Like many providers nationwide, Integris – the largest non-profit health system in Oklahoma – realized that its billing processes were not attuned to the economic realities many of its patients face when managing the rising cost of care.

THE PROBLEM
"We lacked granular insights into how our patients prefer to manage their billing obligations and options that meet their financing needs," said Mike Weed, senior vice president, financial operations, at Integris. "We also wanted to improve patient satisfaction and track patient feedback about their individual experiences."

As a community-centered, non-profit, the community is Integris' shareholder, and it's important for Integris to maintain healthy margins in order to give back to the people it serves through investments in community programs, such as local rescue missions, schools and outreach to seniors, or wellness initiatives, such as the provider's mobile wellness clinic, Weed explained.

"However, the challenge for statewide health systems like Integris, with incredibly large and diverse patient populations, is that pinpointing the needs and preferences of individuals is technically difficult, costly and resource-intensive," he said.

To make that possible, a health system the size of Integris needs tools to better understand where patients are in their lives and empower them to make the right financial decisions for themselves and loved ones.

"Our vision was to create a financial experience that rivaled the quality and personalization of our clinical encounters," Weed said. "We wanted patients to feel that they were heard and that their perspectives could change how, when and where we interacted with them. We wanted to modernize and create a self-service experience just as good as what patients received, and expected, as consumers in their everyday lives."

PROPOSAL
Integris selected VisitPay as the technology component of this transformation. According to Weed, the platform offered an integrated system that consolidated patient bills within a unified interface and displayed visit-level EOBs alongside each provider bill.

"We also wanted to offer longer-term financing strategies customized to each patient's needs and preferences," he added.

For the revenue cycle management team, the platform's back-end capabilities promised seamless integration with any of Integris' billing systems, as well as with the health system's new Epic electronic health record, while also automatically posting all transactions back into those billing systems.

"Our leadership team understood that the success of any patient-facing program hinged on redefining success in many of our internal operations, including revenue cycle, call center and patient access."

Mike Weed, Integris

"Automated segmentation capabilities and advanced analytics allows our team to actively test, configure and personalize consumer financing strategies based on our business rules and patient preferences, monitor results, and quickly adjust and evolve strategy," Weed explained.

Longer term, Integris wanted to integrate this platform into its call center and patient access areas, for those patients who prefer to speak with a person rather than manage bills through a portal.

MARKETPLACE
There are many patient billing systems on the market today. Some of the vendors of these systems include Advanced Data Systems, AdvancedMD, CareVoyant Medical Billing, DrChrono, Kareo, MedicsPremier, NextGen Healthcare, RevenueHealth Works and Waystar.

MEETING THE CHALLENGE
Patient financial engagement is an evolving process that requires continual reassessment and refinement.

"We wanted to ensure that revenue cycle teams were able to leverage patient segments, consumer feedback and key performance indicators to implement, test and adjust customized engagement strategies, and facilitate operational reporting as our financial engagement touchpoints spread across the health system," said Weed.

"We also wanted to increase workflow and operational efficiencies by helping staff prioritize accounts for outreach and identify cases where charity care was warranted."

From a technology perspective, Integris, Weed said, looked for an all-in-one platform that:

• Offered intelligent analytics from the existing guarantor data to help the provider understand consumer needs and expectations.
• Helped patients understand what they owe.
• Provided them the tools they needed to make manageable payments relevant to their individual situation.

It was also important to the health system to create multiple gateways for engagement.

"All patients want the same level of control and transparency, regardless of how that experience is delivered," Weed noted. "Whether patients wanted to engage though a self-service portal, email, call center or in-person interactions, the quality of that experience had to feel the same."

This integrated approach not only ensures that people, processes and technologies are seamlessly aligned, but also gives the health system a solid foundation to build a cohesive experience at the moments where clinical and financial domains intersect, he added.

RESULTS
The end of June 2019 marked the health system's go-live with VisitPay. To date, the health system has registered more than 8,000 patients to the self-service portal thanks to strategic efforts of the marketing and communications team.

In September, the platform processed more than $1 million in payments and now accounts for 28% of total patient collections.

"But most important, we have realized significant improvements in customer satisfaction metrics," Weed remarked. "Patient surveys have noted measurable rises in patients' perception of the financial experience, including setting up payment plans, making payments, registering for self-service and signing up for text alerts."

Integris is at work on the next phases of its financial work, including a scripting campaign for the call center and email campaigns, and innovating within the pre-service area of the health system, he added.

ADVICE FOR OTHERS
"One of the most important elements for us was getting the vision for the initiative and project team to implement it right," Weed advised. "We did not want to implement a siloed technology that would be narrowly used by a few specific departments."

Though patients were the obvious focal point of this initiative, they were not the only one.

"Our leadership team understood that the success of any patient-facing program hinged on redefining success in many of our internal operations, including revenue cycle, call center and patient access," he said. "We needed to equip our dedicated staff with the tools and resources necessary to navigate the delicate financial and emotional challenges that often accompany patient billing."

The decision to prioritize the patient financial experience was prompted by the need to integrate the patient financial journey into the overall patient experience, he explained.

"To make that possible, a health system the size of Integris needs tools to better understand where patients are in their lives and empower them to make the right financial decisions for themselves and loved ones," he said.

However, patient billing, like other parts of the revenue cycle, remains wedded to siloed processes when it should be driven by the consumer's expectations and needs, he said. Making that pivot required prioritizing technology, processes and people together, he added.

"With this in mind, it was imperative that our project team include perspectives from a wide range of stakeholders, including information technology services, marketing and communications, members of our Patient Financial Advisory Council, and subject matter experts, including customer service, patient access and financial clearance," Weed advised. "This team established the foundation for reorienting technology, processes and people toward a common vision and goal."

The patient-as-payer era has changed the rules of the game, he explained.

"Health systems need to recognize that the financial experience is a healthcare experience," said Weed. "Our mission is no longer just clinical care, but overall care, including financial well-being. Fortunately, the challenges patients and health systems face today have real and enduring solutions."

Twitter: @SiwickiHealthIT
Email the writer: bill.siwicki@himssmedia.com
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