Shepherding a 22-hospital system through a huge migration is no easy task. Last month, during the VisitPay Financial Health Summit, Todd Craghead, Vice President of Revenue Cycle at Intermountain Healthcare, shared his compelling migration story to a packed house of CFOs. During his session, Todd described the motivation for undertaking the journey, the concerns the team had regarding the level of engagement from consumers–and how they worked to protect and enhance that experience.
Intermountain Healthcare in Salt Lake City is a fully integrated delivery system with a health plan covering more than 800,000 lives in the state of Utah and Idaho. Helping people live the healthiest lives possible, wherever they are in their journey is at the forefront of everything Intermountain does — it’s their primary mission. Widely recognized as an employer of choice, Intermountain has made significant strides forward, aggressively addressing the key changes and challenges occurring in healthcare today.
Leaning in to achieve better outcomes
After spending 25 years building its own clinical information system and patient accounting and financial and revenue cycle system, Intermountain Healthcare decided it was time to lean in and figure out what the possibilities might be if they identified a partner with whom they shared a common vision. The ideal scenario: to work together towards a better, more integrated future to enhance and improve the patient’s experience.
“We are leaning in, and leaning in means doing things vastly different to disrupt our own existence in a way that is very painful for many of the folks who have been inside of healthcare, both clinically and financially.” – Dr. Marc Harrison, CEO, Intermountain Healthcare
Choosing the whole kit and caboodle
After careful exploration of several vendors, Intermountain Healthcare selected Cerner, electing to leverage both their clinical information system and the revenue cycle system. Todd Craghead explains: “Intermountain Healthcare was not just going to pick up a clinical information system, but rather we were buying the whole kit and caboodle–with the intention of working together as a development partner with Cerner, doing our best to try and improve outcomes.”
A steady and staged migration
The road to Cerner system migration didn’t happen quickly. It was a carefully staged process that started in 2015 with one hospital and continued through 2017–across 22 hospitals. Using a geographic approach, the project enveloped both the medical group clinics and hospitals, bringing them up together so they could develop ways to enhance the patient’s experience.
But, trying to manage and migrate two systems, one that Intermountain owned and built and one that is supplier-provided raised concerns about how to maintain a stable patient experience–specifically how to reduce the likelihood of disruption or risk while trying to build a complete experience that patients will enjoy after they finish their clinical experience. In this case, the VisitPay team rose to the challenge, working to bridge the gap, stabilizing the consumer experience in an ever-changing environment.
“Our collaboration with VisitPay ensured the Intermountain customers were satisfied that their financial well-being was being maintained and remained a top priority.”- Todd Craghead, Vice President Revenue Cycle, Intermountain Healthcare
Success tips for creating a consumer-centric financial experience
Stabilizing the consumer experience in an ever-changing environment is never easy, however, it is what every health system wants, and what patients deserve. Here are six of the key takeaways from Intermountain Healthcare’s experience:
#1 Go steady so you can go fast
Stage what you do. Roll out your pilots to your own health system employees. Monitor adoption and use, solicit feedback, find out where the ‘gotchas’ are before implementing any changes intended for patient use.
“Intermountain Healthcare tends to be a fair bit conservative–very careful about how we spend our money. We spend a fair amount of time making certain that we do everything that meets every regulation that could be put into action. We did that same thing when we staged our marketing approach. As we brought VisitPay up, we said, ‘Let’s just try it on employees, because we’ve got 39,000 plus employees at Intermountain Healthcare.’ Most of them have SelectHealth, which is us, and most of them are visiting our facilities, so let’s just try it on them, which we did.” – Todd Craghead, Vice President Revenue Cycle, Intermountain Healthcare
#2 Build a single, integrated experience for your consumers
If you can build a single, integrated experience, you will have better outcomes–at a lower cost. Rather than sending five bills, your patients will see their information electronically. Creating a single experience enables patients to make payment through one vehicle versus payment on every one of those bills.
#3 Identify the best way to engage your consumers
Find opportunities to tailor the experience to each unique patient’s needs. Every patient’s outlook and perception is different. Find out what’s important to each of them. Consider how different options can be constructed so that it is easy for patients to use the technology available to them. Make the financial experience meaningful and consolidated.
#4 Take a marketing approach
Test how things work. How long could the plans be? Can you engage the consumer in a certain way based on some of the information you know about them? Could you tailor any kind of offering, or a payment plan, or recommendations around how they engage the system based their specific needs?
Get feedback and find out what’s working, and what isn’t. Watch and observe how accounts transition and resolve. Then go back and ask the consumer, “Was that a good experience or a bad experience? Tell us about your experience.” Engaging with employees in your staged deployment is a great way to solicit user feedback.
#5 Optimize and troubleshoot as you go along
Of course, no project is free of challenges. Intermountain Healthcare encountered speed bumps. But through collaboration across the ecosystem of partners, the Intermountain Healthcare team navigated through them, delivering a unified experience to its patients.
Key to their success was the ability to passively expose users to new features. For example, after adding the new online billing capability to the main website, Intermountain Healthcare experienced a huge uptick in adoptions. Patients visiting the site could easily explore the online payment module and learn how to set up an account. After making the new option visible, Intermountain Healthcare experienced a huge uptick in adoption.
One of Intermountain Healthcare’s primary goals was to bring accounts in from everywhere – putting everything together so patients could see a single billing experience. The value of having a single URL for patients to view everything proved compelling. Within a 10-month period, Intermountain Healthcare ramped up 26,000 users.
#6 Leverage internal resources and external tools to understand and measure financial impacts
Payment yield and collection success rates are key financial performance indicators every organization tracks. Since implementing the VisitPay platform, Intermountain is tracking towards a 20-30% increase in overall yield, while also experiencing cost reductions.
Leveraging tools from VisitPay enables Intermountain to assess and classify where patients stand regarding their ability to pay, enabling them to identify and create a pathway for each individual based on their circumstances. Intermountain is an organization that prides itself on never turning anyone away based on financial ability. With the new tools in place, the team can quickly identify patients that lack the ability to pay for care, and move them into a financial assistance category. In the same way, for the patients who can pay, and are willing to satisfy their obligations, yield improvements are evident.
In addition to improving patient yield, Intermountain Healthcare lowered the cost of managing the process, deploying resources more effectively. By putting staff on phones to engage with patients experiencing challenges–rather than blindly using resources to call everyone–the call center staff were engaged in more productive conversations that resulted in better outcomes.
An accelerated adoption of a single-view billing experience
Consumers want and need help managing their financial obligations in healthcare. Having a tailored, digital experience won’t solve the problem around cost, but it does give patients a vehicle which empowers them to have more control over their healthcare financing. Once available, Intermountain Healthcare experienced an accelerated adoption of its patient finance platform.
When undertaking a migration project of the scale and scope of Intermountain Healthcare, it’s very important to bridge the gap to ensure a transparent billing experience for the consumers. In the case of Intermountain Healthcare, it took a long time to fully implement Cerner across the entire system. During this time, consumers were unaware what back-end application was producing and managing the bill.
“While I compliment the EMR companies for their attempt and certainly their investment in bringing technology to the market, I think it’s clear that the quality of expertise we received while working with VisitPay has not been replicated by other companies. And, although these other companies may be making attempts to do so, in my view, it hasn’t yet been replicated to the standard exhibited by the VisitPay team.” – Todd Craghead, Vice President Revenue Cycle, Intermountain Healthcare