By: Tricia Anderson | tanderson@barlowmccarthy.com
In our highly competitive markets, innovative and strategic growth solutions are now required for the financial stability of healthcare systems.
With the goal of capturing more patients, healthcare systems have spent a lot of money adding access points to their network. Navigating the care delivery system is often complex and confusing to patients. The connections between these access points are not automatic. Helping patients move between hospitals and providers is essential for both patient care and the hospital’s financial health.
Patient attrition (leakage) can occur anywhere, anytime, from one access point to another. Without care coordination or patient navigation processes in place, patient attrition occurs at an alarming rate. Research indicates that when patients are left to schedule their own follow-up appointments, up to 40% of patients never seek necessary follow-up care.
Where might your organization be experiencing patient leakage?
- Primary care referrals
- Secondary specialty referrals
- Ancillary services
- Urgent care centers / FSED’s
- Transfer centers
- Service line specific services (Oncology, Cardiology)
- In-patient discharges
- Emergency Department discharges
For many hospitals, the Emergency Department (ED) serves as the main entry point. It often delivers the highest level of care to the greatest number of patients compared to other access points, and therefore the focus of this article.
Comprehensive ED care coordination benefits patients, physicians and hospitals. For patients, a fully guided journey between care settings provides a streamlined healthcare experience, thus reducing the stress and confusion of self-navigation. For physicians, care coordination builds strong practice volumes without gaps in care. For hospitals, appropriate follow-up care can improve clinical outcomes, physician affinity, patient retention and increase elective encounter volume.
The following case study focuses on ED discharges at a mid-sized urban hospital. The case study site had current programs in place to assist self-pay and Medicaid patients with their follow-up care needs. The example below includes Medicare and commercially insured patients unless otherwise indicated.
Current state findings:
- 55,500 annual ED discharges – all payors
- 53%, or 29,964 annual discharges – Medicare and commercial
- Of the 29,964 patients, 44%, or 13,184 patients did not have a documented PCP
- Of the 29,964 patients, 27%, or 8,090 patients required follow-up care with a physician specialist
- Patients returning to the hospital system for elective encounters within 30 days post-discharge were far below the national return rate average.
Unfortunately, the 21,274 patients requiring post-discharge care with either a PCP or a physician specialist received vague discharge instructions regarding their follow up care needs.
From a patient perspective, this process may have resulted in a delay in care, confusion, frustration or not seeking care at all. From a business perspective, this process may have resulted in patients choosing out of network physicians, receiving care at a competing hospital, or unnecessary readmissions.
A comprehensive care coordination solution was designed and implemented. Impressive results were generated during the initial 4 months of program launch.
- 1,027 patients were assisted with their post discharge care needs by a designated care coordination specialist
- 300 patients returned to the hospital within 30 days following discharge for an elective encounter
- 72 patients were scheduled with a network PCP
Patient attrition is a costly challenge, but the right care coordination strategy can turn it into an opportunity. As the case study shows, guiding patients to follow-up care improves outcomes, strengthens physician relationships, and boosts hospital retention. Reducing leakage starts with a proactive approach – now is the time to assess your strategy and take action.
What is patient attrition costing your organization? The experts at Barlow/McCarthy can help you uncover access point gaps and pinpoint opportunities to reduce leakage leading to measurable improvements in retention.
Addressing patient leakage requires more than just awareness; it demands innovative process improvements. We work alongside organizations to identify the root causes and, if needed, support seamless implementation. Our customized solutions are built on solid data insights and input from key stakeholders, ensuring that the strategies we recommend are practical, effective, and tailored to fit within your organization’s unique structure. Contact us at info@barlowmccarthy.com for more details!