Experian Health announced it has acquired MyHealthDirect, a SaaS-based company specializing in digital coordination solutions in scheduling. We interviewed Jason Considine, Experian Health general manager of patient engagement and collections, to learn more about the acquisition, as well as opportunities arising in healthcare due to the rise in consumerism. What led to Experian’s interest in MyHealthDirect and the ultimate acquisition? We’ve had a relationship with MyHealthDirect for several years. Experian Health has been reselling the MyHealthDirect solution since 2017, and we’ve long recognized that their platform’s digital care coordination capabilities would be a great match with our existing solutions. MyHealthDirect's platform links patients with the right providers, offering online scheduling tools and referral coordination to ensure more timely access to care for patients. These solutions have proven to increase appointment and referral rates, improve call center efficiency, reduce no-shows and enhance the overall patient experience. By coupling this technology with our Experian data, we can ensure patients are getting the care they need in the management of chronic diseases and wellness programs. This acquisition evolves our core revenue cycle management capabilities and helps us make gains in the patient engagement space with all-new innovative offerings. You referenced “digital care coordination.” What does this mean and how does it apply to healthcare? Digital care coordination, as it applies to the MyHealthDirect suite, is comprised of self-scheduling, call center, referral coordination and automated outreach solutions, making it easier for people to access healthcare. By combining these scheduling solutions with Experian’s existing digital patient engagement solutions, we can deliver a seamless consumer-centered experience – from serving up an estimate, to streamlining the registration process, to providing consumers with the ability to pay their healthcare bills via multiple channels. Today’s healthcare consumer expects a turnkey, personalized, on-demand experience. When you think about the best engagements we all enjoy in retail, financial services, travel and entertainment, the expectation is that the healthcare experience should be no different. We need to arm consumers with the ability to streamline their healthcare and make it easier for them to access care. Why is the scheduling component so key in the overall patient journey today? Scheduling is the one of the very first steps of the care journey and booking an appointment has traditionally been a poor experience. Common frustrations include not being able to reach the provider, finding out that no appointments are available, or being forced into a time-consuming three-way call between the health plan and provider. Without fast and easy access, patients may not be able to get the care they need. When healthcare plans use technology to better connect patients to needed care, quality scores for patient experience rise and efficiencies are gained. Can you give us an example on how more automated approach to scheduling could lead to better health outcomes for the consumer? Sure. Take for instance an individual who is living with diabetes. It is important for this person to have regular check-ins with their provider to monitor their condition and adjust care plans accordingly. If this person is challenged to see their provider, or doesn’t have regular appointments booked, they could run the risk of becoming an unhealthy diabetic, being faced with additional health challenges. By tapping into digital appointment scheduling, a provider or payer could create an automated outreach plan to make the scheduling hassle-free. Appointments could be streamlined and scheduled directly on the phone via IVR or text, and appointment reminders can be delivered. How do you see providers responding to the rise in healthcare consumerism? It’s no secret that healthcare costs are rising, and consumers are increasingly bearing more of those costs. Providers, therefore, are telling us they need to deliver a better experience. They are asking for digital technologies to gain rich insights into consumer behavior and then adjusting their care delivery plans accordingly. They recognize that consumers have a choice on where to take their healthcare business, so they need to compete. In the case of scheduling, MyHealthDirect conducted some research and revealed 66% of patients would switch providers for more convenient access. In that same study, 77% of patients think the ability to book, change or cancel appointments online is important. My point? Those providers and payers investing in on-demand tools to interface with their consumers will win, simplifying many of the administrative tasks associated with healthcare. — Learn more about scheduling solutions.

Managing the revenue cycle draws in considerable resources for healthcare organizations, even when it’s working as planned. The American Medical Association puts direct transaction costs and inefficiencies associated with the “claims management revenue cycle” at around 25-30% of overall healthcare spending. But when errors are made and claims end up being denied, providers could end up missing out on as much as   The total revenue leakage is probably higher, when you consider the opportunity cost of staff time spent sorting out denials. Among the most common reasons for denials are missing or incorrect billing information, non-covered charges for care, and absent authorizations. Thankfully, these are all issues that can be minimized with the right strategies and tools. By optimizing your revenue cycle from the outset so that claims are right first time, you can save hassle and expense later on. Here are 7 ways to proactively reduce claim denials in your health system. Figure out why claims are denied First things first. You need to understand where denials are occurring in your revenue cycle and why. You can determine the root cause of denials by analyzing data that’s already available to you alongside information on industry trends. A business intelligence tool can help you use advanced data analytics to find opportunities for improvement, and generate actionable insights that are focused on your specific KPIs. Once you know where the weak points are, you can get the ball rolling with solutions. Prioritize the big-impact fixes In all likelihood, most providers will have the opportunity to improve the claims process at several points in the revenue cycle. You can’t do everything at once, so identify the areas with the greatest potential impact on your hospital’s bottom line. Can denials be traced to a particular department, service line or physician? Has a certain payer changed their approach? Compare the cost of implementing processes to tighten up the weak points in the cycle with the amount of revenue likely to be recovered to ensure you get the biggest ROI for your efforts. Automate patient access for more accurate claims Up to half of denied claims occur early in the revenue cycle, during patient access and registration. Automating the patient access workflow with real-time data can create a more efficient and accurate process, linking front and back office staff with shared systems that minimize errors and staff time. Martin Luther King Community Hospital experienced these efficiencies first-hand, when they integrated eCare NEXT® within their existing Cerner® system. As a result, their registration process became more streamlined, enabling them to cut two to three minutes from more than half of their registrations. Ensure patient matching is as accurate as possible Incorrect patient matching is a major source of revenue leakage for many providers, with around a third of claims denied on the basis of inaccurate patient identification. When it costs $25 to rework a claim and around $1000 for each mismatched pair of records, that’s a lot of lost revenue. Resolve your patient identities with the most robust data sources, and not only will you reduce claim denials, you’ll also have a more complete picture of each patient, which in turn will give them a better patient experience. Streamline prior authorization checks A survey by the American Medical Association found that prior authorization checks created a substantial burden for providers, with physicians spending an average of nearly 15 hours per week dealing with related tasks. For patients, this process can lead to delayed or even abandoned treatment. Using automated software, you can check claims against payer rules for medical necessity, frequency, duplication and modifiers, so you can quickly spot any claims that may be denied and correct them before submission. Process claims effectively Once you’ve streamlined the front-end of the claims process, you should of course look for ways to improve efficiencies throughout the rest of the cycle and immediately before the claim is sent to the payer. In fact, providers are expected to invest up to  , as the need to crack down on denials grows. Submitting claims in the correct format is a common and frustrating challenge. Since each payer has different requirements and formatting preferences for claim forms, edits should be customized. A revenue cycle service provider can help you build these custom edits and check each claim line by line, so you can submit with confidence and avoid having to redo them later. Monitor and analyze your revenue cycle Regular analysis is essential to consistently improve denial rates. By monitoring your internal processes across a range of metrics, you can gain a holistic view of the entire revenue cycle to see where there are further opportunities to optimize performance and prevent denials. When you have confidence in the freshness and accuracy of your data – including patient access data, payer performance information and patient matching – you can make confident decisions about exactly what needs to happen to improve your claims denials. Learn more about how leveraging data-driven insights to tighten up your claims management systems and take proactive steps to find lost revenue.  

  Medical identity theft is a growing problem for the healthcare industry: nearly 15.1 million patient records were compromised in 2018, an increase of nearly 270% on the previous year. While providers are busy rolling out patient portals and electronic medical records to better serve consumers, criminals are sneaking through the cracks to steal patient data and profit from vulnerable health systems. The rapid rise in medical identity theft is partly explained by the fact that it goes undetected for much longer than other types of identity theft, giving criminals more time to use stolen personal information for financial gain. It’s also a lot more lucrative. Medical identities can be used to access treatment and drugs, make fraudulent benefits claims and even create fake IDs to buy and sell medical equipment. This can be devastating for victims, both emotionally and financially. Unlike credit card theft, where victims aren’t considered financially liable, 65% of people who fall prey to medical identity fraudsters are left with hospital bills running into the tens of thousands. The compromised medical record is tough to reconcile, jeopardizing future medical treatment. For providers, a data breach can mean significant reputational damage and loss of trust, and huge financial consequences – each breach costs an average of $2.2 million. But what’s most alarming for providers is that more than half of data breaches originate within the organization. Unfortunately, many providers lack sufficient security protocols and detection tools to safeguard the data they’re holding. The good news is that the tools exist to help you protect your patient data. What can healthcare providers learn from other industries about identity protection? Banking and financial services have pioneered identity protection over the last twenty years, and healthcare can learn a lot by looking at what’s worked in those industries. For consumers, using digital technology to pay your bills, book flights and buy pretty much anything is the norm, all with reassuringly quick fraud detection and resolution. Healthcare has been a little slower to embrace digitization in this way. Despite the opportunities, fears around security, privacy and inconveniencing patients have stalled efforts to transform outmoded processes. Drawing on two decades of innovations in other fields, fast-paced technological developments mean many of the early challenges around implementing safe and secure patient portals have been overcome. 6 strategies to keep patient data safe Here are six smart ways to ensure your organization has done everything possible to safeguard patient data.     Tell your patients how you’re keeping their data safe Patient trust is at the heart of a successful patient-provider relationship. Share the steps your organization is taking to secure patient information, so patients feel reassured and confident in using their portal. Data security should be a key strand in your patient engagement messaging.     Verify patient identities to protect access to medical records To avoid HIPAA violations, it’s critical to ensure you’re giving access to the right patient. Secure log-in monitoring and device intelligence can help you confirm that the person trying to log in is who they say they are. When something doesn’t add up, identity proofing questions can be triggered to provide an extra check. In an exciting new development, the healthcare industry is also starting to see the use of biometrics to supplement existing identity-proofing solutions. Just as you might use facial recognition to unlock your smartphone, there are now ways to authenticate your healthcare consumers’ identity using the same technology.     Automate patient portal enrollment You want your portal to be as secure as possible, but not at the expense of your patients’ time and effort. An automated enrollment process can eliminate the hassle of long, complicated set-ups and reduce errors at the same time.       Arm your organization with a multi-layered security strategy There is no silver bullet for protecting patient information—it will require various tools. A robust data security strategy will be multi-layered, including device recognition, identity proofing and fraud management.     Educate staff on security threats and warning signs Data breaches aren't all malicious – human error is a massive component, from mailing personal data to the wrong patients, to accidentally publishing data on public websites or leaving a laptop behind after getting off the subway. Training staff on the potential pitfalls will help them help you in protecting confidential patient information.     Develop a robust device strategy ‘Bring Your Own Device’ arrangements (BYOD) are convenient for staff and patients, but personal devices need to be secured when accessing patient information across the network. Make sure your teams, patients and visitors are aware of how to log-on securely to WiFi and follow best practice to keep data safe. In a climate of ‘doing more with less’, healthcare leaders are turning to other industries to find ways to boost quality of care and streamline operational efficiency. Automation, digitization and consumer-centric approaches make good business sense across the board, but they’re sensible investments for your data security strategy too. Investing in secure patient identities is a way to prevent painful and unnecessary losses down the line – and it’s what patients have come to expect. ⁠— Find out what more you could do to shore up your data security and prevent medical identity theft.

“Build it and they will come” might work for 1980s movie characters, multinational coffee franchises and beloved sports teams, but it’s not a great engagement strategy for most consumer-facing organizations – especially in healthcare. Take patient portals, for example. Giving your patients a way to access their health records can help improve their health outcomes, increase compliance with care plans, and create a more positive healthcare experience overall. But do your customers know the portal exists? Do they know how it could serve them? Do they trust it? You’ve built it, but how many patients are actually logging on? In 2017, over half the US population had access to a patient portal. Around half of those people used it at least once in the previous year. Of those who didn’t, 59% said it was because they didn’t feel they needed to access an online medical record, and 25% were worried about privacy and security. This tells us two things: If healthcare providers want to increase the number of patients using their portal, they need to proactively communicate the benefits to those patients, and healthcare providers could do more to reassure patients they take portal security seriously. If patients discover that using the portal is better than not using it, and that they can do so securely, they will be more likely to log on. You can address both in your patient engagement and marketing strategies. Perhaps the better mantra is: “if you solve their problem and tell them about it, they will come”. Balancing portal security and patient convenience Your patient portal is more than just a platform for patients to access test results, sort out bills or schedule appointments. It’s a way to nurture the patient-provider relationship. And at its heart, that relationship is about trust. One way to build trust is to ensure your portal meets the strictest of security measures without creating an excessive admin burden for patients. You can do this with a security strategy that layers up several protective measures to help you tackle common areas of vulnerability, including weak ID verification, over-reliance on password-protection, and failure to encrypt sensitive data. A few practical ways to keep your patient portal secure include: using ID verification when someone signs up for the portal using device intelligence and identity proofing when a user signs in to the portal deploying extra security checks where the risk of identity fraud is higher putting systems in place to flag and respond to security breaches as fast as possible. A solution like PreciseID® can help you take care of your patients’ privacy and security behind the scenes. They’ll see just enough to reassure them that you’re taking their security seriously, without any protracted log-in process that puts them off using the portal altogether. Marketing your patient portal so more patients benefit from it Solving your patients’ concerns about security is just one route to boosting portal utilization. Another important way to ensure more patients use and benefit from the patient portal is to actively encourage them to access their online records regularly. Research suggests individuals who are encouraged to use their online medical record by their provider are almost twice as likely to access it, compared to those who weren’t actively encouraged. So how do you convince your patients of the benefits of regularly logging on? That it’s not just a convenient way to manage their medical journey, but could result in better health? The answer lies in consumer data – the lifestyle, demographic, psychographic and behavioral information that gives you a fuller understanding of what drives your patients. Experian Health’s ConsumerView data analytics can capture insights that let you reach out to your consumers with the right message, in the right way, at the right time.  Do they live a busy lifestyle? Reassure them that the portal can save them time. Are there lifestyle factors that may hinder their adherence to medication? Encourage them to use the portal to make sure their prescriptions are up to date. If you discover your consumers are big social media users, you might target your portal engagement campaign through those channels. Equally, if a consumer doesn’t have any social media accounts, there would be no point investing in Facebook ads. Personalization makes your patients feel taken care of, leading to greater trust, loyalty and satisfaction. Increase patient portal engagement today In the wake of consumerism and IT transformation across many other industries, a tailored and digitally secure healthcare service is a must.  “Consumers now expect to be provided with a turnkey, individual experience that is fast and seamless,”  said Kristen Simmons, Experian Health’s senior vice president of strategy and innovation. Your patient portal must be seen to provide a valuable and secure service. While there’s a way to go to increase the number of patients making full use of portals, the tools exist to support healthcare providers’ engagement goals. Learn more about how your organization can leverage consumer insights to improve patient retention and engagement. 

It’s a puzzle many healthcare providers are still working to solve: when over 80% of health outcomes are influenced by non-medical factors, how can health systems help their patients achieve better outcomes? From affording time off work so they can attend an appointment, to accessing healthy food, childcare or transport, your patients’ ability to engage with and benefit from health services can be heavily influenced by a host of social and economic dynamics Understanding these social determinants of health (SDOH) gives you a more complete picture of your patients’ health and life circumstances. You can anticipate their needs, coordinate their care more effectively, and ultimately give them a better healthcare experience. What’s more, harnessing the right data on SDOH leads to smarter investment and operational decisions, yielding advantages for your health system as a whole. That’s why many providers are starting to use non-medical consumer data in their care management planning. Here we look at some of the top use cases for SDOH data. 5 top use cases for data on social determinants of health     Reduce missed appointments No-shows cost providers an average of $200 each (plus a lot of wasted physician time). Often these are down to lack of access to transportation or childcare. SDOH data can help you anticipate where these challenges might occur, so you can offer additional services like a free shuttle bus or crèche. You’ll make the experience a little easier for the patient, and potentially prevent an unchecked health issue from becoming something more serious.     Save costs from preventable health events Unfortunately, life circumstances can lead to many people using health services in a way that could be avoided. Missed appointments or difficulty following a care plan can lead to escalating medical issues, entailing more treatment and readmissions. Patients might also fall back on emergency services because they can’t easily access appropriate alternatives. SDOH data helps you understand the circumstances that might lead to this kind of patient behavior. For example, if you can spot patients who may be likely to dial 911 because they have no other way to get to the health services they need, you can offer alternatives that avoid an unnecessary visit to the ED. This could help you save up to $2000 per Emergency Department visit and around $10,000 for each hospital stay (which often can’t be fully reimbursed if the patient ends up being readmitted).     Increase care plan compliance A patient’s living situation can often determine whether or not they’ll be able to stick to their care plan. For example, specific dietary advice can be a real challenge for a diabetic patient if they have a limited food budget, lack of time to shop and prepare food, or a plain lack of options of where to buy it. An SDOH needs assessment can flag this in advance so clinicians can help patients find a plan that will work for them. Similarly, pharmacies might use consumer data to help minimize abandoned prescriptions or situations where a patient fails to follow dosage directions, which is estimated to cost the industry $290 billion per year.     Save administrative and clinical time Analyzing consumer data can help your operations run more efficiently, which benefits your patients through well-coordinated care, timely information sharing and prompt referrals. Many providers are taking advantage of automated solutions for leveraging SDOH data, saving massive amounts of administrative time for care managers by pre-populating patient data and automating SDOH needs assessments. Consumer insights solutions like Experian Health’s ConsumerView analytics can optimize operational efficiencies and ensure your care managers use their time well.     Investing in relevant community health programs One of the most impactful use cases for SDOH data is to gain a richer understanding of your member base, so you can invest in the most relevant community health programs. For example, a 2018 pilot project by Atrium Health in North Carolina screened for food insecurity in older patients who may have been at risk of readmission. Emergency food services were provided where needed, and as a result, readmissions dropped by 60%. Your purchasing power can also be a force for change. The Cleveland Clinic outsourced its laundry service to Evergreen Cooperative Laundry, a local collaborative working to combat poverty. Ralph Turner, executive director of patient support services at the Cleveland Clinic says: “Establishing the foundation for people to stabilize their incomes and become part owners in a business… in itself generates health and wellbeing in our community.” Leveraging consumer data to improve patient outcomes These examples show some of the varied ways screening for social determinants of health can open the door to understanding your patients and creating truly person-centered care services. Who knows what opportunities are hidden in the SDOH data for your patient population? Are there gaps in your data? Could you combine different data sets for a fuller picture? What exactly is your consumer data telling you, and how do you turn it into meaningful management decisions? At Experian Health, we have comprehensive data assets and analytics platforms to help you answer these questions and more, and leverage consumer data most effectively.

Patient identity is the backbone of the healthcare system. However, when patient records are mismatched, overlaid, or incomplete, it can lead to serious and wide-ranging consequences. Patients may receive incorrect drugs or treatments, while clinical staff face increased workloads trying to locate missing information and overcome delays. Billing teams may issue statements with incorrect amounts or send them to the wrong address. Moreover, data breaches expose providers to both financial and legal vulnerabilities. It's a wicked problem. And it's an expensive one – a survey by Patient ID Now found that healthcare organizations spend an average of $1.3 million per year attempting to resolve the issues. Identity management involves multiple individuals, teams and systems that are constantly changing. Solutions can be hard to pin down in such a dynamic environment. While there's no single cause, understanding the contributing factors is the key to preventing mismatched patient records to ensure safe, effective and efficient patient care. Common causes of mismatched patient records Misidentification occurs for several reasons. Some of the most common operational pitfalls include the following: The patient is linked to the wrong record during registration. Queries result in multiple or duplicate patient records, or no record at all. Time pressure means staff are forced to work quickly and may miss important details. Insufficient training and awareness mean staff aren't following identity management protocols properly (in one evaluation of 60 patient transfers, not one transfer was carried out according to the hospital's patient identification policy). Identity management protocols are non-existent or substandard. Inefficient information-sharing between departments leads to gaps or duplication in patient records with no easy way to verify patient details. Over-reliance on DIY solutions fails to deliver robust, lasting results. Human error – staff may accidentally enter the wrong details into the patient's record. Beyond the operational factors, patients themselves play a role in misidentification. Usually this is inadvertent: they may give a slightly different version of their name or address than the one listed in their record. Sometimes it is deliberate, when patients submit false information to access treatment or medication that may be otherwise unavailable to them. Most errors do not occur because providers or patients are being careless. Patient data is complex and changing: people change their name, address or contact details many individuals share the same names and birthdates (one Houston-based health system reported 2833 patients called Maria Garcia, 528 of whom had the same date of birth) data can be formatted in different ways, so one person's details look like they belong to different people. To add to the challenge, the volume of data being created, accessed and exchanged within and between health systems is increasing exponentially, complicated by greater use of remote devices. It's no surprise that organizations have an average of 10 members of staff devoted to patient identity resolution. How to avoid and fix mismatched patient records The most effective way to manage and match patient data would be with a national unique patient identifier. This would assign a bespoke code to each patient that would follow them throughout their healthcare journey, ensuring the integrity and security of their data. Healthcare organizations (including Experian Health) have advocated for such an approach for many years, though federal funding currently remains out of reach. In the absence of a national UPI, healthcare organizations must rely on alternative solutions. Many use traditional matching tools, such as an enterprise-level master patient index or manual verification processes. However, these tools are often a feeble response to the challenges associated with the “4 Vs” of big data – volume, variety, velocity and veracity – which make patient records so difficult to manage. Experian Health's Patient Identity Management solutions help providers build a more connected data ecosystem, using universal patient identifiers. This approach creates the most complete view of patients from reliable health, credit and consumer data sources, to reduce the risk of mismatched records. Universal Identity Manager spans hospitals, health systems and pharmacy organizations, processing more than 550 million health records. Integrating patient information from sources beyond an organization's own enterprise-level data makes it possible to accurately match, manage and protect patient data, and root out the causes of misidentification before it occurs. Prevent patient misidentification with proactive identity management solutions According to the Patient ID Now survey, just under half of healthcare organizations are planning to implement new identity management processes and solutions in the next 12 months. Alongside a more robust software solution, providers should also cultivate a culture that encourages proactive risk assessment, rather than waiting until after a serious mistake occurs before acting. With the right workflows, training and identity matching software in place, patient misidentification is preventable. Learn more about how to address the most common causes of patient misidentification with patient identity management solutions.

Since the Health Insurance Portability and Accountability Act (HIPAA) heralded the mainstreaming of electronic medical records over two decades ago, healthcare organizations have been slowly making the shift from paper-based patient information to online records. Digital records are more efficient, no doubt, but the transition hasn't been smooth. There are challenges and risks in managing and protecting patient data online. With patient information flowing through multiple systems, devices and facilities, it can be extremely difficult to guarantee the accuracy and freshness of the data. Patients move to a new house, change their name or switch doctors. They may go for years without any interaction with the healthcare system. How can hospitals and other providers be sure that the records they hold are correct for each patient who walks through the door? Incorrect patient matching is a major source of revenue leakage for many providers, with around a third of claims denied on the basis of inaccurate patient identification. When it costs $25 to rework a claim and around $1,000 for each mismatched pair of records, that's a lot of lost revenue. In 2017, the total lost revenue for the average hospital was around $1.5 million. Clearly this a financial headache for providers, but it's also a major patient safety issue. How can patients get the right treatment at the right time, if their physician is looking at an out-of-date record, or worse, the record of a completely different patient? Good health outcomes rely on good data. Matching patient records: the old way Traditionally, healthcare providers might use a patient matching engine (an enterprise master patient index or EMPI) to identify patients and match up their records from different parts of the health system. These work by checking demographic data to compare the details on each record and combine the ones that are likely to refer to the same person. This can usually handle a simple change of name or address, but for anything more complex, it'll likely hit a roadblock. EMPIs are limited by their reliance on a single data source – the data that's visible to them in patient rosters. So what happens if that demographic data is wrong? What if there are typos or spelling mistakes? How do you differentiate between a misspelled name and a completely different person? Any errors in the data are inherited by the matched record, and as a result, EMPIs are often plagued by gaps, mistakes or outdated patient information. A new solution for patient matching: Universal Patient Identifiers A better solution is to combine the information in patient rosters with comprehensive reference and demographic data held by data companies such as Experian, to create a more complete picture of each patient. A universal patient identifier (UPI) can be assigned to each patient and stored in a master identity index, so that whenever and wherever they pop up in the health system, the referential matching technology knows exactly which data is theirs. When health systems implement UPIs, you can connect disparate data sets and have confidence in the fact that every new data point will be instantly checked and updated. You'll know that the Maria currently seeking diabetes treatment in Austin is the same Maria who was treated for asthma in Houston last year. You'll know that Thomas sometimes goes by Tom. You're far less likely to have a patient turn up at the pharmacist and be given a prescription that belongs to another patient with the same name. It's more efficient for clinical and admin staff, and copes more efficiently with patient mobility. Highlighting the importance of reliable patient matching technology, Karly Rowe, Vice President of Identity Management and Fraud Solutions at Experian Health says: "When you send us your patient demographic information, we will provide you with the insights and identifiers that you need to better manage your patient identities. The benefits are improved patient safety, better care coordination, better patient engagement, and overall driving better efficiencies and financial benefits." Not all reference data is created equal Of course, referential matching is only as good as the data it’s trying to match. Some vendors repurpose data matched for credit checks, using patients’ Social Security Numbers. But this data can be equally vulnerable to inaccuracies. Experian offers access to the industry’s broadest and most trustworthy datasets and provides ongoing monitoring to constantly check the accuracy of that data. Our healthcare-specific algorithm is finely tuned to meet the data needs of the healthcare industry, without any risky repurposing. With this in mind, ValleyCare Health System in California used Experian Health's Identity Verification solution to give patient access staff the freshest demographic information, including more accurate names and addresses, leading to a 90% reduction in undelivered mail. Janine Edwards, Patient Access Services Quality Assurance and Training Coordinator at ValleyCare told us: “Since implementing Identity Verification, we’ve improved the accuracy of patient demographic information throughout ValleyCare Health System. More valid data up-front means better revenue cycle results on the backend.” The entire health ecosystem relies on knowing who patients truly are. With the highest quality reference data and powerful unique patient identifiers, Experian goes beyond the limits of conventional methods to give providers the highest confidence in matching and managing patient identities. To start resolving your patient identities today, contact us to see how many duplicate records we can fix.

The President, members of Congress and consumer advocates are all demanding price transparency within the healthcare universe.  The major push of late is President Trump’s executive order that will be issued in June 2019; while critics hope this initiative will fade, the topic has been on the industry radar for many, many years. How did we get to today’s scenario? We have a robust perspective on this subject at Experian Health because we’ve been working with healthcare organizations offering various solutions that inform consumers about the costs of their care for more than 10 years. We brought to market the first iteration of our current Patient Estimates product back in 2008, responding, in part, to the growing issue of medical debt and inherent risk to providers not getting full payment for services. The challenges presented by medical debt are well documented, but the important point to focus on is that as long as Americans continue to lack the ability to pay for their care and health organizations struggle with collections, the push towards price transparency will continue. Perhaps this is much needed progress? Since 1957, nearly 75% of Americans have consistently reported being insured but unable to pay their medical bills, according to a study by the Centers for Disease Control. Now, more than 50 years later, many legislators hope mandated price transparency will alleviate the surprise factor of medical costs and spur a more competitive environment. In 2008, helping patients understand their costs was intended to improve providers’ collections success. The term ‘price transparency,’ with additional connotations (e.g. better experience for the patient, improved efficiencies), popped up about the same time as the introduction of very high deductible health plans. The phrase started gaining traction following passage of the Affordable Care Act, and as patients were responsible for more of their medical costs. Add in the rise of consumerism within healthcare and Americans’ digital lifestyles, and it’s no surprise there are calls for pricing to be as easy to understand as they are in the retail space. We harness the power of data and analytics to fulfill these needs in the marketplace. The healthcare industry was ripe for change more than a decade ago, as evidenced by the desire of organizations to leverage what we could offer. While there is continued debate on the transparency topic, the good news is today’s data-driven technology can create a patient financial experience that is friendly, understandable and accessible, delivering the good-faith estimates many consumers, legislators and the industry-at-large wish to see. Consumerism drives price transparency expectations Ultimately, the financial aspect to care is a key component to consumers’ satisfaction with a provider. This realization began to bubble to the surface over the last several years. In fact, Experian Health conducted research last year to understand consumer pain points during the healthcare journey. Consequently, it was no surprise when the study revealed consumers’ biggest frustrations and challenges – above clinical areas – is dealing with the financial aspects of healthcare: 90 percent of respondents ranked worrying about paying their medical bills as a very important to extremely important pain point. 30 percent acknowledged the challenges of determining what financial support options (e.g., payment plans, government grants, and hospital charity care programs) are available 90 percent reported significantly underestimating the costs associated with major medical procedures (e.g., knee replacement) The takeaway from this study is clear: consumers want a streamlined payment process that builds confidence and provides peace of mind. We know that healthcare providers want to increase the efficiency and success of their collections efforts. Ultimately, everyone benefits from clarity around pricing. So whether government-mandated or not, there is no denying that price transparency, in some form, is here to stay and a transformation in the industry is taking hold. Experian Health is leading the way to innovations that will help healthcare organizations thrive in this new era. By leveraging our expertise in data and analytics and our understanding of healthcare costs, we can help patients successfully navigate their financial obligations from primary care appointments through subsequent diagnostic procedures and surgeries. The potential is there for everyone to benefit from an evolved, modern system. Related Articles: How Blessing Health System personalized estimates to improve patient satisfaction

  The roll-out of patient portals has been a slow burn. While consumer finance, retail and other markets have given customers secure electronic access to their personal information for decades, healthcare has been playing catch-up. But thanks to regulatory pushes, such as the Promoting Interoperability and Meaningful Use programs and the Affordable Care Act, digitized health records are now the norm. Over half of healthcare consumers in the US use patient portals to access their health information at the click of a button – just as they do with their bank accounts or grocery deliveries. Aside from the convenience factor, research suggests that when patients have access to their health records through patient portals, they experience better health outcomes, greater satisfaction levels, and improved communication with their provider. There’s a higher chance of spotting errors. Adherence to medications is increased, and care becomes more accessible for some otherwise hard-to-reach patients. For providers, this sense of ownership, transparency and connection contributes to elevated consumer loyalty and engagement. As consumers embrace online portals to view their medical records and lab results, renew prescriptions, schedule appointments, and in some cases pay bills, they expect and assume their provider will keep that data secure. Providers must balance convenience and security. Unfortunately, some patients remain unconvinced of their providers’ ability to get this balance right. Patients worry about portal privacy and security Despite the upsides, a quarter of patients with access to online portals in 2017 chose not to access them because of worries about privacy and security. They’re right to be cautious: medical identities are said to be worth 20-50 times more than financial identities. It's no wonder identity thieves are increasingly targeting the healthcare industry. In 2018, the US Department of Health and Human Services’ Office for Civil Rights (OCR) reported 351 data breaches of 500 or more healthcare records, resulting in the exposure of more than 13 million patient records. Hackers are always on the lookout for vulnerabilities to exploit, with patient medical records, log-in credentials, passwords and other authentication credentials among their top five targets. Without adequate IT security, your prized patient engagement tools – like patient portals – can become an open door for hackers. As a provider, your job is to make it easy for patients to access and manage their own data, but hard for fraudsters to get their hands on sensitive data.​​​​​​​​​​​​​​ ​​​​​​​How to keep patient portals secure The good thing about being somewhat late to the party is that healthcare organizations can learn from other industries in how they have tackled online security challenges without creating too much of a burden for consumers. Think about how consumers authenticate their accounts for financial services or even social media profiles. Typically, there's an email to verify they are who they say they are, or a two-factor authentication process with a code sent to their cell phone. Most patient portals don't have these layers of security. At Experian Health, we recommend a multi-layered solution incorporating device recognition (especially important as more users access portals via cell phones and tablets), identity proofing and fraud management. Here are some examples: Sign-up screening When someone enrolls in the portal, use identity proofing to ensure they are who they say they are. It’s particularly important to ask out-of-wallet questions, such as their city of birth, first car model, or previous address to make sure they’re not an imposter.     Log-in monitoring Device intelligence will help you confirm the patient is using a cell phone or tablet your system recognizes, to minimize the risk of someone else accessing their account. This technology will tell you if the device is associated with previous fraudulent activities or potentially impersonating multiple patients. If a device fails to meet the risk threshold, identity proofing questions can be used to verify the user’s right to access the account. Additional checks on risky requests Some patient portal activities, like downloading medical records and editing a patient’s profile, increase the risk. You’d want to add an extra layer of control here, such as additional out-of-wallet questions, to safeguard your patient’s data. Rapid response and damage containment Given the sensitivity and richness of medical data, an attack on the portal can be devastating for patients and costly for providers. In the event of an attack, providers can put in place early warning systems to flag up which patients have been compromised and trigger rapid response measures to shut down the attack and prevent the damage from spreading. Promote interoperability Physicians and care providers need to share information on patients in the course of providing good care. But how are they doing this? To keep that data secure and ensure it’s only seen by the right people, you can set up your systems to share data across different platforms in a safe and secure way. Underlying all of this is the need to reassure your patients that you can be trusted with their data. Victoria Dames, Senior Director of Product Management, Experian Health, explains: “Healthcare breaches are nothing new, and neither is hackers’ and identity thieves’ penchant for medical records. What is new, however, is the broad range of tools that organizations can now utilize to stop them from accessing that personal data. Give patients the peace of mind they deserve by taking advantage of up-to-date solutions that actually work in our ever-evolving tech climate.” Learn more about how protect patient portals and encourage more patients to enjoy the full benefits of their patient portal, knowing that their sensitive personal details are safe.