New Ways to Improve the Patient Experience: Because it Begins Before the Front Door

1. “New Ways to Improve the Patient Experience: Because It Begins Before the Front Door”

2. TraceCommunication.com “New Ways to Improve the Patient Experience: Because It Begins Before the Front Door” Patti Consolver, Senior Director of Patient Access Scott Phillips, Senior Director of Patient Access Texas Health Resources

4. TraceCommunication.comProprietary and Confidential ©2014 The White Stone Group, Inc. Housekeeping Items • Welcome to Today’s Webinar! – Phone lines will be muted – For technical support, please contact: WebEx Technical Support 866-229-3239 or support@webex.com

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6. TraceCommunication.comProprietary and Confidential ©2014 The White Stone Group, Inc. Asking Questions • Submit questions at any time using Q&A box in the bottom right hand panel • Questions will be addressed at the end of the presentation

7. TraceCommunication.comProprietary and Confidential ©2014 The White Stone Group, Inc. Today’s Presenters Patti Consolver, CHAM Senior Director, Patient Access Texas Health Resources Scott Phillips, CHAM Senior Director, Patient Access Texas Health Resources

8. “New Ways to Improve the Patient Experience: Because It Begins Before the Front Door” Patti Consolver, Senior Director of Patient Access Scott Phillips, Senior Director of Patient Access

9. About THR Includes more than 20,500 employees working in 24 acute-care and short-stay hospitals that are owned, operated, joint-ventured or affiliated with THR Texas Health is one of the nation’s largest faith-based, nonprofit health care delivery systems.

10. About THR Serves 16 counties in the Dallas-Fort Worth area of north central Texas, home to more than 6.2 million people

11. Learning Objectives 1. Consolidate pre-service communications to a single touch point to reduce confusion, duplication and inconvenience for patients. 2. Identify common patient complaints with pre- service activities and update processes to resolve the issues. 3. Record conversations in pre-service areas for a complete picture of the patient’s experience from first encounter to the point of admission and beyond.

12. Today’s Agenda • Review THR’s patient experience strategy • Describe the role patient access plays in the overall patient experience • Consider the benefits of a centralized model for patient access services • Review industry best practices for patient financial communications • Describe challenges that drove THR’s need for change • Review the process we implemented • Review benefits realized and lessons learned

13. Our Patient Experience Journey • Goals & progress • Key players • Role of Patient Access

14. Patient Access Model

15. Schegistration • Centralizing pre-registration and insurance verification • Eliminate redundancies by partnering scheduling & pre-registration processes – Reduce number of calls to the patient – Optimize flow for patients by reducing duplication – Eliminate rescheduling/cancellations

16. Schegistration • Streamline patient access to the system to improve the overall experience – Schedulers conduct a warm transfer to the Patient Access Intake Center (PAIC) to complete call – Documentation standardization – including authorization, scheduling and registration info

17. Challenges Faced • Patient complaints often led to he-said, she- said scenarios • Inability to determine root cause • Lack of standardized training for staff on how to resolve the issues • Effectiveness of handoff between scheduling and PAIC

18. Our Journey • 2002: Began recording insurance verification phone calls – Established proof of patient coverage for reimbursement • 2007: Opened Patient Access Intake Center – Centralized insurance verification and pre-registration activities • 2009: Began recording phone calls with patients at the point of scheduling and pre-registration – Expanded from system already used to record authorization phone calls with payers • 2012: Began recording in-person conversations with patients at registration – Entire patient access experience is recorded. (Scheduling, Pre- registration, Verification, Face-to-Face at Registration.)

19. Recording Patient Interactions • Step 1: Scheduling – Record patient and/or physician phone call – Capture faxed physician order – Document patient information – Screen for risk • Right procedure • Right order • Right physician

20. Recording Patient Interactions • Step 1: Scheduling • Step 2: Pre-Registration – Patient demographics – Benefits and eligibility – Self-pay estimates – Scheduling instructions – Directions

21. Recording Patient Interactions • Step 1: Scheduling • Step 2: Pre-Registration • Step 3: Insurance Verification – Correct authorization – Correct status – Confirm for appeals

22. Recording Patient Interactions • Step 1: Scheduling • Step 2: Pre-Registration • Step 3: Insurance Verification • Step 4: Face-to-face at Registration – POS collections – Financial counseling – Bedside registration in ED

23. Recording Patient Interactions • Step 1: Scheduling • Step 2: Pre-Registration • Step 3: Insurance Verification • Step 4: Face-to-face at registration • Step 5: Indexing and retrieval

24. Indexing and Retrieval • Index recordings to patient account • Establish audit trail for every encounter • Complete picture of a patient’s pre-service experience – from the initial encounter at scheduling to the point of admission

25. Process Improvements • Identification of common indicators – Asked for the same information – address, phone number, etc. – multiple times – Told wrong location for a procedure – Given inaccurate instructions – Told different copay during different conversations

26. Process Improvements • Identification of common indicators • Service recovery – Responding to negative surveys – Addressing patient complaints – Identifying risk opportunities – Identifying training opportunities

27. Process Improvements • Identification of common indicators • Service recovery • Staff training – Proactive monitoring: 10 recordings/month – Identifying outliers – Conducting employee evaluations – Providing 1-to-1 training – Self-training; replaying interactions

28. Process Improvements • Identification of common indicators • Service recovery • Staff training • Drilling down – Eg., Compare length of admission encounter for pre-registered vs. walk-in patient – Eliminate duplication to optimize flow for patients

29. THR Pilot Project • Leadership Retreat: How can we improve? • Pilot project – Make a change – Test and monitor impact – Roll out across organization • Eg., recording of mammography patient’s registration experience; what we learned

30. Next Steps at THR • Further implementation of best practices • Expand on pilot project • Implement quality scoring tool – Measures – Scorecards – Reports

31. Quality Scorecards

32. Reports by Criteria

33. Scorecards by Department

34. Process Overview Scheduling Communication management system records & indexes the calls/conversations If there is ever a complaint, administration can review the patient’s entire experience to identify the problems The recordings also provide a valuable training tool for allowing staff members to hear their own mistakes Texas Health is able to drive new initiatives that improve patient satisfaction Pre-Registration Insurance Face-to-Face

35. Patient Financial Communications Release of new industry-wide best practices for improving and standardizing how healthcare organizations communicate with patients about financial issues Best practices developed by group representing healthcare organizations, physicians, payers, and patient advocates Healthcare organizations have the opportunity to achieve adopter recognition to demonstrate core commitment to best practices Best Practices Released Oct. 2013

36. Best Practices “These common-sense best practices bring consistency, clarity, and transparency to patient financial communications, and outline steps to help patients understand the cost of services they receive, their insurance coverage, and their individual responsibility.” Patient Financial Communications

37. Patient Financial Communications Emergency Department Time of Service (Outside the ED) Advance of Service All Settings Measurement Criteria 5 Key Areas:

38. Time of Service Pre-Registration Discussions Maintain a thread of registration, insurance verification and financial counseling discussions If these discussions took place during pre-registration, no need to repeat

39. All Settings Incorporate compassion, patient advocacy and education in all patient discussions Use standard language to guide staff in common types of discussions Resolve issues face-to-face when able

40. Conclusion • The experience begins before the front door • Benefits of a centralized model • Patient financial communication best practices • Recording provides valuable insight for change • Monitoring and measuring impact of change

42. TraceCommunication.comProprietary and Confidential ©2014 The White Stone Group, Inc. Thank you! Blair Wright blair.wright@twsg.com The White Stone Group, Inc. Patti Consolver patriciaconsolver@texashealth.org Texas Health Resources Scott Phillips scottphillips@texashealth.org Texas Health Resources

New Ways to Improve the Patient Experience: Because it Begins Before the Front Door

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New Ways to Improve the Patient Experience: Because it Begins Before the Front Door