Patient engagement: Your patient, your consumer

Rick-Shepardson.jpgNordic Practice Director Lauren Griessmeyer recently sat down with a few Nordic experts for conversations on a variety of topics related to patient engagement. In this video, the first in a series with Nordic Director of Optimization Rick Shepardson, Rick and Lauren talk about how patients should be treated more as consumers and how that can benefit both the patient and the organization.

Rick and Lauren discuss the following topics:

  • What is the definition of patient engagement?
  • How does patient engagement intersect with billing cycle and revenue cycle optimization?
  • Why is there an increased focus on patient engagement?
  • What are healthcare organizations doing to be more attractive to consumers?
  • How does Epic's MyChart help with revenue capture?

If you have questions about your Epic implementation, optimization, working with affiliates (including mergers or acquired organizations), or what is possible via remote support, please contact us. We’d enjoy the conversation.

Time: 11 minutes, 43 seconds

Read the video transcript.

Hi, I'm Lauren Griessmeyer, the Willow and Beaker Practice Director, and I'm here today with Rick Shepardson. Why don't you go ahead and tell us a little bit about yourself?

Rick: I'm the Director of Optimization Solutions here at Nordic. We do a lot of work with strategic optimization opportunities, tying together operations with technology.

Lauren:What did you do before your time at Nordic?

Rick: Before my time here, I started at Epic, worked from there from '04 to '10, and left to put together a healthcare platform on the One Laptop Per Child program in South America, trying to give some remote care to villagers. I came back and have done a variety of optimization projects since then, largely focused on rev cycle.

Lauren: We have been talking a lot, lately, about patient engagement and what patient engagement actually means and how Epic is adding to this patient engagement “thing,” for lack of a better word. Each person that we've talked to has had a different definition of what patient engagement is. What would you define as patient engagement?

Rick: To me, patient engagement is ensuring that patients take accountability and involvement in their own healthcare. That can mean making sure that they are following up with their care plan and things that are going to keep them healthy. That can mean taking active part in giving care, like reaching out to their providers when they're ill, making sure that they have awareness of what they need to be doing to be healthy. There's a lot of ways that we can keep patients engaged. Ultimately, I think that's the end game. I think we're going to see a lot more consolidation in payer and the provider space, truly trying to get us to a point where patients have ultimate control as consumers to make their own health care decisions.

Lauren: I think, because you just described the patient as a consumer, that you're dragging me in this direction to start off with, but how does patient engagement intersect with what you've been doing with billing optimization and revenue cycle optimization?

Rick: As we look at how we make the patient a proactive consumer of their healthcare, there's focus on the front end, if you want to make it easy for them to schedule their own visits, or you might make it easy for them to pay for their business on the back end. Making sure that they can also get in and be seen, right? The availability of appointments, a lot of the growth of the retail market, CVS, Walgreen’s, developing pop-up clinics.

Lauren: Sure.

Rick: That really is just in response to trying to get patients to have access to their care in a convenient location.

Lauren: Rather than having to go to their actual physician's office to get a flu immunization, you can just go to Walgreen’s and get your immunization.

Rick: Super easy, right? Part of the problem is that patients see barriers to being seen at these clinics. If we can remove those barriers, it allows them to have convenient access to care and also gives opportunity for more revenue to a care provider, to a hospital organization, because they're not losing that patient revenue for the individual visit, but they are also not losing the downstream revenue. If the patient comes in and has an immunization, something else is potentially wrong with them, they don't know that they're well or that they're sick. You lose that opportunity to provide continuous care to them, and you lose that downstream revenue for return patient visits and getting them into your hospital.

You don't want to risk losing market share to anyone right now, and, bottom line, that's what we're talking about.

Lauren: One of the reasons that we've been doing this series on patient engagement is that it is a big topic within the healthcare industry right now. Why do you think there has been this increased focus on patient engagement?

Rick-and-Lauren.jpgRick: Well, I was also trying to figure that out a couple of years ago and did some research. It goes back to 2003, I think, with the Medicare Modernization Act. That was when people implemented the HSAs, and that led to the high-deductible health plans. That was all intended to start to drive individuals to save more money for their own healthcare and then pay more money. Kind of going around some of the payers, right? Having a system that wasn't as reliant on insurance companies. Now as that model has continued to progress, we had the open insurance exchange. I have a high-deductible health plan. I think a lot of younger, healthier adults do, and ultimately, that's led us to a spot where we, as individuals, are now more of a consumer of our healthcare coverage and the services that we get.

We're a lot more empowered to make decisions now; we're expected to.

Lauren: It's now the money that we're spending on healthcare is ours. It's not the insurance company, so now it's a little bit more of a show me some value for the money that I'm paying.

Rick: Right, and it's not just that dynamic. We also have the dynamic of the employer. Employers purchase insurance plans from insurance companies, and they subsidize, and then, ultimately, then a portion of the total cost is passed on to the individual, and through that series of subsidizations and cutting the costs here and there, we ended up with a really, really vague picture of what are we individually actually spending on our healthcare. 

Now, as we move to high-deductible plans, and we're expected to maybe pay for some of this using our HSA savings, we're really getting a lot more exposure to what is the true cost of healthcare.

Lauren: What are we actually paying for, and what is the actual dollar amounts of those services that we're receiving?

Rick: Right. Well, we're actually a lot more cognizant of what are we’re actually paying for. What we're paying for hasn't really changed. Costs have continued to increase. The way that we're paying for it has changed in that, unfortunately, now with these plans, people are, in some ways, less inclined to go and be seen. If I now know that rather than a $10 copay, I'm now out of pocket for $50 or $60, that is, in some ways, going to decrease my interest in going and being seen.

Lauren: Sure. What are some of the tools that you're seeing organizations deploy as they are trying to capture more of the market, and they're trying to be more attractive to consumers?

Rick: Right. The first step is not just trying to offer services, but it is making your organization attractive. There's a lot. Where do people go to find information?

Lauren: The internet.

Rick: The internet. Right? The new word of mouth that used to be so powerful in our parents' age is now the internet and forums and Yelp and Healthgrades and all of these other areas. Organizations really need to be cognizant of what their online reputation looks like, how they are interacting with patients online, how those patients are sharing information, and what they're sharing about their health experiences. Step one is really being a good owner and acknowledgement of what your reputation looks like in that online space and how you're representing yourself.

From a marketing perspective, that's step one.

Lauren: Okay.

Rick: Moving forward, it's really about allowing patients to take more control of their own healthcare experience and having more timely access to care, so online scheduling, allowing for e-visits for non-acute problems, maybe getting them into provider messaging, getting results back, being able to see what your care plan looks like over X period of time. These are all things that are really pretty quick wins that organizations can implement. Just really making sure that they use the full scope of technology available for these visits.

Lauren: Okay. The obvious tool that we've talked about a little bit during these conversations has been Epic’s MyChart. MyChart being used for your scheduling and for reaching out to the patient, making sure that they're aware that they need to come and have something done. Are there areas that MyChart helps with the revenue capture piece?

Rick: It does, and there are specifics that it can do, but also, there's underlying revenue that I think people need to understand. Purely from a revenue cycle perspective, you can take a statement, you can put that statement online, increase its visibility. It can also allow patients to make payments via credit card via the portal. Ideally, that should reduce AR days. I don't know about you, but if someone's expecting to check for me, good luck. I mean, I ...

Lauren: Snail mail is not the best way to get a payment out of Rick Shepardson. 

Rick: No, I mean, I didn't write a check for years, but if someone wants an online payment, I can go online and I can submit my credit card number. . .

There we go, right? Just having that convenience from a patient perspective. It's silly. Is it engagement? I don't know, but it's a way that you can. . .

Lauren: It's another way to reach out to a patient in a way that they're going to pay attention to.

Rick: Correct. Absolutely. Right?

The other thing, really, from a true revenue cycle perspective is as patients are scheduling or going through a preregistration process, being able to provide them accurate estimates of what their copay will be. What will their coinsurance be? What is their expected total out-of-pocket given their insurance situation?

Being able to provide that information allows the patient to make better decisions around who or where they want to be seen.

Lauren: Be a smarter consumer.

Rick: They'd be a smarter consumer, and then, ultimately, if you presented it at the right time, and you have convenient access to make payments, well, you should get money in sooner. That money may not–it's not going to take you as long or as much effort on the back end to collect and then follow up with that patient. You have fewer people going into collections, just the whole process ends up being a lot smoother.

Topics: revenue cycle, improved outcomes, billing, patient engagement, Epic MyChart

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