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From the Consultant’s Corner 4/5/16

April 5, 2016 News No Comments

Improve Patient Access – and ROI to Boot

Providers understand how important it is for patients to have easy access to healthcare services in order to achieve higher patient satisfaction and potentially better outcomes. However, figuring out how to improve patient access in an affordable way can sometimes be a challenge.

One way to improve patient access is by optimizing physician capacity through a centralized patient access center. This approach is attractive to patients because it offers a single, easy-to-reach contact point for scheduling appointments, checking benefits eligibility, and getting answers to billing or clinical questions. With one resource, they can reach all providers and resolve multiple issues. Likewise, multispecialty practices can secure multiple appointments with just one phone call, improving care coordination.

Despite the cost to develop a central access center, practices can actually realize significant ROI by conducting an in-depth analysis of physician capacity to accept additional appointments. Increasing capacity isn’t as easy as simply adding another slot to an already-packed schedule. Instead, an analysis should be used to design a business plan based on benchmark data that helps increase both access and practice revenue.

A Win-Win for Patients and the Bottom Line
Patient access challenges — including scheduling delays and long appointment wait times — may be linked to poorer health outcomes, and can be a financial burden on patients who may seek non-network and possibly more distant care. Delays in care, because of poor patient access, may also cause unnecessary physical discomfort for patients, and dissatisfaction with the healthcare system as a result.

In most cases, practice administrators already know when their group has a patient access problem because of complaints from new or existing patients about long wait times for appointments. Therefore, the first step toward improving patient access is to determine and document the scope of the challenge. Identifying access challenges allows practices to decide where they need to concentrate the bulk of their efforts —such as which providers or specialties have longer waits than others.

Maximizing Capacity Yields New Revenue Opportunities
Implementing a centralized patient access center is an efficient and effective way to help maximize physician schedules while also delivering a satisfying patient access experience. A centralized patient access center certainly requires an investment in staff, hardware, software, and services, yet practices often can generate enough revenue to cover the costs — and even more — by simultaneously analyzing provider capacity. In fact, it is not uncommon for practices to realize an ROI of 25 percent, while some larger practices have even generated revenue of almost double the investment.

The key is to evaluate access at the individual provider and the practice level, taking a hard look at factors such as:

  • Practice capacity policies and standards: Does each provider’s wRVUs, for example, match practice expectations? Establishing and enforcing administrative policies regarding the required number of patient care hours or wRVUs is essential to ensure long-term behavioral changes.
  • Benchmark data: Sharing practice or other peer benchmark data can help prompt any behavioral changes needed to overcome capacity shortfalls.
  • Individual schedule variations: How long until each provider’s next available appointment, on average? Is time being spent on activities that could be delegated to clinical support staff? In some cases, analysis might reveal that there are truly so many patients on a provider’s panel that the panel should be closed for a time.

Improving physician capacity first requires verifiable data and benchmarking. Once this evidence is available, strong physician leadership is necessary to drive policy enforcement. Success with scheduling and behavioral change is much more likely when capacity conversations are led by a clinical peer rather than an administrator. Physician leaders who can speak with their colleagues one-on-one typically are better able to focus the conversation on benefits to patient care and the patient experience, resulting in a more open dialogue and positive results.

Good for Business, Good for Care
Patient demand for healthcare services is rising. Concurrently, healthcare markets are consolidating due to mergers and acquisitions. From a business perspective alone, practices should take a closer look at how improving patient access could help them succeed in highly competitive environments.

By optimizing physician capacity through a centralized patient access center, practices have an opportunity to grow revenue and marketplace reputation, while serving more patients and enhancing the patient experience. This can result in healthier and more engaged patients, which is the ultimate benefit for any practice improvement.


Johanna Epstein is vice president of management consulting services for Culbert Healthcare Solutions in Woburn, MA.


JenniferMr. H, Lorre, Dr. Jayne, Dr. Gregg, Lt. Dan

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