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Improve Patient Satisfaction Through Segmentation
By Tina Eller, Vice President, SearchAmerica®, A part of Experian
Hospitals have turned to new technology to better serve their patient populations by segmenting outstanding receivables. As with any solution, hospitals are asking whether it is helpful or hurtful to the patient’s financial relationship with a health care provider.
Fortunately, leading hospitals are turning to advanced segmentation strategies to strengthen their community and patient relations, provide an unbiased approach and improve their bottom line.
One of these hospitals is INTEGRIS Health, a large health care system in Oklahoma with 14 hospitals. After implementing a patient segmentation strategy in 2004, the organization has virtually eliminated all customer service complaints related to patients’ financial experience. How? The company uses an automated probability-of-payment model across all of its hospitals to apply the proper collection activities to each patient.
Smarter segmentation based on payment likelihood
Predictive modeling is used to segment patients by using data elements to
predict future behavior — in this case, paying their hospital bills. The use
of predictive modeling tools is growing significantly in health care, with
hospitals employing the results to improve their revenue cycle and prevent
fraud.
Predictive modeling is simply an equation used for scoring and ranking patients based on payment likelihood. Hospitals using predictive modeling to determine payment likelihood typically leverage three key performance indicators (KPIs):
- History of behavior
- Medical data available
- Age of account (30, 60 or 90 days)
In addition, most also are leveraging third-party services that offer credit and financial information. By adding these attributes to their modeling, hospitals can better derive payment advice specific to their patient population.
With the use of predictive modeling, it is possible to examine groups of patients and determine their payment likelihood. These results will allow facilities to segment out patients with high probability of payment and approach them differently than they would a patient with low probability of payment.
It
all hinges on communication
A patient’s impression of a health care facility is determined by his or her
experiences, both with clinical treatments and financial interactions. Both
activities rely on communication.
To establish a level of trust, a hospital’s frontline staff must be able to establish the appropriate financial relationship with each patient based on advanced segmentation to effectively and politely communicate the patient’s financial responsibility, if any. If this is not done well at the onset, a patient is quickly frustrated and the relationship is off to a poor start.
Instead, organizations must equip their staff with systems to rapidly identify the appropriate collection strategy for each patient at that point in time. If they qualify for financial assistance, patients should be told their options and enrolled immediately, whenever possible. For the remaining patients, registrars should provide payment options, if needed, and/or remind patients of their financial responsibility.
Communication doesn’t stop after the patient leaves the hospital. Hospitals know that a billing statement can either strengthen or weaken patients’ satisfaction with your facility. One of the largest complaints from patients is the vague or cryptic information on their billing statements. The harder it is for them to understand, the less likely they are to pay the bill on time.
Billing statements offer today’s hospitals an opportunity to demonstrate their commitment to patient satisfaction. With informative statements based on the patient’s appropriate collections strategy, patients will respond more quickly and favorably.
Hospitals today need to improve how they communicate not only with their patients, but also with the community they serve.
Thus, INTEGRIS and other health care organizations are curing potential media misperceptions by reaching out to educate and build awareness within their service area. For example, local consumers are saving significant dollars on health care annually through the hospital’s charity care programs. The general public generally is unaware of this generosity. Everyone benefits from making this fact known in the community.
Best practices in segmentation: a case study
At INTEGRIS Health, the company has achieved a reputation for excellence in
its communication with patients regarding financial responsibilities. Using
predictive modeling to segment its patient population since 2004, INTEGRIS
now applies the proper collections activities to each patient account.
“We wanted our patients to have a positive experience with INTEGRIS’ administrative and financial operations, as well as our clinical side,” stated Brent Grimes, Corporate Director of Patient Financial Services at INTEGRIS. “Today our segmentation strategy is consistent across all facilities and patients, providing an unbiased approach to our patient relations. Using a probability-of-payment segmentation strategy, our staff can have straightforward and sensitive discussions with our patients, resulting in a better outcome for all. Since implementing our segmentation strategy, our patients are happier and less stressed as they understand their financial responsibility. Most importantly, we have a mutually agreed-upon plan to eliminate surprises.”
INTEGRIS is focused on communicating its financial assistance offering and related screenings as part of its admissions process. Due to the nation’s economic recession, more patient populations need hospitals’ charity care and/or other financial assistance programs to help cover the gap between billed charges and what their insurance plan pays. Thus, INTEGRIS is communicating its financial assistance options to patients much earlier than before.
On the front end, INTEGRIS uses a predictive modeling service to segment patients as they enter their facilities based on their probability of payment. They are quickly able to identify qualified charity care accounts, offer payment options to those who need them and ultimately make all patients aware of their financial responsibility at the onset of their relationship.
After a patient leaves its facilities, INTEGRIS uses predictive modeling on the back end to determine the best strategy for collections — for example, the number of phone calls, the letter series, and when an account should be tagged as bad debt or presumptive charity. By communicating with each patient in a unique manner based on the financial responsibly established at registration, a patient’s dignity is maintained and so is INTEGRIS’ bottom line.
Automation delivers consistent, unbiased results
Smarter segmentation is achieved only by automating the process, making it
consistent and unbiased. With an automated system, the guesswork is removed
and staff must follow a predetermined process that applies to all patients
in a particular segment, regardless of age, race or education.
In conclusion, all segmentation is not equal. Exclusively relying on credit histories isn’t likely to yield the financial, community and patient satisfaction results that health care networks are looking to achieve. Understanding a patient’s payment likelihood can achieve this result — just ask INTEGRIS Health.
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Innovations '10 for Healthcare IT
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