The right prescription for improving hospital admissions

The right prescription for
improving hospital admissions
A large regional healthcare system transformed the way it interacted with
incoming patients to streamline their admissions, address their financial
concerns, and improve the bottom line by preventing last-minute
cancellations.
Executive Summary
Client’s challenge:
To address revenue and patient
acquisition challenges by:
•
Understanding reasons behind
patients’ dissatisfaction with the
admissions experience
•
Developing new organizational
and operational processes to
support patients on highdeductible insurance plans
•
Reducing revenue loss by
mitigating the risks for patient
cancellations
PwC’s Solution:
Create a new patient admissions
process that can be easily deployed
across many hospitals by:
•
Collecting and analyzing patient
data to understand the currentstate and specific unmet needs
•
Crafting new customer-centric
processes that address patients’
financial concerns to prevent
last-minute cancellations and
improve collections
•
Writing and deploying a playbook
outlining staffing, training,
procedures, and metrics for the
improved processes
Healthcare
Consulting
May 2015
What started as a series of
conversations about
customer satisfaction turned
into a complete operational
and organizational overhaul
across more than 20
hospitals.
.....xxxxx
Impact on Client’s Business:
•
•
•
The new processes rolled out to
the more than 20 hospitals
within the healthcare system well
ahead of schedule
Better-informed patients are
making fewer cancellations
Patient satisfaction is on the rise
as revenue losses from
cancellations have
simultaneously been stemmed
Client’s challenge:
A large regional healthcare system
found itself struggling with its
admissions procedures. Incoming
patients were frustrated not only
by the redundant processes they
faced but also by unpleasant
financial surprises, especially
when they were unaware of their
own high deductibles. The
hospital staff was ill-equipped to
deal with the questions and
concerns that were arising, and the
healthcare system needed a
scalable and easy-to-implement
admissions process that could be
easily replicated across the many
hospitals in its network.
It was clear that in order to
improve patient satisfaction
during the pre-admission and
admission processes, the
healthcare system would need a
thorough organizational and
operational overhaul that would
upend the traditional ways that
patients were admitted, even if
that meant impacting staffing and
training, and there was little time
to waste.
Last-minute cancellations for prescheduled surgical procedures—
often by patients who hadn’t been
adequately informed about costs
ahead of time—were extremely
costly to the healthcare system and
had to be avoided whenever
possible.
PwC’s Solution:
PwC responded to and won an
RFP from the healthcare systems’
revenue cycle leadership. Our
initial conversations focused on
improving patient satisfaction with
strategies that would improve
revenues in the hospitals, which
were ultimately implemented. Our
plan was to help the healthcare
2
system find the root causes of the
dissatisfaction, fix them at a single
hospital location, and then roll out
the improvements across more
than 20 hospitals in the system.
And we had just six short weeks to
help figure out what those fixes
should entail.
We began by assembling a tenperson PwC team consisting of
both customer experience and
revenue cycle advisors. They set
out not only to analyze the current
processes that were causing
problems but also to analyze all
the data the healthcare system had
collected on its customers’
experience while we
simultaneously began to collect
and analyze our own facts.
Through observation and
interviews, we were able to
segment the patient population
demographically, socially, and
attitudinally to look for patterns.
Then we blended that data with
staff interviews. One major
finding: incoming patients were
frequently unaware of their high
deductibles, and the hospital staff
was ill-equipped and not trained to
assist them in navigating and
evaluating their financial options.
With a mix of younger and more
affluent patients alongside fixed
income retirees who were not
digitally savvy, the healthcare
system needed a unified way to
reassure everyone that financial
concerns should not trigger a lastminute cancellation of a scheduled
procedure.
PwC’s recommendation was to set
up an offsite call center to reach
out to patients before their
admission to talk over the financial
realities of their upcoming
procedures. Those staffers would
be trained to handle any financial
issues that might come up. We
also proposed that each hospital
strive to centralize its admissions
wherever it was possible and
sensible and to put a well-staffed
“welcome desk” at the main
entrance to serve as another place
where incoming patients could get
their questions—financial and
otherwise—answered ahead of
time.
Finally, we recognized that veteran
admissions staffers who
specialized in admissions in only
one department could cause an
inconsistent flow of incoming
patients. Retraining and
redeploying that staff so it could be
more versatile and productive was
a crucial step.
…the healthcare system would need a
thorough organizational and
operational overhaul that would
upend the traditional ways that
patients were admitted…
…we were able to help the
healthcare system transform its
patients’ experiences while
simultaneously improving
revenue flow.
Consulting
May 2015
Now patients who are
scheduled for a
procedure are far less
likely to cancel due to
unanswered financial
questions.
PwC Helped the client
create a unique
customer experience
and unlock data
possibilities.
The healthcare system agreed with
our proposals, and we immediately
helped turn them into a 170-page
playbook outlining departmental
organization, job descriptions,
training, patient interaction
scripts, ideal-state patient
journeys, communications
methods, implementation
timelines, and metrics dashboards.
With this toolkit, every hospital in
the system could evolve its
admissions processes on its own.
In the end, we were able to help
the healthcare system transform
its patients’ experiences while
simultaneously improving revenue
flow. Now patients who are
scheduled for a procedure are far
less likely to cancel due to
unanswered financial questions,
and while they enjoy more peace of
mind as they get better, the
healthcare systems’ revenue cycle
directors are feeling better too.
Impact on client’s
business
As it turned out, the initial pilot at
the first hospital went so well that
rather than wait for a full year of
testing to pass, the plan rolled out
within months at all 20+ hospitals
in the system. The success is
attributed to the ability to bring a
customer-centric sensibility to
what looked at first glance like
simply a tangled operational issue.
For more information, please visit
www.pwc.com/us/consulting
Or contact
Scott Weber
Director
(312) 298-3666
[email protected]
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