Quality is table stakes, but patient financial experience of care is key to future referrals

• Bjorn Thaler, the CFO of membership-based primary care practice One Medical, in an interview with Healthcare Dive, explains what their looking for in a partner, including reputation, access and data sharing.
• HFMA’s Chad Mulvany says if a hospital can’t provide a patient experience of care that matches its clinical quality of care, then it will increasingly miss out on referrals, which will likely impact the bottom line.
• HFMA’s Consumerism Maturity Model provides a tool that organizations can use to determine how consumer-centric their organization’s patient financial experience of care is and insight on what to do to improve it, according to HFMA’s Chad Mulvany.

Healthcare Dive recently ran an interview with Bjorn Thaler, the CFO of membership-based primary care practice One Medical. While the whole interview is worth reading, one of the questions posed was, “When you are considering partnering with a health system, what do you assess?”

Thaler responded, “It starts with: What is their reputation in the marketplace? We want to make sure that, frankly, we deliver on the brand promise that we have as One Medical for our members. So we want to make sure that we partner with some of the best hospital systems in the country, point one. Point two, a big part of why we partner with our hospital systems is what we’re hearing from our members is they want to get access to specialists if and when they need specialist care. So having that openness on behalf of that partner to say: Yes, I am going to interface with you, and the technology. Yes, I’m going to exchange data with you. Yes, I’m going to maybe even let you talk directly to my system. That willingness and openness is very, very important to us because otherwise we can’t deliver on what our members and our enterprise customers need us to do.”

Takeaway

Obviously, quality is important here. But the thing that consumers can perceive more than the clinical quality of care is their experience of care. And health system revenue cycles typically are the first and last points of contact when a patient needs an elective service. If a hospital can’t provide a patient experience of care that matches the clinical quality of care it delivers, then it will increasingly miss out on referrals from growing “concierge-like” practices that cater to relatively affluent, well-insured individuals.

While the example of specialist access and ease of scheduling with a specialist is just one example cited in the interview, there are a range of revenue cycle interaction channels through which hospitals will engage with patients:

• Ease of appointment scheduling
• Information availability
• Authorization resolution
• Price transparency
• Financial responsibility resolution
• Service upon arrival
• Post-service communication

The bar for “acceptable” service is drifting higher based on expectations set through encounters with companies in other segments of the economy. Historically, this has not been an area where health systems have shined. But, for those that can deliver a higher quality patient experience of care can create a differentiated offering that secures referral streams in a time when inpatient volume is declining, and more outpatient services are provided in a freestanding setting.

Consumerism Tool

HFMA’s Consumerism Maturity Model provides a tool that organizations can use to determine how consumer-centric their organization’s patient financial experience of care is and illuminate where the organization needs to make investments in revenue cycle capabilities. This insight will allow provider organizations to improve how they are perceived by both the consumers in their communities and the physicians who serve those communities as well as drive referrals.