McLeod Health
Florence, SC (606 Bed regional tertiary healthcare organization)
First Class Patient Access: Bringing The Ritz-Carlton Standards to Healthcare
The Challenges
Much like the Ritz-Carlton, McLeod Health believes that “customer” satisfaction is their highest priority. Patients have consistently ranked McLeod above national averages for satisfaction. So when they began receiving complaints from their customers (patients, families and physicians) regarding the lengthy registration process and long wait times in the clinical departments—McLeod knew that they had a problem and saw this problem as an opportunity to improve its already high customer satisfaction ratings.
From a financial perspective, McLeod was faced with rising patient volumes and falling reimbursements. They needed better control over the management and documentation integrity of their revenue cycle activities and a means of navigating impending Healthcare Reform as well as a host of other challenges including:
- Readmission Payment Bundling
- Present on Admission = No Payment on Claim
- Pay for Performance vs. Fee for Service
- Increasing Medicare/Medicaid Population with Decreasing Fee Structures
- Alphabet Soup of Audits, i.e. RAC, MAC, MIC, ZPIC, CERT
The Goals
McLeod’s Access Management initiatives focused on three primary goals:
1. Fix the “Front Door”/Improve the “First impression” of McLeod’s facilities by implementing a centralized, scheduling solution across multiple entities
2. Ensure that “Nothing Slips through the Cracks” to ensure fiscal integrity by aligning:
- Pre-registration
- Insurance Verification
- Authorization Management
- Patient Flow
- Cash Collections
3. Maintain a responsive “Customer-centered” environment (patients, physicians and internal departments)
The Solutions
Sophisticated, Centralized Scheduling
In 2001 McLeod rolled out SCI’s Schedule Maximizer® in its Centralized Scheduling Call Center (a.k.a. Reservations and Scheduling.) This team currently services over 80 departments across five locations and includes physician self-scheduling portal (including patient itinerary) as well as touch screen kiosks for way finding to assist patients in navigation from the front-door through the expansive McLeod Campus.
Provider Portal, Self-scheduling
McLeod’s self-service Provider Portal gives physicians (office staff) the ability to schedule appointments online, at their convenience making the entire healthcare delivery process more efficient, allowing more focus on delivering quality care, instead of the logistics required to coordinate it. Currently McLeod’s Provider Portal serves 36 practices(Departments/Industries) within the enterprise, including their own Human Resource department for scheduling employee (new hire) physicals. The set-up of the Provider Portal is a simple, scalable deployment which accommodates anything from a single physician office to a large multi-specialty practice with 20 physicians.
Automated Appointment Reminders
McLeod uses automated Appointment Reminders as another Customer Service initiative, allowing the patient to determine the most appropriate language and delivery method (phone, voice, email), ensuring proper pre-appointment preparation and minimizing no-show rates.
Physician Access Center
Provides targeted physician services, optimized patient flow, complete financial effectiveness
In 2007, McLeod adopted the Total Access Management approach. By understanding that the ‘outpatient setting’ (Patient Access) and ‘patients in beds’ (Physician Access) share many common traits and each require consistent data collection for improved reporting and revenue integrity, Schedule Maximizer was the clear solution. Their goals were threefold:
1. Improve physician satisfaction
- serving as a buffer for the Hospitalist
- implement a One-Call Admission process
2. Pull appropriate patient flow
- Right Patient
- Right Bed
- Right Time, Every Time
3. Compliantly maximize revenue
- Reduce EMTALA Halo Effect
- Medical Necessity/Transfer DRG Vetting
Schedule Maximizer is the overarching tool to support the Total Access Management.initiatives at McLeod. In both the outpatient and inpatient environments, it encourages appropriate use of facilities and assures that the highest levels of customer service are achieved, while driving staff competency through standard work and maximizing reimbursement of all patient types.
The Results
Patient Access Services
- ’01-’07 Reduced scheduling phones lines from 36 to 1
- ’01-’02 Increased MD Satisfaction by 24%
- ’02-’03 Decreased patient complaints by 72%
- ’02-’05 Decreased insurance claim rejections by 40%
- ’02-’07 Decreased insurance denials by 91.7% for contracted payers
- ‘05-’06 Saved departments 8326 hours of scheduling time that was reverted to clinical functions
- ’05-’06 Saved our patients 5680 hours of waiting time in registration
- ’05-’06 Collected additional $250,000 of co-pays, deductibles and self-pay balances
- ‘08-’09 Increased advanced financial vetting by an average of 7 days for scheduled procedures.
- ‘09-’10 Increased pre-registered patients by 20%
Physician Access Services
- Physician Satisfaction Increased to 94% - a 10% increase in 1 year!
- PAC Vetting 89% of Transfers – a 61% increase from inception
- 92% of patients meet InterQual criteria on admission
- 97% of patients meet acute criteria with Case Management Intervention
- Revenue Integrity of $6.2M insured through proactive management of cases
Conclusion
Much like the Ritz-Carlton, McLeod and scheduling.com have embodied their own blueprint for Gold Standard service, “Excellence is never an accident: it is always the result of high intention, sincere effort, intelligent direction, skillful execution and the vision to see obstacles as opportunities.”
client quote:
“SCI Order Facilitator has streamlined our orders workflow, increased provider and patient satisfaction and reduced operational delays.”
Mary Godwin, Manager Centralized Scheduling
Baptist Health Care
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