The Medical Group Management Association’s most recent MGMA Stat poll, conducted on Oct. 1, 2019, asked healthcare leaders, “What is your organization doing to increase patient access?” Many practices reported multiple efforts to increase patient access. The most popular responses described workflow changes, efforts on the practice’s portal and online scheduling, and extending hours. Other popular responses were hiring additional providers and staff and upgrading technology in the clinic.
As medical practices work to see patients as quickly and conveniently as possible, there are several initiatives savvy practice administrators can take to improve patient access without hiring more providers. For example, reducing no-shows allows patients to be seen sooner and ensures providers are working more efficiently. Similarly, if a practice can reduce unfilled appointment slots, patients will spend less time waiting to be seen and providers will be more productive.
A third suggestion to improve patient access is to make existing appointments more productive. For example, if a patient waits three weeks to see a specialist only to learn he or she was scheduled with the wrong specialist and need to wait three more weeks, everyone involved may become frustrated. Scheduling patients with the right specialist can be tricky if nonclinical staff do the scheduling, but some practices have built tools and techniques to make the process easier.
Figure 1 is an example of a tool an orthopedic practice built to help nonclinical staff schedule patients. The tool looks complex, but it is the result of years of experience refining best practices in matching the way patients describe symptoms to the physicians’ treatment preferences. The data in the form is stored so that if a patient sees the wrong provider, the form can be modified and clarified to reduce future problems.
Figure 1. Sample patient scheduling tool for an orthopedic practice.
Source: Moore N. Even Better Data, Better Decisions— Advanced Business Intelligence for Medical Practices. Englewood, Colo: MGMA, 2017.
Another way to make existing appointments more productive is to mine future appointments data to identify potential problems before the patient arrives. Practice administrators are familiar with a claim scrubber that tests charges for potential problems before sending claims. Imagine a similar process for upcoming appointments; call it an appointment scrubber. Picture an automatic daily email that reports future appointments with the following problems:
- Patients without pre-authorization for the visit
- Patients with an appointment type of post-op surgery visit in which the related surgical appointment was canceled
- Patients missing labs or other tests required for the visit
- Patients with an insurance no longer accepted by the practice
- Patients in a collection or account hold status
- Patients who have not made the required deposit for the appointment (such as for a cosmetic filler appointment in a dermatology practice)
- Minor patients whom the provider will not see without a parent or guardian present
- Patients in a global period who do not need to be seen in a global period
- Appointment types scheduled with the wrong provider
- Appointments missing a related appointment, such as a glaucoma appointment without a visual field evaluation on the same day
- Patients who did not show for their last appointment
Staff could use the advance notice to solve many of these problems before the patient arrives, making the appointment more productive. As the team gets more familiar with the appointment scrubber, any time a patient arrives for an appointment with a problem that could have been recognized and solved before the appointment, a new rule is added to the appointment scrubber. Over time, the appointment scrubber can make the practice more efficient.
Each of these suggestions improves patient access in a medical practice. Patients can be seen sooner and more effectively. Providers’ time, often the scarcest resource in the practice, is used more efficiently. A more efficient practice also gets the front desk and clinical staff home sooner. These suggestions are much more cost effective than hiring additional providers. Analyze opportunities to improve patient access in your practice. Your patients, your providers and your staff will thank you.
Additional resources:
- Even Better Data, Better Decisions: Advances Business Intelligence for Medical Practices
- Better Data, Better Decisions: Using Business Intelligence for the Medical Practice
- 2019 MGMA DataDive Practice Operations
- Executive Session podcast and Q&A: Nate Moore on data in healthcare
- Executive Session podcast: Getting the data you need for better decision-making
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