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Here’s how medical groups can use digital care coordination to improve patient access and build loyalty

Published: November 5, 2019 by Experian Health

Healthcare consumerism is on the rise. Your patients no longer see themselves as passive participants in their healthcare journey—they’re active consumers, who have come to expect the same frictionless experience they might find in other industries.

They have options. If they’re dissatisfied with their experience, they can go back to the menu of providers and choose something different. But when patients feel supported and respected through their healthcare journey, they’ll remain loyal to your organization, even becoming brand ambassadors.

Following the Medical Group Management Association’s (MGMA’s) Annual Meeting in New Orleans a few weeks ago, it became clear that nurturing patient loyalty remains at the top of the list for medical groups looking to stay competitive in an increasingly consumer-driven market.

For providers wanting to create an outstanding patient experience (and encourage greater patient loyalty), a good place to start is improving access to care. Win patients’ hearts and minds before they’ve even set foot in your facility. The goal should be to leverage advances in digital technology to make it as easy as possible for patients to find physicians, access schedules, book appointments and take control of their health.

Improving patient access through digital care coordination

Medical groups should look at how they are using data and digital technology to improve the patient experience in three key areas:

  1. Scheduling

Laying the groundwork for a positive patient experience starts with making sure the appointment process is as painless as possible.

Imagine a mother is woken during the night by her sick infant. Using a traditional scheduling model, she’d have to wait until the next day to call and schedule an appointment with the pediatrician. But if she could schedule an appointment there and then through the pediatrician’s website, this would not only be more convenient and reassuring for her, it would reduce operational strain on the medical practice, who would have fewer calls to handle.

Online self-scheduling is the most convenient way for patients to both find a physician or specialist and access care, all on their own terms. By implementing online scheduling, medical groups will see higher rates of patient satisfaction and engagement and an increase in patient acquisition and retention.

  1. Care referrals

The referral process is another common pain point for patients. For such a crucial process, it’s surprisingly consumer-unfriendly. Patients struggle to connect with recommended specialists and when they do, they often can’t get an appointment for weeks. Many organizations don’t realize how much revenue they could be losing when frustrated patients look elsewhere for care.

With a more sophisticated referral process, providers can transform the discharge experience and ensure patients get the follow-up appointments they need—within the same network. One health system in the south east has generated tens of millions of dollars simply by booking follow-up appointments before patients even leave the facility, so they’re less likely to be lost to out-of-network referrals.

  1. Decision support

Most providers have scheduling rules that determine which patients their clinicians should see and when. What they don’t always have is a way to automate the process so that patients can book online or seek a referral, while still following these scheduling criteria. The provider needs to be confident that if a patient with knee pain wants to book an appointment with an orthopedic specialist, they need to be sure they don’t inadvertently choose someone who specializes in shoulder injuries or pediatrics.

The problem isn’t solved by booking by phone. Securing referrals through a call center can be a cumbersome process, eroding patient trust and contributing to scheduling bottlenecks and staff dissatisfaction.

But when scheduling is digitized, providers no longer have to worry about these challenges. Automating decision-making creates a simpler process for everyone and most importantly, ensures the patient connects with the right specialist in the least amount of time.

How analytics can help you create a consumer-centric organization

For leaders considering how to create a more consumer-centric health system, re-imagining patient access should be a top priority. A tool such as Patient Schedule gives your patients a convenient and simple way to manage their appointments and follow-up, so they see the right clinician at the right time, without any of the usual hassle that comes with the scheduling process.

On the flipside, automating your patient access protocols also gives your team the intel required to increase capacity to see patients and boost revenue through better acquisition and retention. You’ll be able to track how many patient visits turn into booked appointments, identify the points at which patients drop out of the process and spot bottlenecks in your scheduling. These insights could reveal endless opportunities to make simple tweaks that will give both patients and staff a smoother ride through patient access.

Data analytics mean you no longer need to be operating blind when it comes to unblocking the bottlenecks in patient access. You’ll know exactly where to focus your efforts to improve the experience for your patients and grow your competitive advantage at the same time.

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“You know when the Patient Access Curator went live because you can see it in our stock price. It helped us drive a $100 million bottom-line improvement within two quarters.” —Ken Kubisty, Vice President of Revenue Cycle at Exact Sciences Challenge Exact Sciences is a prominent cancer diagnostics laboratory with an annual net revenue of around $2.6 billion, that's best known for its flagship cancer screening test, Cologuard. After a period of rapid growth demand for its test, Exact Sciences faced the difficult task of collecting accurate patient data and verifying insurance eligibility at scale. Anticipating a 25% growth in annual testing volumes, Ken Kubisty, Vice President of Revenue Cycle at Exact Sciences, says the organization “needed an automated, real-time solution" to capture accurate data from the start. The company had four specific objectives: Improve the accuracy of patient insurance data to reduce errors and denials. Streamline processes to handle rising testing volumes without increasing headcount. Reduce claim denials to bring in more revenue (especially those related to eligibility and timely filing). Ensure accurate identity verification in lab settings, where patient, physician and lab data aren't unified within a single data management system. Watch the webinar: Hear our pre-recorded session from our annual Experian Health High-Performance Summit 2024 (HPS), featuring Exact Sciences and Trinity Health, as they reveal how Patient Access Curator helped their organizations automate eligibility, reduce denials, and more, all with a single click. Solution In need of a single solution to solve multiple challenges, Exact Sciences turned to Experian Health's Patient Access Curator. This new product provided the team with a way to run inquiries for eligibility, Medicare beneficiary identifiers, coordination of benefits, insurance discovery and demographic data with a single click. Instead of juggling multiple products and vendors, registrars would be able to capture and verify patient data in a single transaction. Through automation and machine learning, Patient Access Curator could deliver results in less than 30 seconds and help submit clean claims the first time – reducing the risk of denials even as volumes increased. Experian Health's implementation experts configured the tool to Exact Sciences' needs, integrating over 4,000 payer plans nationwide and customizing parameters for real-time eligibility checks and data validation. Experian Health also delivered staff training to support the transition to the new system. Watch the video: See how Experian Health's Patient Access Curator streamlines patient access and billing, addressing claim denials, data quality and real-time corrections to boost your business's bottom line. Outcome Thanks to Patient Access Curator, Exact Sciences achieved the following results: 15% increase in revenue per test due to accurate eligibility and fewer denials 4x business volume without increasing headcount 50% reduction in denials and major improvement in timely filings $100 million added to the bottom line in 6 months Ken Kubisty, VP of Revenue Cycle at Exact Sciences, shares how Patient Access Curator improved eligibility processes, reduced errors and more. Overall, Kubisty credits Experian Health's Patient Access Curator for helping Exact Sciences overcome critical pain points resulting from data errors and eligibility issues. Solving for bad data quality with real-time data correction freed staff from tedious manual work, ensuring faster, more accurate claims processing – all without growing headcount. After implementing Patient Access Curator, the company is ready to scale and handle growing volumes efficiently, say goodbye to late filing denials and scale smarter. For Kubisty, this highlights how technology drives efficiency and sustainable growth. Learn more about how Patient Access Curator helps patient access teams prevent claim denials by solving for bad data quality with real-time data correction. Learn more Contact us

Published: February 27, 2025 by Experian Health

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