by Scott Zimmerman
Medical practices are taking a financial hit as Medicare and Medicaid reduce reimbursements. Meanwhile, negotiations with private insurers are becoming even more challenging as insurance companies draft contracts asking physicians to join formal accountable care organizations, a move that changes the way physicians are compensated.
As the shift to value-based healthcare becomes very real, physicians and practice managers at small to midsized practices are shifting their focus away from just treating illness to preventing and managing chronic disease. By embracing preventive care, they can improve health outcomes for patients while boosting revenues.
One problem, though, is that consumers aren’t accustomed to seeking preventive care – they are confused about which tests to ask for, view preventive care as costly and aren’t aware of the free benefits provided under the Affordable Care Act. All Marketplace plans and many other plans must cover a multitude of preventive services without charging patients a co-payment or co-insurance, even if the patient hasn’t met his or her yearly deductible.
Indeed, 30 percent of insured health consumers don’t even know what their insurance policy covers in terms of preventive care, according to the TeleVox report, “Know Your Health: A Necessary Focus on Prevention.” Another recent consumer survey found that 75 percent of U.S. adults cite out-of-pocket cost as the primary reason they decide whether or not to seek preventive care.
It’s clear consumers aren’t aware of the preventive care benefits available to them at no cost and, as a result, too many patients aren’t scheduling preventive care appointments. At the same time, medical practices are missing out on opportunities to increase revenue.
How can these trends be reversed? When it comes to preventive care, what can physicians and practice managers at small and midsize practices learn from large health systems?
First and foremost, healthcare providers can drive increased revenue by leveraging their existing appointment reminder systems to promote preventive care services and drive increased revenue.
By simply sending patients an automated voicemail or text message letting them know what preventive care services they are eligible to receive at no cost, and asking them to schedule their appointment, physicians and practice managers can book thousands of preventive screenings every year, a strategy that translates to hundreds of thousands of dollars in additional revenue for medical practices and improved health outcomes for patients.
Take colorectal cancer screenings, for example. This preventive screening is covered under the ACA. Yet, CDC data shows that a quarter of eligible Americans are in need of this exam at any given time – but they just are not scheduling the tests.
Ochsner Health System, one of the large health systems leading the transition toward the preventive care model, is using its appointment reminder system to change that for its patients. The strategy is simple – send an automated phone notification letting patients know they are eligible and remind them to schedule the test. By delivering automated phone notifications to aits group of 3,137 patients with recent orders for a colonoscopy or upper endoscopy, Ochsner scheduled 578 colorectal test screenings – an 18.4 percent conversion rate. The preventive screenings from the two-month calling campaign generated $684,930 in revenue for Ochsner, based on the national average of $1,185 per procedure. More importantly, since there is an expected 25 percent pre-cancerous polyp detection rate, an estimated 145 patients benefited from early detection as a result of these examinations. Patients also expressed appreciation, saying if they were not nudged or reminded, they would not have completed this important preventive test.
Group practices can also learn a lot from MetroHealth, one of the largest healthcare providers in Northeast Ohio. MetroHealth taps the data in its patients’ electronic health records to identify adolescents needing immunizations. Then, it leverages its appointment reminder system to send parents or guardians of those adolescents an automated message reminding them to get their children vaccinated. This simple strategy prompted approximately 40 percent of parents contacted to get their children immunized and delivered significant gains in revenue for MetroHealth.
And it’s not just the big health systems that are successfully generating revenue by promoting preventive care services. Scottsdale Medical Imaging, a radiology practice located in Arizona, is increasing revenue year-over-year by using its appointment reminder system to automate prevention-focused patient outreach campaigns. Currently, the practice targets any patient who has ever been in for a mammogram and is 30 days past due for their next one. By simply sending these overdue patients an automated voicemail asking them to schedule their appointment for this screening covered under the health reform law, the practice books approximately 1,200 mammograms annually – a figure that translates to $240,000 in additional revenue for the provider.
Willow Bend Pediatrics, located in Plano, Texas, is another mid-sized provider benefitting from the shift to preventive care. The pediatric practice knows annual wellness visits, also covered under ACA, provide a foundation for prevention and early diagnosis of chronic conditions. The practice also knows wellness visits are typically required for patients who are returning to school and participating in fall sports programs. To increase revenue, the practice leveraged its appointment reminder system to proactively reach out to parents with an automated voicemail reminding them to schedule their child’s annual wellness visit. This simple strategy netted 267 additional well visits worth an estimated revenue increase of $43,770.
Your practice should consider taking a page from of the same book and put appointment reminder technology to work automating prevention-focused outreach campaigns. Remember, communicating with patients on their terms – whether that means sending an automated text message, email, or placing an automated call – makes patients happier, but it also drives higher response rates and increased revenue.
Originally published on Medical Pratice Insider, May 20, 2015