship” not “encounters” — Business office is “pre-registration” to a next visit Healthy Clinical Need / — Satisfaction somehow connected to Living Schedule perception of institutional quality — More consumer choices and involvement every day Self-Pay Patient 1 Treatment Collection • Priority has to be to connect “back” to “front” — Payment patterns (cash value, business office support requirements, etc.) Commercial Coding / — Clinical context (recurring, patient vs. Collection Billing guarantor, etc.) • Continuum of opportunities — E.g. Free parking on next visit Patient 2 — E.g. “loyalty” program — E.g. Integrated clinically-based collection processes …. and many others Proprietary and Confidential ©2011 Connance, Inc. Proprietary and Confidential ©2011 Connance
  • 24. Summary Lessons From Customer Satisfaction Data • Opportunity area to improve satisfaction in the business office process • Dissatisfaction has system wide implications beyond simply disappointing patients… — Raising operating costs — Reducing cash — Impacting hospital reputation and “recommend-ability” • Immediate actions that can be executed on today — Remembering they are consumers not healthcare experts — Incorporating segmented communications: address their different needs — Improving process integrity: avoid breakdowns • Consumer centric business processes change the dynamic — Certainly improve immediate cash equation and related processes and team of the hospital — Leading practice “closes the loop” and to impact new business Proprietary and Confidential ©2011 Connance, Inc.
  • 25. THANK YOU STEVE LEVIN CEO CONNANCE SLEVIN@CONNANCE.COM 781-577-5009 Proprietary and Confidential ©2011 Connance, Inc.