The Executive Suite: What medical practices are adding in 2021 to improve patient experience

The Medical Group Management Association’s most recent MGMA Stat poll asked healthcare leaders, “What do you plan to add in 2021?”

12% said “telehealth.”
14% said “contactless payment.”
4% said “payment plans.”
23% said “more than one,” with most planning to add some combination of telehealth, contactless payment, or payment plans.
46% responded “none.”

The poll was conducted Dec. 8, 2020, with 569 applicable responses.
COVID-19 accelerating adoption of innovationDuring their session at the 2020 Medical Practice Excellence Conference, Steven Merahn, MD, FAAP, chief medical officer, Essen Health Ventures, and Jan Oldenburg, consumer health information strategist and patient engagement specialist, Participatory Health Consulting, pointed to building patient engagement and improving patient satisfaction as key challenges for medical practices as the COVID-19 pandemic continues.

“When we talk about patient satisfaction, we’re not necessarily talking about CAHPS scores,” Merahn says. “We don’t talk a lot about the financial aspects of care [for patients], and yet we see it has been a major issue,” especially with rising out-of-pocket costs, changing patient expectations and healthcare consumerism. Those elements of today’s healthcare landscape were already central to the overall patient experience, and the pandemic’s impact — including job and insurance losses — only intensified the pressure on healthcare provider organizations to adapt.

“One of the good news pieces about the pandemic is that it’s revealed to all of us in the healthcare system that when we really have to make changes, we can make them much faster than we ever expected or dreamed,” Oldenburg says.
TELEHEALTHIn the early weeks of the pandemic, Merahn worked with a practice in the Bronx with 29 clinics serving a high proportion of low-income, high-risk patients that saw significant increases in cancellations because of safety concerns.

While visit and procedure volumes rebounded for many practices, it was the rapid expansion of telehealth that enabled the restoration of those care connections between physicians and patients. “I think we probably did about 600 [telehealth] visits in the first week of the pandemic in New York City,” Merahn says. “Four weeks later, no exaggeration, we did 9,000 telehealth visits a week” among the 300 providers in the group.

Download Optimizing Telehealth During COVID-19 and Beyond, an MGMA Research & Analysis report detailing proven strategies for getting the most out of telehealth services.
Listen to the Executive Session podcast on effective telehealth in pediatrics and OB/GYN.
Find MGMA’s latest telehealth resources in the COVID-19 Recovery Center.
CONTACTLESS PAYMENTThe expansion of telehealth was just one piece of a larger trend toward a “digital front door” approach to healthcare, Oldenburg says, “of people rethinking what it means to register people, to give them the ability to queue for an appointment … and what it means in terms of rethinking workflows.”

One aspect of that increasing digitization is extending the capabilities for people to pay for service and avoid handling physical money or passing a credit card between a patient and staff member. “We want to allow people to be able to pay in the ways that are most convenient for them,” Oldenburg says.

This is a particularly important innovation, as consumer polling on contactless payments reveals that more than eight consumers in 10 (82%) said they consider contactless payments a cleaner way to pay, and more than half (51%) of consumers say they are using cash less often or not at all.
Hear Karen Zupko on improving the patient financial experience on the MGMA Insights podcast.
PAYMENT PLANSMore options for patients help shift a potentially difficult conversation about payments from hearing about the patient’s problem to offering potential solutions, such as paying over time in installments.

“As healthcare organizations, we need to think through the ways that we can structure the financing that we offer, so we can give patients choices that work effectively for them and for us,” Oldenburg says. While practices may not always measure patient satisfaction based on the financial experience, “our patients do,” she notes.

To measure the financial experience, practices should pay particular attention to:

Adherence to financial policies
Balances paid in full
Balances overdue (by time period)
Bad debt/write-offs/collections
Referrals and retention.

At the same time, there are specific patient behaviors to gauge your success:

Is a financial tool used to explore cost?
Is payment made at point of service?
Are patients enrolling in financing options?
How many billing inquiries are tied to confusion or concern?
How many payment-related complaints and grievances does your practice receive?

Oldenburg points to an example from Wendy Hanson, support manager, Nebraska Medicine, on the need for financial options as patients confront increasing amounts of sticker shock as their out-of-pocket payments rise. “When you have lots of options for a patient, it gives them the feeling that you care about their future, their abilities and their health,” Hanson says. “They need to know that we’re not just some business — we’re here to care for them.”