Driven by major revenue losses due to COVID-19, increasing patient volume was deemed the top priority for physician practices in 2021 and beyond, according to a recent poll conducted by Epion Health. Poll respondents characterized boosting the number of appointments to their practice as “critical” or “most critical,” more than any other priority for 2021.
Likewise, increasing referrals, which is closely related to increasing patient volume, was practices’ second-highest priority. These revenue-boosting goals were ranked higher for practices than the following important operational and patient-care activities (in descending order):
- Improving online reputation and outreach
- Administering COVID-19 vaccinations
- Addressing staff shortages
- Reducing prescription drug costs
- Reaching patients with compromised access to care
- Participating in clinical trials
Practices should realize that increasing patient volume alone might not effectively solve their revenue recovery challenge. Simply overscheduling providers and expanding hours may not sustainably increase revenue to pre-pandemic levels if patient flow efficiency and experience is not addressed first.
A patient-volume improvement focus for practices is highly understandable given the significant drop in elective care in 2020 due to the COVID-19 pandemic. A survey by the Medical Group Management Association (MGMA) from July of last year, for example, found that 55 percent of group practice leaders reported that new patient volume decreased. A separate earlier study estimated that primary care practices would lose $67,774 in gross revenue per full-time-equivalent physician due to the drop in preventive and acute care.
For 2020 overall, health insurer spending on physician office services dropped by four percent, which may seem small, but is the most significant drop in recent history compared to other economic recessions dating back to 1981. Other estimates are higher, such as an earlier survey by the American Medical Association (AMA), which reported the average drop in revenue was 32 percent as of July and August 2020.
State restrictions on elective services early in the pandemic drove some of the volume decrease, but 41 percent of patients surveyed between March and July last year reported that they chose to forgo needed care. Of patients who missed care, 57 percent reported it was due to fear of catching COVID-19.
Improving Volume by Improving Flow
As vaccines become more widespread and cases steadily decrease, patient volume should naturally increase. The vast majority of practices anticipate they will fully recover within the next three years. Inefficient clinical and administrative workflows, however, could slow or bring recovery to a halt, especially if patients who are eager to catch up on deferred care need to wait too long for an appointment.
A post-pandemic surge of care demand poses another challenge due to “the increasing complexity of established sick patients and new patients,” according to a physician who participated in the Epion poll. Caring for higher-risk patients who have deferred care during the pandemic means new care gaps likely have emerged, requiring additional appointments and more provider time during each one. To accommodate the demand and complexity, practice efficiency will be as essential as increasing volume.
Increasing volume and improving flow comes down to simplifying care access and minimizing wasted time. Some practices, though, especially those with entrenched and seldom-changed operational workflows, are likely unaware of inefficiencies in these processes given their numerous other competing challenges. That is why practices need to examine how their patients perform the following:
- Find the right provider
- Schedule appointments
- Prepare paperwork before the visit
- Communicate with the practice
Likewise, as some physicians attribute practice inefficiencies to their EHR, they should analyze how data from patients is entered into the EHR and ask how it could be streamlined or automated and how many steps the physician needs to access this information.
Once these access and efficiency factors are assessed, practices should concentrate on removing the operational or technological barriers that slow down patient flow before, during and after the visit. They should minimize their administrative burden where possible while improving the patient experience through automated, online care access steps and practice communication.
Finding a Solution
EHRs can be a contributor to practice inefficiency, especially when excessive manual data entry is required. Fortunately, a patient engagement solution integrated with the EHR can automate many of the care access steps for the patient, including provider selection, appointment scheduling and check-in as well as practice communication for both in-office and telehealth visits. Practices can also automatically confirm the appointment, send reminders to patients and collect co-pays and payments, thereby off-loading the crucial aspects for increasing patient volume and revenue that can also inhibit patient flow. An integrated patient engagement solution also captures crucial pre-visit data entered by patients directly in the EHR to further save time for administrative and clinical staff.