Providers Respond: Patient Feedback at the Forefront
Just as their counterparts in health plans are turning to customer experience in response to marketplace trends, the provider community is reacting to these trends — including the increasing influence of consumerism, the demand for transparency, an influx of new customers and attempts to manage accelerating costs — with a variety of innovations.
Reimbursement Models Focus on Patient Satisfaction
Medical reimbursement is shifting to incentive programs, often with patient satisfaction as a criterion for incentive payments. For example, in Medicare, there is now a direct correlation between a provider’s ability to earn a reimbursement and the experience of the patient during the provider’s care. Mechanisms such as customer satisfaction surveys and Overall Star Ratings have been put in place to track these responses. Traditionally focused on high-quality clinical care delivery, healthcare providers must now also create positive customer experience as well. Not only does this patient satisfaction survey data drive reimbursement, but, it is often publicly available on government websites, further creating incentive to create experiences that drive good results.
Risk Contracts: Managing Outcomes and Total Cost of Care
More providers are entering into financial risk-sharing deals in the health plan networks they participate in where they are responsible for a patient’s outcome, various quality measures and cost of care, whether a service is rendered at the provider’s own facility or in the case of a total cost-of-care arrangement, even at a competitor’s. Inside of a total cost-of-care-based arrangement, a provider is highly incentivized to focus on customer experience, to make sure they are creating a lasting relationship with that patient. Since patients enjoy broad choice, providers want to ensure the patients choose to get as many services as possible from their health system, helping the provider manage a quality outcome along with the financial risk they have taken in the total cost of care arrangement.
“Providers must re-evaluate their customer relationships and redefine themselves to remain competitive.”
Opportunities within Community Health Needs Assessments
In compliance with the Affordable Care Act, providers must file a Community Health Needs Assessment (CHNA). Intended as a tool to develop strategies for addressing the unmet needs of a community, the CHNA systematically examines a community’s health and includes implementation strategies for how a provider organization intends to address the health needs of their community. While one could view this effort purely as a compliance exercise, the information gathered can prove pivotal to helping a provider formulate a patient experience management program, driven from their understanding of the health needs of their current and potential patients. Simultaneously, the data could direct outreach as providers create programs to engage those members of the patient community who could become customers.
More Patients, Including first time patients
Another effect of the Affordable Care Act has been to bring new consumers into the traditional care delivery process leaving providers seeking to influence behaviors of this new population of patients. This opportunity to initiate a new customer base into the options of preventative medicine and wellness-based programs requires increased attentiveness to customer experience and patient education.
For example, the newly insured may never have had a primary care physician before and are more likely to use the emergency room for non-emergency care. Through proactive outreach, providers can help the new customer get aligned to a PCP, promoting preventative medicine and incorporating them into the primary care community with care focused on wellness, instead of reactionary, high-cost emergency care.
A recent report by Blue Cross Blue Shield indicates that newly enrolled members have higher rates of certain diseases, used more medical services across all sites of care and have higher medical costs associated with care. To manage a population requiring additional outreach to transition towards PCPs and preventative care, the report recommends “patient-focused care programs that emphasize prevention, wellness and coordinated care so that individuals get healthy faster and stay healthy longer.”
Harnessing Customer Experience Initiatives to Navigate the Changing Healthcare Landscape
Providers must reevaluate their customer relationships and redefine themselves to remain competitive. With so many forces compelling healthcare providers to refocus their customer experience imperatives, it never hurts to seek help from the experts. Visit Baker Tilly to find out how we can help you differentiate through customer experience innovation.