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The Patient Experience and Its Impact on Your Health Practice and Profitability
- 1. The Patient Experience ©2018 Total System Services, Inc.® Confidential and Proprietary. All rights reserved worldwide. The Patient Experience
- 2. ©2018 Total System Services, Inc.® Confidential and Proprietary. All rights reserved worldwide.2 Key Industry Drivers 65 and older population growth increases demand for service diversification KEY METRICS 40% of revenue comes from out of pocket expenditure Medicare and Medicaid benefits continue to increase and expand 64% of the U.S. population have dental benefits •Increasing coverage •Advances in technology •Growing awareness of oral care and hygiene Source: The National Association of Dental Plans
- 3. Patient Challenges ©2018 Total System Services, Inc.® Confidential and Proprietary. All rights reserved worldwide.3 Patient challenges and barriers Fear Bad news Instruments Poor habits Cost Schedule conflicts Time off from work Time Affordability Lack of coverage
- 4. ©2018 Total System Services, Inc.® Confidential and Proprietary. All rights reserved worldwide.4 Overcoming Objections A positive patient experience promotes an active and engaged patient.
- 5. Patient Journey ©2018 Total System Services, Inc.® Confidential and Proprietary. All rights reserved worldwide.5 PRIOR TO VISIT WAITING AREA RECEPTION EXAMINATION ROOM/CHAIR DENTAL EXAMINATION CHECK- OUT FOLLOW UP CARE Patient Journey Touch Points
- 6. ©2018 Total System Services, Inc.® Confidential and Proprietary. All rights reserved worldwide.6 I can quickly schedule an appointment. My dentist listens to me and gives me answers I understand. I feel heard and respected by my dentist and staff. My dentist knows my history. I get timely reminders and follow-up care. Consumerism effect
- 7. ©2018 Total System Services, Inc.® Confidential and Proprietary. All rights reserved worldwide.7 Practice Payment Assurance Patient Satisfaction Convenience Putting people at the heart of every decision
- 8. ©2018 Total System Services, Inc.® Confidential and Proprietary. All rights reserved worldwide.8 Advantages of Patient Satisfaction Greater Efficiency Improved Complian ce Greater Profitabili ty 1 Improved Patient Retention 2 Reduced Staff Turnover 1 Improved Collectio ns 2 3 Overall Fulfillmen t 4 Increased Patient Referrals 3 Improved Patient Loyalty 4 5 STAFFPRACTICE
- 9. Why Patients Leave ©2018 Total System Services, Inc.® Confidential and Proprietary. All rights reserved worldwide.9 • Feeling neglected or left out • Lack of concern • Poor communication • Feeling rushed • Lack of understanding • Pricing or billing issues
- 10. ©2018 Total System Services, Inc.® Confidential and Proprietary. All rights reserved worldwide.10 What is your patient attrition rate? By the time you see an increase in attrition it is six or eight months after the point in time when the patient actually left.
- 11. Effects of Patient Retention ©2018 Total System Services, Inc.® Confidential and Proprietary. All rights reserved worldwide.11 Studies show that acquiring a new customer is anywhere from 5 to 25 times more expensive than retaining an existing one.
- 12. Implementing a Patient Retention Strategy ©2018 Total System Services, Inc.® Confidential and Proprietary. All rights reserved worldwide.12 Retaining Existing Patients Getting Back Lost Patients Reach out in personalized and timely ways Be receptive and accommodating to patient requests Offer convenient payment options Contact them to find out why they left and apply their feedback Reach out with reminders for care Incentivize their return
- 13. ©2018 Total System Services, Inc.® Confidential and Proprietary. All rights reserved worldwide.13 5 Ways to Improve Patient Satisfaction Provide excellent service Communicate patient outcomes and treatment Explain financial responsibility Adopt new technology Watch the wait times
- 14. The Cost Challenge ©2018 Total System Services, Inc.® Confidential and Proprietary. All rights reserved worldwide.14 Lack of or little insurance coverage Existing or current outstanding bills Postpone or decline care Financial options are a challenge • 1 in 5 Americans have problems paying medical bills • 62% say the postpone dental care due to outstanding bills • 69% cite lack of financing as a reason to decline care Source: Dental Economics, 2018
- 15. ©2018 Total System Services, Inc.® Confidential and Proprietary. All rights reserved worldwide.15 Alternative Options • Ensure your website is ready to take online payments • Add the web address to statements for convenient online payments • Mobile payments as a payment option is likely to be anticipated Estimation • Pre-estimate by overestimating insurance benefits • Refunds are more friendly than over- charging • An understanding of all components can help make an educated decision Fulfillment of Obligation • Once a patient understands their responsibility, review payment options • Request full payment at check-out • Offer financial options such as flexible payment plans Statements and Billing • Bill more frequently • Use patient’s preferred method of communication to coordinate payment • Electronic reminders for upcoming appointments can be coupled with outstanding balance notification Ways to Reduce Accounts Receivable
- 16. ©2018 Total System Services, Inc.® Confidential and Proprietary. All rights reserved worldwide.16 Reduce Anxiety Provide Financial Options Offer convenient and efficient processes while the patient is at the practice
- 17. QUESTIONS? To Learn More: Contact 844.300.4347 or Availity@tsys.com. ©2018 Total System Services, Inc.® Confidential and Proprietary. All rights reserved worldwide.
Editor's Notes
- Before we get started, let’s review a few key drivers in the dental industry today: 1. According to the National Association of Dental plans, an estimated 64% of the US population have dental benefits; 92% of which are from employers or group programs. As more individuals have dental health insurance, more patients can afford to visit the dentist. 2. Although health insurance and government health programs pay for a portion of services, patients are still financially responsible for a considerable amount of their dental expenditures. As income levels increase, individuals will want more dental procedures representing a potential opportunity for the industry. Overall, dental practices generate over 40% of revenue from out of pocket expenditures resulting in industry revenue being largely tied to patients discretionary income. 3. Publically funded benefits, such as Medicare and Medicaid, reduce the out of pocket cost of dental services for consumers, thus increasing industry demand. Funding is expected to increase and benefits are to expand. 4. Growth in the elderly population increases demand for implants and other cosmetic procedures. As we age and our dental health declines, we require more dental maintenance. This has a profound shift to service diversification, expansion of restorative care and surgical services. Overall, in the past five years, the dental industry has benefited from these favorable trends including increasing coverage, advances in technology and mounting awareness of the importance of oral care and hygiene. Additionally, the industry as a whole is receiving more healthcare insurer reimbursements than that of the past driven by patients having greater access to coverage due to healthcare reform. This is a great segue to stress the importance of analyzing the overall patient experience at the practice.
- It’s important to note that too often, before even making an appointment, that there are barriers and challenges the patient must overcome in order to take action. Some of these concerns include: fear, cost and time. Understanding that these concerns exist, what does the practice need to know about helping patients overcome these challenges? Often, people hesitate to make an appointment because of fear. Fear encompasses several things: it’s the fear of needing work to be done. Sometimes it’s not only being afraid of the cleaning but of hearing bad news that will require additional treatment or identifying dental problems they’ve acquired. It could be a fear of instruments; even the most advanced techniques cannot erase bad memories involving pain or scary instruments. People are also afraid of being lectured or called out on bad behaviors. Setting an environment of empathy and reassurance can help the most anxiety ridden of patients to feel comfortable and cared for. Another juggernaut reason that patients avoid the dentist is cost. Overall, only 65% of us go to the dentists and in some states, it is even lower, around 52%. This is more than just unfortunate; it’s dangerous considering regular dental check ups are key to dental health. According to the ADA, lack of coverage is one of the top reasons individuals forgo the dentist. If a patient is concerned about having no insurance or their visit may not be covered, what could the appropriate response be to their objection, “I can’t afford it”? Stressing importance of the procedure is important but doesn’t resolve the root cause. Coming up with a plan to make the treatment affordable is one way to combat this reason and we’ll discuss this in detail in a few slides. Explaining that delaying care can lead to bigger issues, with potentially more pain or impact, thus costing more may be scary to hear but help patients understand the larger picture. The third challenge to setting to an appointment is the patient’s personal schedule, carving out time to do so. Patients often say to themselves, “I'm too busy “ … or maybe they are not prioritizing their need for care or must put other needs or issues first. New patient scheduling requires recognition of their need for certain times or dates, and in doing so, avoids second thoughts that may turn into cancellations.
- The patient experience reminds us that there is an emotional component when they are seeking care. People are coming from a place of fear and of hope. Knowing there are realities that may prevent them from coming into the office and concerns they may have when they arrive, help us to get them the care they need while they are at the practice. When we can overcome objections with affordable, convenient, and comfortable options, we see a positive effect at the office and on patient bookings. However, what a patient doesn’t have insight into is that the doctor’s priority is for them to be well but policies and other legislative forces are driving healthcare like never before. Patients who participate in their healthcare rather than being an unengaged patient helps everyone. Next we will discuss how understanding the journey including their expectations and perspectives will help provide a positive experience at the practice so they are likely to remain active and engaged patients.
- The patient journey at the office has 6 main key touchpoints: It begins before they even step foot into the office, marked as prior to visit on the top right of the circle The next step is their arrival and waiting area experience Then, the examination room or in the chair Their meeting with the dentist Then proceed to check out Lastly, another part of the journey which occurs out of the practice, is what happens in their follow up care or leading up to their next appointment Let’s take a look at the journey in a little more depth over these key areas.
- One thing that ties into the journey is the effect of “consumerism” on healthcare. According to research from The PwC Health Research Institute, patients are expecting the same type of service from their practitioner as they would from a bank, hotel or airline. Let’s pause to let that sink in for a minute. The PwC Health Research Institute surveyed thousands of patients to gauge their opinions of healthcare and found that active listening and transparency are the top priorities for patients when it comes to choosing a practitioner. Getting a warm welcome when checking into a hotel shows friendliness, but in the office, it can be a game changer. The studies suggests that patients are twice as likely to choose or leave practice on the basis of friendliness. In the journey, expectations from the patient which include: I can quickly schedule an appointment My dentist listens to me and gives me answers I understand I feel heard and respected by my dentist and staff. My dentist knows my history I get timely reminders and follow ups
- To review, when making an appointment, patients are primarily looking for the restoration of health when they are ill or in pain. Following that, they are looking for timeliness of prompt appointments, openings that are convenient, a friendly staff and a provider who conveys hope and certainty. Additionally, they want to pay as little as possible, receive clearly explained costs and get sufficient appointment reminders for their next visit. When a patient is engaged, a good experience can certainly follow and ultimately, leads to their better health. A good experience turns into patient satisfaction. Patient satisfaction has enormous impact on the practice and we’ll talk more about that next.
- Patient satisfaction is a measure of care quality and gives providers valuable insights into the effectiveness of care and their patient’s level of understanding. Improving patient satisfaction has become one of the primary goals for many providers. Patient satisfaction level is directly linked to key success metrics and it impacts outcomes, patient retention and sometimes even reimbursement claims. Changes, big and small, during this process can improve a patient’s overall experience. Here are some of the reasons why patient satisfaction is important to the practice: From a practice perspective, the higher patient satisfaction, the greater the profitability. According to industry estimates, in the U.S., loss of a patient due to dissatisfaction can result in the loss of over $200,000 over the lifetime of the practice. Improved patient retention: No matter what the business, happy customers come back and refer others. As the cost of patient acquisition is high, so retaining existing patients saves the practice money and we’ll discuss that in greater detail. Increased patient referrals and improved patient loyalty is another advantage. Research says satisfied patients share their experience with five others while unsatisfied patients will complain to nine or more people. Online reviews put gas on the fire as increasing numbers of patients posting about their good and bad experiences online. If your patients are satisfied, people find about it and to contrast, negative remarks can snowball, catching the eyes of potential patients. Improved compliance: According to a study in Academic Medicine, patients who trust their doctors have better clinical outcomes. As important to note is how higher patient satisfaction positively affects the practice. We see a reduction in staff turnover, improvement in collections and greater efficiencies. Along with an increase in personal and professional satisfaction in the office, patients who are happier and improve under your care bring more happiness and job satisfaction to the practice overall.
- There are controllable and uncontrollable reasons why patient’s leave an office. Some of those out of the practice’s control are relocation, a move or changes in insurance. Those “controllable” reasons include: feeling neglected, left out, lack of concern; Poor communication or misinformation; Feeling rushed; Lack of description for tests/procedure; Pricing or billing issues.
- Considering that there are uncontrollable factors of patient attrition, such as moving or change to insurance, an established patient base cannot be considered permanent. The process of improving retention is grounded in the internal communications skills of dentist and staff. The goal for the practice is high patient retention and low attrition. If you haven’t done this lately, calculate how many patients you are losing each year and compare that number to your active patient base to come up with your attrition rate. Once you have uncovered your attrition percentage, calculate or estimate what that represents in lost revenue. You’ll be surprised to see that often it represents a significant number. Research and analytics say that “by the time you see an increase in attrition it is six or eight months after the point in time when they actually left.” Understanding your rate of attrition is an opportunity to get ahead of losing patients rather than just accept it. Patient attrition is also an indicator of behavior which can sometimes be attributed to processes and outside driving factors that take our attention away.
- It has been reported that 70% and more of people who take their business elsewhere do so because they perceive an attitude of indifference. Let’s qualify that to say their perception may not have been due to a deliberate slight or discourtesy, but the result is compelling. When it comes to the business of dental care, it costs 7x less to retain a patient than attract a new one. Studies show that acquiring a new customer is anywhere from five to 25 times more expensive than retaining an existing one. The cost savings makes sense: you don’t have to spend time and resources going out and finding a new client, the focus is on keeping the ones you have happy.
- There are multiple strategies which can be executed to improve your patient retention efforts. A diligent focus around all the small details of the customer experience creates a foundation of success. When implemented, these efforts economically enhance your operations. Setting yourself apart from the competition means setting your practice up for success in the long-term, because they’ll keep coming back until you give them a reason not to. For existing patients, a retention strategy is about building a community of content and connectivity; while listening and engaging with them. Communication is key: create engaging marketing content to stay relevant in their lives. Be receptive to their requests. Offer convenient and flexible payment arrangements. To understand why a patient has left, reach out to them and ask. There are things that can be controlled versus things that cannot such as a move or relocation or changes in insurance. If it’s something within your control, try to resolve their concerns. Both of these center around communication and staying in touch. The primary message here is to find out why they left or were unhappy. It may not be easy to hear but it may just be critical information you can use to learn from it and avoid happening in another case. Reach out to remind them to make another appointment. Incentivize their return, for example extending a promotion for specialty services, such as new cosmetic procedures or free informational developments, preventative advice, or discussions of common problems.
- How can the practice improve on patient satisfaction? Here are the top 5 components: The first is focus on care: high-quality service with a positive patient experience. Encourage your team to suggest ideas for improving patient satisfaction within your practice. Next is efficiency: By improving the efficiency of your practice, you can reduce wait times both for scheduling appointments and while a patient is waiting to be seen. One of the top complaints of patients is the wait in the waiting room just to be seen. Check in and check out are important parts of the process. Ensure you are using the most efficient systems to help and support these key functions. The ability to adopt new technology to assist in the range of services provided and increase productivity making the appointments, scheduling, check in and out processes run smoothly. Cost is another component: Clear explanations of financial responsibility and insurance coverage help patients understand their part and plan accordingly. Lastly, communication: providing your patients with necessary information is imperative to achieving a positive patient experience. A patient will feel empowered when he or she leaves your office with knowledge about their diagnosis and treatment options. Additionally, studies show that greater patient empowerment leads to better patient adherence, which leads to improvements in patient satisfaction and outcomes.
- One of the challenges we discussed earlier in the presentation is now part of our best practices. First, let’s talk about the challenge. 1 in 5 Americans report having problems paying medical bills in the past year causing significant financial challenges and changes to their employment and lifestyle. This places a burden on dental providers as bad debt and collecting on costs increase. Declining case acceptance rates as 62% of people with medical bills report postponing needed dental care. 69% cite lack of financing as the reason they delay or decline care. How can dental offices increase access to care without putting themselves at risk?
- We can turn cost and finances into a strength by instituting key components. What patients most want is a clear understanding of cost for the procedure or treatment, how much insurance will pay, if anything, and what their payment options are. Let’s break this down one piece at a time. Offer real time benefits eligibility verification and patient responsibility calculation. It’s great to have this conversation before they sit in the chair. If possible, offer a payment plans to fit their budget, prepay or prompt pay discount, no interest short team payment plan or long term plan with various degrees of interest. Offer all payment options: cash, check, credit card, debit card, FSA/HSA, online, mobile. A specific note about alternate methods of payments. First, patients want to make payments through the practice’s website. Payments to providers through a website has increased 89% or 24% on average each year. Think about emailing or texting when a balance is due with a link to an online portal or website for your patients to pay. They are likely to pay faster when the convenience is there. Mobile is also becoming the norm for a convenient experience. Mobile payments have become so ingrained in the digital world that more than half of the top 2017 apps in the Apple App Store featured the ability to make or send payments as core to its functionality. Consumers want the mobile experience in healthcare too as shown by the 80 percent of consumers who want to check in for a provider visit on their own secure mobile device and 65 percent who would download a mobile app to pay all of their healthcare bills.
- For long term practice success, it is important for dentists to establish and nurture a culture that focuses on continuous growth. Reducing anxiety, providing financial options and offering convenient, efficient processes while the patient is in the practice will allow for an optimal patient experience. Through patient-centered service and an understanding of what it takes to make a practice profitable, a practice can be unstoppable.