Becker s 3 rd Annual Revenue Cycle and CIO/CFO Conference. Cheryl Kreider, FACHE Irene Vergules, MSN,RN Shannon Hubler, MAOL, RN

Transcription

1 Becker s 3 rd Annual Revenue Cycle and CIO/CFO Conference Cheryl Kreider, FACHE Irene Vergules, MSN,RN Shannon Hubler, MAOL, RN

2 Introduction of Panel (contact Information included) Strategic Plan to Integrate 6 Key Performance Areas Impact on lost Revenue, Growth, and Transformation of Care GAP Analysis and KPI s required for the Senior Leadership Engagement of both internal and external experts for building SBP, Interim IT Requirements and Costs, ROI Present 5-year Strategic Business Plan and ROI to CEO/Board Assign a Senior Leader, PMP Leader, and Team Members to implement plan with weekly updates communicated. Presentation of Case Studies with Challenges, Results, Implementation, and Technology Utilized Q & A

3 Building a Strategic Business Plan for increased Revenue Cycle and Growth! Let s start with the future Strategic Vision so we don t duplicate resources! What do all these areas have in common?

4 Human Capital, Technology, Integration and Networking Challenges, at times fragmented Goals and Communication

5 Scenario- You are part of large Clinically Integrated System that will be implementing a new EMR (Timeline 2-5 years) Currently your healthcare enterprise has lost revenue on the Hospital Acute Care, Ambulatory and Physician Network areas Competitors are capturing more of your volume Patient, Employee and Physician Satisfaction is decreasing. Staff Turnover in your individual Contact Centers is high. Staffing Level Needs to Quantified, Enhance Knowledge Base. Employees + Family have difficulty navigating your system. ROI on possible solutions is needed GAP Analysis Required.

6 1. Employee Insurance costs used at other Healthcare Entities, unless not offered, equals lost volume and increased Employer Benefit Costs. 2. Insurance Verification can fail if the process of scheduling, authorizing, registering,verifying is not accurate-increase denials lost revenue. 3. Real-Time Scheduling and monitoring of calls is required to not lose volume. Lost calls need to have call backs to not lose the patient or physician office call. 4. Marketing/Communication efforts for outbound calls on new services, preventative services (i.e. breast & colon cancer awareness,and screening, plus text reminders, s, web chat and Skype. 5. Population Health supports the Full Continuum of Care - Case Managers are alerted when a covered life is in another healthcare facility, and investigates the situation. Prepares next POC! 6. Physician Network and Ancillary Scheduling should be integrated and verified daily to ensure the patient does not get lost in another system.

7 TRENDS AND TECHNOLOGIES TO BOOST CALL CENTER PERFORMANCE Irene Vergules MSN, RN

8 What do these organizations have in common? Academic Medical Centers Multi-Hospital Networks Community Hospitals Physician Office Networks

9 Common Challenges DRIVING VOLUME Easy Seamless Integrated Coordinated

10 Common Challenges ACHIEVING KEY PERFORMANCE INDICATORS Although the specific indicators may vary from one organization to the next, there are some common goals: Customer s Perspective Internal Business Perspective Innovation and Learning Financial Perspective

11 Common Challenges ACHIEVE KEY PERFORMANCE INDICATORS ENSURING EASY ACCESS MUST MOVE BEYOND JUST CALLS Integration of multiple channels and key programs

12 KEYS TO SUCCESS Adequate Space Wallboard displays to make data easily visible Work areas that are bright and quiet Adequate and efficient workspace

13 KEYS TO SUCCESS Technology Individualized Agent Displays System flexibility is critical Quality Monitoring Capabilities

14 KEYS TO SUCCESS Metrics and Reporting: - Can t Improve what you don t measure Abandonment Rate and Service Levels are critical Understand your volume

15 KEYS TO SUCCESS Staffing Analytics and Productivity Monitoring

16 CASE STUDY #1 The Challenge: A community based health system with three hospitals and a number of outpatient clinics faced significant issues with managing their call volume in their Radiology Scheduling Call Center. Senior Management received ongoing complaint calls from patients and referring physicians. Assessment The reports indicated an abandonment rate that ranged 16-20% 25% of call were going directly to voic Over 100 calls were handled with live messaging Average time to answer over 8 min Reports available inconsistently and on a daily or weekly schedule Staff positions were vacant and took long to fill

17 CASE STUDY #1 The Solution: Due to constraints with the telephone system and lack of adequate reporting tools, live monitoring or recording capabilities a decision was made to purchase a solution that did not require a capital investment and that was able to meet our needs within a short period of time in the most cost effective manner. A 90 day remediation plan was proposed. The work flow and all processes were re-evaluated. The immediate need was to eliminate the voic s and live messaging despite poor services levels. The complaints were significant and needed immediate attention. Staff training was also provided prior to implementation of new system and processes.

18 CASE STUDY #1 Results: Worked with HR and managers to fill all open positions. Decreased talk time by implementing Pre-Registration instead of complete Registration at the time of call New hires and temporary staff trained Revation system implemented October 15 th October 16-30, 2015 preliminary data demonstrated: Decreased abandonment rate to 23% with no voic s, no live messaging Average time to answer 2:38 min/sec. Average talk time of 7:15 min/sec November 1-30, 2015 data continued to show significant improvement Abandonment rate: 5% (goal 5% or less) Average time to answer: 34 sec (goal less than 45 seconds) Average talk time: 6:38 (goal 5 minutes) Service Level 75% (goal 80% or above)

19 CASE STUDY #1 Data Analysis:

20 CASE STUDY #1 How are they doing today? Despite typical challenges that all call centers face on a daily basis, they have been able to not only maintain focus of their metrics, consistently conduct monthly quality monitoring and also transitioned new services into the call center that increased call volume by over 2000 calls monthly August 2017 Abandonment rate: 5% (goal 5% or less) Average time to answer: 47 sec (goal less than 45 seconds) Average talk time: 6:28 (goal 5 minutes) Service Level 73% (goal 80% or above)

21 CASE STUDY #2 The Challenge: A large multi-physician specialty practice with three locations and scheduling handled in each location. Data was not available except for sporadic reports with very little detail. Some locations service levels were significantly lower than others. Complaints were consistent in one location particularly. Assessment Although utilized ACD technology for call routing there were no valuable reports available for analysis. Staff were distributed to handle different types of calls (general vs appointment) Data was inconsistent and could not be validated. Adequate staffing compliment could not be confirmed. No cubicles, just desks, no sound proofing, room noisy. Single monitors on all desks. No voice recording tools available.

22 CASE STUDY #2 Results: Implemented Revation Systems in all locations July Migrated two locations to handle the same call types and the plan is to migrate all three locations to handle overflow. Implemented dual monitors to improve their efficiency Decreased busy signals within the practice Changed one position from a full time to two part-time to handle the peak volume. Developed cross training with other staff in the office (medical records) to cover in the event of call outs. Began quality monitoring and agent scorecard Live monitoring of volume and shifting staff as needed to coverage peak volume

23 CASE STUDY #2 How are they doing today? Despite implementing EMR within the practice and modification to a number of internal escalation changes and processes they continue to work towards their goals. Additional staff was recommended however due to budget constraints that is still being evaluated. Need to implement Knowledge base system to assist with scheduling across the various locations. Migration of the two call center queues have not yet occurred but will after the EMR and Knowledge base system implementation is complete. June 2017 Abandonment rate: 6% (goal 5% or less) Average time to answer: 40 sec (goal less than 45 seconds) Service Level 78% (goal 80% or above)

24 CASE STUDY #3 The Challenge: A Health System with three hospital locations and two scheduling call centers. Both faced challenges with handling call volume and impacted organizational growth needs. (CHERYL ADD) Assessment Call Center #1 scheduled for 2 hospitals with a call volume 4,000 4,500 calls per month and abandonment rate of 15-20%. In addition 15-20% directly to voic or bell. Schedules approximately 4,000 appointments month Staffing consisted of 9 FTE s and one supervisor. large volume of fax requests from physicians resulting in outbound calls to schedule these patients. Intermittent FMLA issues have negatively impacted staffing and phone coverage Call Center #2 scheduled for a smaller community hospital with a call volume approximately 3,000 calls per month with an average abandonment rate of 23-29% Staffing was budgeted for 5.5 FTE s and one supervisor but was consistently understaffed Schedules approximately 1,200 appointments monthly

25 CASE STUDY #3 Assessment Cost of Doing Nothing Call Center #1 Call Center #2 Financial Info Based on Radiology Provided Data: - Abandonment rate 15-20% - 4,000 calls monthly - Lost call volume is approximately 700 calls monthly - Lost dollar opportunity annually (even if only 7% actually LOST) is 833,280 - Abandonment rate 23-29% - 3,000 calls monthly - Lost call volume 750 calls (25%) monthly - Lost dollar opportunity annually (even if only 10% is actually LOST) is 1,227,600 COMBINED CONSERVATIVE ANNUAL LOST REVENUE 2,060,880 Hospital A- $286 Hospital B- $210 Average - $248 Hospital C- $341 Combined Average - $279 This includes a blend of the following: Diagnostic Radiology MRI Interventional Mammo Ultrasound Nuclear Med CT Scan

26 CASE STUDY #3 Results: Built a centralized location to accommodate all staff New space with proper work surface area and quiet environment. Dual monitors in workspace and wallboard around call center perimeter Common area for meetings, trainings and lunch room Implemented Revations system Reviewed scheduling protocols across three entities and streamlined processes. Cross trained staff to handle scheduling for all three hospitals. Began quality monitoring and agent scorecard

27 CASE STUDY #3 How are they doing today? All staff have been scheduling for all three locations Moved a small physician scheduling group into the Call Center with 2 dedicated FTE s but not yet integrated into the call center. July 2017 Total FTE s 11 and 1 team leader Total Incoming Calls: 6419 Total Outbound Calls: 2462 Abandonment rate: 4% (goal 5% or less) Average time to answer: 32 sec (goal less than 40 seconds) Service Level 81% (goal 80% or above)

28 North Memorial Health Improving Revenue Cycle through Text/Chat To Schedule Patient Communications

29 Revation Multi Channel Communication Platform Virtual Visit.com Mobile Worker Referral Relationship Management Knowledge Base Voice, web chat, video, Co-Browse s Revation Solution Suite Intelligent self-service (IVR) Live session monitoring, call and screen recording, QA Automated outbound for feedback, surveys and notifications Performance reporting, analytics and dashboards Single Integrated Solution HIPAA/HITRUST Compliant Performance Reporting and Compliance Recording Encrypted Interactions Without a Software Residual End to End Recording

30 The Challenge 2014: North Memorial Health started the search for a cutting-edge technology to help differentiate from other organizations in the metro area As a leading organization in healthcare it became a must to have the ability to communicate with patients in a convenient manner through unified communications Vital for the communications solutions to be secure and in compliance with HIPAA regulations Growing need for call center agents to quickly and effectively switch from a chat or text conversation

31 The Solution June 2015: North Memorial Health began working with Revation Systems Implementation of chat/text to schedule platform across all 27 clinics and both hospitals to improve scheduling process and patient-provider communications In addition, North Memorial Health also deployed Revation s Knowledge Base solution Instant access to information for call center agents through a robust search function that can

32 The Results Significant improvements in revenue cycle Uptick in appointments made and kept - 6% First month using LinkLive for text/chat to schedule appointments North Memorial Health had 422 inbound chats or texts for appointment scheduling 90% resulted in scheduled appointments Only 1 case of conversation escalating to audio phone call Achieved goal to decrease call volume while increasing number of visits through additional multimedia channels

33 Knowledge Base Searchable Results display in specific categories such as clinics, providers, or documents Ability for Agents to Flag Errors If agents find an error, they can click a button at the top to fill out a short form The page with the error is noted and placed in a queue for admin to mark it as archived or rejected tracking feature Compliance Feature Allows management to track compliance of procedures and documents by restricting agents to move forward before opening a document and reading through it

34 Knowledge Base

35 Please feel free to contact panel members with any questions. Thank You.

36 As CEO of Kreider Health Solutions, Cheryl Kreider, MBA, FACHE has over the last 25 years, created and implemented best practices in healthcare strategy and technology across numerous platforms. Cheryl holds an MBA degree, and is completing her M.S.O.D degree at the University of Pennsylvania. She is a nationally recognized Fellow of the American College of Healthcare Executives. Most recently, Kreider was the Vice President of Ambulatory Growth for the Mercy Health System-part of Trinity Health. Kreider also served as the Chief Operating Officer and Facility Compliance Officer at Phoenixville Hospital- CHS, and as Associate Hospital Director for Temple University Hospital, and Temple University Children's Medical Center. Cheryl is currently the President of the Perkiomen Valley Chamber of Commerce in Pennsylvania. Cheryl Kreider can be reached via LinkedIn for questions or consultations.

37 Irene Vergules MSN, RN With over 25 years in the health care sector and extensive experience with a wide range of contact/call center implementations, call center design and operations. Provide consulting services to large health systems, hospitals, physician practices and other health care environments on variety of call center initiatives including: - Population Health and Disease Management - Physician and Ancillary Scheduling - Marketing and Physician Referral - Nurse Triage and Navigation Softech Consulting, President ivergules@hotmail.com Cell:

38 (952)