Healthcare Consumerism and Patient Access Management

Healthcare consumerism is going to be an important factor in the new healthcare financial environment where many patients are going to be responsible for a large portion of their healthcare costs. Consumer self-service is already becoming common place in healthcare today. Access to healthcare kiosks and patient portals will become an expectation in patients’ healthcare delivery processes. Allowing healthcare consumers to research costs, schedule appointments, receive online statements and make electronic payments are just some of the options consumers are demanding.

The healthcare revenue cycle is just beginning to feel the effects of this consumerism as employers focus on containing healthcare costs. Revenue cycle solutions that extend the capabilities of a healthcare organization’s hospital information system are the key to improving access management, responding to healthcare consumerism, accelerating cash collection and improving payer performance.

Patient Access Management

The expanding role of patient access professionals in the revenue cycle is the next step in responding to healthcare consumerism. In the future, these professional will become the “face” of many healthcare providers to the general public. Patient access representatives, used early in the healthcare delivery process, can help providers not only determine insurance eligibility, but also the consumers’ ability and willingness to pay for their healthcare costs. Including medical necessity checking during registration, scheduling and ordering can also help reduce Medicare denials and increase reimbursement by providing medically necessary services or by issuing an ABN for non-covered services.

With the growing financial pressures on healthcare organizations, due to the influx of high-deductible consumer/patients, providers need to seek innovative strategies to improve their revenue cycle performance. The use of patient access management early in the revenue cycle may be a way to avoid financial disaster downstream.