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Case Studies Healthcare

Optimizing Patient Management Process

Background

 

Our client experienced an organizational shift toward integration, new leadership, and a renewed sense of transformation in the first half of FY21. At the request of executive leadership, Unify was engaged to support this transition through focused execution of key initiatives to achieve operational and financial excellence, with the top priority focused on Patient Access operations.

 

Solution

 

Given the current COVID environment, we minimized our onsite activities and took a data-driven approach to identify opportunities in access and scheduling to improve operational efficiency in order to realize a $3.9M financial benefit. ​We then reviewed prioritized current state processes and conducted a gap analysis to identify the root cause in process breakdown that were resulting in high no-show and late cancellation rates, and increased denials and underpayments. Based upon those findings, we worked with the client to develop future-state processes, train impacted staff, and define performance management metrics to monitor and sustain progress.

 

Key Outcomes

 

A future-state Access to Care strategy was developed to remediate the identified breakdowns in process and re-organize roles and responsibilities to align with the new future-state. We created a centralized model to handle scheduling, registration, and referral processing with location-based access staff responsible for managing the pre-visit preparation and re-confirming registration and benefit coverage, when necessary. We also engaged physician champions to review, revise, and standardize scheduling templates across specialties, as well as defined scheduling parameters to assist schedulers and ensure patient complexity matched appointment lengths and provider types​