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Organizations that are committed to taking a data-driven approach to monitoring patient access can elevate operations and set the stage for a robust, efficient, and productive revenue cycle.
Monitoring and managing patient-access performance has never been more important as hospitals and health systems face an influx of newly insured patients, navigate rising patient payment responsibilities, and cope with increasingly sophisticated payer rules.
Just how important is patient access? "Fundamentally, the patient-access performance drives everything else in the revenue cycle," says HFMA's Sandra J. Wolfskill, FHMFA, director of healthcare finance policy for revenue cycle MAP.
If an organization becomes stronger in collecting patient payment at the time of service and referring self-pay patients to financial counseling, it generally will see a boost in patient collections and reduce the number of accounts goingto bad debt. Similarly, if front-end staff preregister scheduled patients efficiently and accurately, their efforts can reduce payer denials, preserving cash flow and growing revenue. There are not only financial benefits to smooth patient access, but also advantages related to patient satisfaction, because patients appreciate an easy and well-organized entrance to the care episode.
"If you get things right in patient access, then the rest of the revenue cycle flows pretty easily," Wolfskill says. "If you get things wrong, there can be a cascading effect that significantly impacts an organization's bottom line."
Data can play a key role in optimizing patientaccess functions. Getting performance in line often begins with objectively measuring performance, recognizing improvement opportunities, holding staff accountable for performance, and evaluating progress toward predetermined goals. Well-defined and industrycomparable metrics-otherwise known as key performance indicators (KPIs)-are essential to these efforts.
Without the right measures in place, an organization can lose focus. "People pay attention to what you measure," says Jane Berkebile, system vice president for revenue cycle management at OhioHealth, based in Central Ohio. "To get staff and leaders on board with patient-access improvement, you should establish the major factors that demonstrate performance, clearly define metrics that reflect those factors, ensure data are reliable, and routinely provide the information to stakeholders in a format they can understand."
Determining the Right KPIs
Although organizations have flexibility in selecting which patient-access KPIs to measure and report, certain indicators are more common than others. These metrics can...