em breve
Dívida inadequada das contas de responsabilidade do paciente e uma mudança contínua dos pagadores para mudar os custos para os pacientes significava que o sistema de saúde da Ochsner precisava de uma nova abordagem. Em parceria com a Huron, Ochsner alavancou uma equipe de consultoria multifuncional para implementar novas políticas e aumentar a responsabilidade. Isso levou a US $ 11,7 milhões em melhorias anuais recorrentes no total de coleções de pacientes. A dívida adaptando as interações do paciente para se alinhar com o risco financeiro e criar mais eficaz ...
Desafio
O sistema de saúde Ochsner havia melhorado anteriormente os processos de pagamento do paciente e suas métricas para preservação e coleta de pontos de serviço estavam no quartil superior nacionalmente. Apesar disso, eles experimentaram aumentos de dívidas ruins das contas de responsabilidade do paciente. Com os pagadores continuando a mudar os custos para os pacientes, a liderança em Ochsner concluiu que era necessária uma nova abordagem. O engajamento ajudou Ochsner a expandir uma cultura de responsabilidade e fazer melhorias significativas nas coleções, além do seu desempenho já acima da média nas coleções de responsabilidade dos pacientes. Como resultado, a Ochsner alcançou US $ 11,7 milhões em melhoria anual recorrente no total de coleções de pacientes.
Approach
Huron partnered with Ochsner to enhance patient liability collections and reduce bad debt by tailoring patient interactions to align with financial risk and created more effective patient counseling about financial options. The engagement helped Ochsner expand a culture of responsibility and make significant improvements in collections, beyond its already above-average performance in patient liability collections. As a result, Ochsner achieved $11.7 million in recurring annual improvement in total patient collections.
Implementing new policies: Huron worked closely with Ochsner to design and implement a new, systemwide, financial clearance policy. The policy included minimum payment thresholds for scheduled services with high financial risk and allowed for a deferment of services if minimum requirements were not met, giving patients more time to make financial arrangements. Exceptions were allowed for medically urgent services. Ultimately, less than 1% of services were deferred.
Engaging stakeholders: The Huron team worked closely with clinical and operational stakeholders to ensure success and sustainability. A cross-functional advisory team including key physicians and operational stakeholders was formed to gain business and increase communication between revenue cycle, medical and clinical operations staff.
Increasing accountability: The engagement fostered an accountable, proactive environment by providing summary reports on key performance metrics including lead days, at-risk volumes, financial clearance rates, patient liability collections and write-offs. Huron developed a workflow integrated within the health information system (HIS) to track outcomes and identify at-risk accounts.
Improving processes and training: The engagement improved the insurance verification processes, allowing preservice collections teams sufficient time to engage with patients. Eligibility counseling and financial assistance processes were incorporated into the new approach for patients who truly could not pay. Huron also provided scripting and training for hospital and physician office staff regarding patient liability and financial counseling.
Ochsner Health System is Louisiana’s largest non-profit, academic healthcare system with 13 owned, managed and affiliated hospitals and more than 50 health centers. The system includes approximately 1,000 physicians in the Ochsner Group practice, representing over 90 medical specialties and subspecialties. It also works with 1,500 affiliated physicians and has more than 15,000 employees.
