Adding Physicians or Available Clinic Hours Webinar | April 17, - - PowerPoint PPT Presentation

Results Delivered. Performance Improved.

Improve Patient Access and Increase Revenue Without Adding Physicians or Available Clinic Hours

Webinar | April 17, 2018 | 12:00 PM CST

Mary Baker

Chief Clinical Operations Officer ProHealth Care

Presenters

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Brandt Jewell

Director Prism Healthcare Partners

Improve Patient Access and Increase Revenue Without Adding Physicians or Available Clinic Hours

How do you define patient access?

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Improve Patient Access and Increase Revenue Without Adding Physicians or Available Clinic Hours

What challenges are associated with improving patient access for individual providers and medical groups?

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Improve Patient Access and Increase Revenue Without Adding Physicians or Available Clinic Hours

What are the primary drivers of restricted patient access for most provider practices and what impact do provider schedules and templates have?

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Improve Patient Access and Increase Revenue Without Adding Physicians or Available Clinic Hours

• 1. Rigid scheduling templates and unique provider preferences
• 2. Restrictions and/or complex scheduling rules or algorithms
• 3. Not empowering staff (or enough staff) to make scheduling decisions
• 4. Challenging patient populations with high no-show and cancellation rates

Primary Drivers of Restricted Patient Access

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Patient scheduled for a 45 minute visit at 8:30am, leaving 2 unbookable 15 minute slots

• pen (at 8:15AM and 9:15AM),

which could have been used for a single 30 minute visit Blocked physician time that requires MD permission to schedule a patient Appointment note does not provide adequate information to allow for potential scheduling / resource adjustments

What are the benefits of improving access for patients? For providers? For a hospital or health system?

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Improve Patient Access and Increase Revenue Without Adding Physicians or Available Clinic Hours

Patients

• Easier / faster access to care
• Enhance satisfaction
• Increase loyalty

Hospital / Health System

• Increase revenue
• Optimize provider productivity
• Inform strategic decisions
• Expand market share and

better determine demand

Providers

• More balanced schedule
• Increase productivity
• Less provider input required
• More effective scheduling:

key appointment types, patterns, and auto-release

Benefits of Improving Patient Access

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Improve Patient Access

Improve Patient Access and Increase Revenue Without Adding Physicians or Available Clinic Hours

How can organizations enhance revenue by improving patient access?

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Improve Patient Access and Increase Revenue Without Adding Physicians or Available Clinic Hours

Financial Benefit of Improving Access

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Providers are able to see more patients in a clinic session

• More appropriate visit types and lengths
• Fewer vacant appointment slots
• Simplified templates enable staff to fit in

more patients

Staff are able to more effectively manage schedules and patients

• More efficient communication with

reduced messaging and call backs

• Clinical staff and providers spend

less time approving or managing scheduling decisions

Patient Revenue Staff Expense

Improve Patient Access and Increase Revenue Without Adding Physicians or Available Clinic Hours

Which specific strategies and solutions can improve patient access?

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Improve Patient Access and Increase Revenue Without Adding Physicians or Available Clinic Hours

Patient Access Strategies and Solutions

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• Consistent visit lengths / definitions as well as standard definitions of a

clinic session and patient contact hours per FTE

• Simplify scheduling algorithms and restrictions at the specialty level
• Strengthen scheduling documentation to facilitate more efficient visits

Enhance provider scheduling efficiency with consistent criteria and protocols

• Cross train staff and provide layers of scheduling support
• Empower schedulers to make decisions and reduce the need for clinical

staff or providers to get involved

• Institute some degree of centralization

Better utilize scheduling resources to manage provider schedules

• Establish clear protocol for cancelling clinic session or slots
• Remove unnecessary holds or blocked patient contact time

Reduce un-booked appointment slots and gaps on provider schedules

Improve Patient Access and Increase Revenue Without Adding Physicians or Available Clinic Hours

Patient Access Strategies and Solutions

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• Utilize objective criteria and data to support decisions
• Hold providers accountable to prevent reversion

Establish consistent policy and process to manage practice closures

• Define roles and responsibilities and enforce accountability
• Coordinate APP recruitment plan to support patient access objectives

Standardize APP utilization and protocols

• Utilize consistent definitions, policies, and patient communication
• Implement reminders and contingencies for chronic no-show patients

Reduce impact of no-shows and cancellations

• Include physicians early in the solution development process

Engage physician leaders across the organization

Improve Patient Access and Increase Revenue Without Adding Physicians or Available Clinic Hours

Example: Practice Assessment Tool

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Improve Patient Access and Increase Revenue Without Adding Physicians or Available Clinic Hours

Metric Less Than Between Greater Than RAF Score 1.0 1.0-1.14 1.14 Number of visits per panel 1.8 1.9-2.2 2.21 % of Patients Over 55 50% 51%-79% 80% % of Medicare/Medicaid 35% 36%-54% 55% Functional Panel Size* 1,800 1,801-2,099 2,100 3rd Next Avail - Physical 69 70-111 112 3rd Next Avail - 30 Min FU 46 47-64 65 Average Lag Time 51 52-60 61 Example of Practice Closure Evaluation Criteria

• Used to objectively and consistently evaluate an individual provider practice
• Does not ultimately determine whether a practice is opened or closed

How can organizations engage physician leaders and administrators to implement sustainable change?

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Improve Patient Access and Increase Revenue Without Adding Physicians or Available Clinic Hours

Committee Structure Example

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• Long-term physician

leadership groups

• Monthly meetings
• Project-oriented
• Physician and admin leaders
• Bi-weekly or monthly meetings

Clinic Practice Operations Council Clinical Operations Team Physician Advisory Team Ambulatory Care Redesign Operational Team ACR Strategic Steering Team Executive Steering Committee

Physician leaders drive communication Improve Patient Access and Increase Revenue Without Adding Physicians or Available Clinic Hours

Engaging Physicians: Validate the Issues

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15 30 45 60 45 Physician Example Unbookable Minutes 1 week = 195 minutes

Mon Tue Fri Thu Wed

23% 49% 47% 46% 38% 45%

PCP 1 PCP 2 PCP 3 PCP 4 PCP 5 PCP 6

Productivity Percentile Physicians with Closed Practices

12 15 1 1 37

PCP 1 PCP 2 PCP 3 PCP 4 PCP 5 PCP 6

"Unbooked" Hours: Primary Care 3 months

Improve Patient Access and Increase Revenue Without Adding Physicians or Available Clinic Hours

How can organizations effectively monitor and manage patient access?

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Improve Patient Access and Increase Revenue Without Adding Physicians or Available Clinic Hours

Monitoring Patient Access

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MGMA Productivity %tile

• Avg. Un-booked

Hours/Month No-Show Rate Cancellation Rate Slot Utilization Clinic 1 47% 115 15% 5% 87% Clinic 2 65% 69 8% 11% 95% Clinic 3 57% 76 17% 15% 89% Clinic 4 59% 26 6% 3% 98%

Primary Care Location Patient Experience(Recommend) Baseline Current Clinic 1 92.2 93.6 Clinic 2 88.9 91.0 Clinic 3 88.2 92.3 Clinic 4 90.9 95.6 Clinic 5 90.0 96.9 Clinic 6 94.0 95.0 Clinic 7 95.5 92.0 Clinic 8 95.5 92.6 Clinic 9 87.5 97.8 Clinic 10 90.8 94.6 Clinic 11 95.5 88.0 Clinic 12 50.0 75.0

Improve Patient Access and Increase Revenue Without Adding Physicians or Available Clinic Hours

Monitoring Patient Access

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Physician Minutes Gained Slots Gained A 12,815 1,282 B 12,495 1,249 C 16,410 1,641 Total 41,720 4,172

138 48 40 19 32 27

New Patient Physicial 30 Min F/U

Change in 3rd Next Available Appt Days to 3rd Next

Baseline Current

Improve Patient Access and Increase Revenue Without Adding Physicians or Available Clinic Hours

Mary Baker

Chief Clinical Operations Officer ProHealth Care Mary.Baker@phci.org

Brandt Jewell

Director Prism Healthcare Partners bjewell@prismhealthcare.com

Questions?

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Improve Patient Access and Increase Revenue Without Adding Physicians or Available Clinic Hours