HealthLine Systems enjoys a twenty-six year record of client results with software solutions serving over 1,000 healthcare organizations throughout North America. HealthLine Systems’ EchoAccess is a fully Web-enabled contact center solution. Whether or not you deploy an official Accountable Care Organization (ACO), EchoAccess delivers tools needed to move forward in today’s complex environment. ACO or not, your contact center is vital to your future, and EchoAccess can help. Consider these opportunities:
EchoAccess Opportunity 1: Place post-discharge calls to reduce readmissions: Reducing readmissions is a tangible financial opportunity. Beginning in 2013, excess readmissions of Medicare patients will result in decreased reimbursement. The three initially targeted conditions for penalties are congestive heart failure (CHF), heart attack, and pneumonia. In the following example, a one percent excess in CHF admissions results in decreased reimbursement of over $400,000. What could be the financial cost if your organization had two or three clinical areas with just a one percent rate of excess readmissions?
For example, hospital A has an expected CHF readmission rate of 190 cases out of 1,000 but an observed rate of 200 readmissions, a twenty percent readmission rate versus the nineteen percent anticipated or a one percent excess of readmissions. The outcome will be that“Hospital A’s reimbursement will not be $80,000 less than the $8 million it bills to Medicare. Instead, it will be $421,053 less,” said David Ollier Weber in H&HN Weekly’s Sept. 27, 2010 issue.
Post-discharge calls can clarify follow-up care instructions, confirm medication and dosage accuracy, and schedule follow-up physician appointments – all to contribute to reduced readmissions. Clients can activate post-discharge callbacks using the EchoAccess comprehensive outbound call queuing and documentation system. Several EchoAccess clients make these calls now – and for good reason.
The Studer Group documents that healthcare organizations making discharge follow-up calls achieve a twenty to thirty percent reduction in preventable readmissions. One study identified initial results of piloted post-discharge outbound calls with patient prioritization, including a 46 percent reduction in readmissions for CHF patients and a 21.6 percent reduction in readmissions for pneumonia patients.
EchoAccess Opportunity 2: Deploy evidence-based clinical triage: Clinical triage manages utilization by directing callers to the most clinically appropriate and cost-effective care – whether you’re trying to moderate cost for a hospital, a health plan, a managed care organization, or an ACO. Clinical triage directs the truly “at risk” to immediate emergency care. Concurrently, it redirects the inappropriate use of high acuity clinical services to primary care or homecare. EchoAccess is the exclusive source of proven clinical guideline protocols from ClevelandClinic. These evidence-based clinical guideline protocols address ACO requirements for evidence-based medicine, patient engagement, and coordination of care.
EchoAccess Opportunity 3: Eliminate roadblocks to care: Short of experiencing your organization’s care personally, there’s no better way to understand what patients experience than to ask them. It is important to know what barriers to remove and what action to take to make it inviting and welcoming to access care. EchoAccess makes it easy to capture the needed information. The survey tool delivers flexibility to activate and track results of polls, questionnaires, and assessments. Surveys can support inbound, outbound, telephone, or Web components of your contact center. This provides an important opportunity to identify and eliminate roadblocks to care.
EchoAccess Opportunity 4: Shorten physician appointment wait times: Some clients have adjusted their referral policy in an effort to reduce the time a caller has to wait for an appointment to see a participating physician. The goal is to minimize the likelihood of that patient choosing to go elsewhere if a different healthcare provider can see him or her sooner. Tools to enable this opportunity are built intoEchoAccess. Consider making referrals to participating physicians on physician-selected timeframes with physician involvement, the preapproval of legal counsel, and full disclosure to meet safe harbor regulations. Referral priority setting options include the ability to assign priority to a practice based on physician agreement to see patients within 48 hours, 72 hours, five days, or more.
EchoAccess Opportunity 5: Provide one call preregistration: An important opportunity to ease access to care is making it easy to register for urgent care – so you are expected when you arrive, and your paperwork is already underway. Your EchoAccess contact center can be the call to action for urgent care and preregistered patients. At the time of the patient call, the contact center will document patient preregistration information and schedule automatic emails or faxes of this data to Urgent Care in advance of the next day’s patient visit. Because the Urgent Care team receives the information in advance, they can greet the patient by with a smile, “Welcome Mrs. Jones, we’ve been expecting you.”
EchoAccess Opportunity 6: Reduce call-processing time: EchoAccess is designed for fewer clicks and faster call-processing. An intuitive call-processing interface with rapid access call-handling controls provides the opportunity to do more in the same amount of time. One client reduced call-processing time by 51 seconds per call. For them, this equates to 536 hours saved in year one or 1.5 FTEs over five years. For this organization, the value of reimbursed revenue from additional call handling enabled savings of $600,000 in just one year and $3.7 million over five years.
EchoAccess Opportunity 7: Document kept appointments: Increasing your kept appointment rate strengthens relationships with both patients and with participating physicians. It allows you to “close the sale” at the time of the initial patient conversation by conducting a three-way call to confirm an appointment with the physician of their choice. Getting more patients into a participating physician’s practice gives you a great answer to a doctor’s question of “So, what have you done for me lately?” One client increased their kept appointment rate from 56 to 71 percent. The more patients who show up for physician appointments means that more patients are likely to require subsequent outpatient and/or inpatient services.
Summary: Healthcare’s shift from fee for service to value-driven payment is underway. Whether or not you deploy an official ACO, EchoAccess is an essential resource. It is your central communication hub that helps you reduce costly readmissions, triage callers to the least costly clinically appropriate care, improve patients’ experience of care, and increase the number of patients who keep appointments with your physicians. ACO or not, your contact center is vital to your future, and HealthLine Systems’ EchoAccess can help.
[From the December 2011/January 2012 issue of AnswerStat magazine]