It’s Your Call: Outsource Calls for Leaner, More Effective Healthcare Delivery

By Steve Whitehurst

As I look out my window and watch one season steadily give way to the next, I’m reminded that healthcare is undergoing a seasonal change of its own. Reimbursements are drying up; consolidation is heating up. Patients are increasingly approaching healthcare with a consumer-oriented mindset, expecting – even demanding – a higher quality experience.

For most healthcare organizations, boosting revenue is no longer a matter of simply performing more procedures. Healthcare’s historically volume-based way of doing business is evolving into value-based models, placing higher priority on preventive care and overall patient wellness. Economic success in this environment requires not only providing the best services to those who are sick but also attracting healthier patients who bring better reimbursement opportunities.

To do this, organizations need to focus on the clinical and operational tasks that generate the highest return on investment (ROI). Clinically, this means identifying and leveraging treatments that deliver superlative outcomes, which in the future will largely be determined by the makeup of the patient population. As such, providers will need to allocate time and resources to effectively manage patients who are well, patients who are aging, patients who are critically ill, and so forth.

To do all of this efficiently, today’s healthcare organizations must optimize their operational processes. In many cases, this means taking a critical look at operational tasks and determining which processes should be outsourced to support enhanced patient satisfaction and retention as well as a better bottom line. Consequently, a strong case can be made for healthcare organizations to seek the guidance of a call center partner to optimize operations. In the midst of an increasingly challenging and competitive environment, many successful healthcare organizations – from smaller group practices to multi-hospital networks – are working with call centers to bolster administrative efficiencies, which enable them to do more with less and to keep their focus on delivering high-quality patient care.

Outsourced Call Centers: An Ideal Strategy: Fielding patient calls 24/7 can be a significant pain point for practices, hospitals, and health systems. While a few major healthcare organizations may have the infrastructure and financial wherewithal to control their own in-house call operations, this is not a core competency for most. To put it simply, building and maintaining such an operation is an expensive and labor-intensive proposition – one that often does not yield a high return on the dollars invested. Moreover, patients become frustrated when communication with their providers is not seamless, yet the growing patient demand for 24/7 accessibility is difficult for the majority of healthcare organizations to handle and staff internally. Finally, particularly in smaller practices, the staff members who take patient calls also manage a wide variety of other clinical and administrative tasks. As a result, typical call center duties can take their focus away from delivering high-quality patient care.

Most in-house call centers – and even many other freestanding services – are not set up to address the patient communication needs required across the full continuum of care. Consider, for instance, how call center operations can be used to help patients find a provider and help healthcare organizations acquire new patients, which directly affects an organization’s revenue. For example, if a patient calls a specialist’s general number listed online, the person who answers may not have the right information to offer the patient beyond just the name of one of its specialists who meets the patient’s desired criteria. In this scenario, the call will likely end before an appointment is made, making the healthcare organization’s chances at acquiring a new patient lower than if the organization had been using a call center.

By contrast, an outsourced call center with sophisticated technology and staff resources can turn a prospective patient call into a scheduled appointment – and a new patient into a regular patient. Call center operators with the right tools and training can suggest multiple provider options, book the appointment, remind the patient of the appointment, and follow up after the appointment to gather feedback about how the appointment went. What’s more, many outsourced call centers have the resources and technology available to capture, centralize, and measure call data against a healthcare organization’s goals – such as new patients per service line – which in turn can drive ongoing communication improvements.

Using this model, patients are engaged and managed throughout the entire continuum of care: from appointment scheduling and follow-up to education and retention. This is accomplished more efficiently and more cost-effectively than can be achieved by a healthcare organization’s limited internal resources. A robust call center partner can improve a healthcare organization’s patient access to care by moving more patients into the organization faster while simultaneously enhancing patient satisfaction by communicating with patients every step of the way.

ROI: Beyond Dollars and Cents: There is no question that delayed or unreturned messages – as well as a number of other communication gaps – can irritate patients, leading to the very real potential for revenue leakage as dissatisfied patients seek care from competing providers. As a result, this is why one Chicago-based health system looking to streamline operations and reduce costs recently decided to tap into the efficient infrastructure and professional expertise of a dedicated call center. By consolidating and standardizing its after-hours telephone services, which previously had been spread among multiple vendors with wide variations in service quality and reliability, the health system saved more than $1 million.

Along similar lines, a West Coast academic medical center with two hospitals and seven outpatient centers enlisted a call center partner to take over the appointment-scheduling services for its radiology department. Challenges for the department, which handles approximately 16,000 cases per month, traditionally included long wait times for patients on the phone, call abandonment rates exceeding 10 percent, and difficulty attracting new physician groups due to poor scheduling and patient accessibility.

The solution, which included a process redesign to streamline incoming calls and provide standardized metrics to measure improvements, resulted in call abandonment rates falling below 4 percent and the recovery of more than $7 million in annual revenue. In addition, the organization saved more than $700,000 per month in administrative costs simply by reducing the number of staff-answered calls.

Despite this, ROI from engaging a call center partner need not be measured exclusively in dollars and cents. For the West Coast radiology department, patient and physician satisfaction also has increased as access for patients has improved.

Additionally, a truly effective call center should generate data that can be used to enhance outcomes, as well as facilitate advances in patient acquisition and retention, management, and spending. Some call center partners offer detailed reports providing insight into essential business drivers like performance levels of service lines, effectiveness of community marketing campaigns generating revenue through classes and other public events, and increased levels of patient acquisition from preventive clinical services, such as breast-screening reminders.

What’s more, by providing comprehensive, data-enriched services, a call center partner can help healthcare organizations indirectly increase ROI by ensuring that in-house staff remain focused on their primary mission of delivering a high-quality patient experience. Ultimately, enhancing the patient experience is likely to lead to greater patient satisfaction and engagement, as well higher HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) scores, which works full circle to attract more reimbursement and more patients.

Better ROI, Better Patient Care: Changing clinical and market dynamics demand that today’s health systems, hospitals, and practices leave behind volume-based models of care delivery for value-based models. This means they must focus on identifying those processes that generate the best clinical and financial outcomes, as well as increase ROI.

Against an increasingly challenging and competitive backdrop, high-quality call service operations can streamline operational efficiencies, enhance the patient experience, reinforce a positive brand image, and improve patient retention. They can help healthcare organizations of all types and sizes do more with less, allowing them to keep their focus on delivering the highest quality patient care.

Steve Whitehurst is vice president and general manager of Stericycle Communication Solutions.

[From the June/July 2014 issue of AnswerStat magazine]