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Beating the Q1 slump: How digitally driven patient engagement can boost revenue


Don't let your practice's year get off to a slow start.

patient engagement computer | © Thanadon88 - stock.adobe.com

© Thanadon88 - stock.adobe.com

Almost as soon as the new year’s confetti has been swept away, physician groups struggle to encourage patients not only to seek needed care, but also pay for it amid a “reset” in insurance deductibles.

It’s a scenario that is especially familiar to specialty groups like physical therapy organizations, where patients may receive treatment multiple times a week. And at a time when 40% of American adults worry about inflation in the year ahead and nearly one out of three say their relationship with money is stressful, according to a recent survey, easing patients’ financial fears while protecting a physician group’s ability to provide care is a top-of-mind concern.

For our multi-site specialty group, a focus on proactive patient financial engagement doubled out-of-pocket collections, even during “slump months,” without an increase in staff. It also strengthened patient and staff satisfaction while positioning our organization to expand services and add four new locations at a time when many physician groups are struggling.

Smart strategies for patient financial engagement

In January 2023, Integrated Rehab Group (IRG), a rehabilitative services provider based in the Pacific Northwest, revamped our approach to patient financial engagement to avoid the slide in cash collections that typically occurs at the start of a new year.

Decades after IRG was formed in partnership with a professional basketball player, the specialty group, which operates 40 physical and hand therapy locations, established itself as an independent entity. Months later, the pandemic hit. Suddenly, our ability to respond with agility to the needs of our specialty group and our patients appeared at risk. No-show rates climbed to 20%, up from 12% before the pandemic, and patients were slower to pay their bills. Meanwhile, volumes were slow to return to normal.

For IRG to bounce forward—not back—from the pandemic, we needed to take a more innovative approach to patient financial engagement, one that lifted pressure from staff to initiate conversations around the cost of care. Conversations about payment can be difficult for staff at any time of year, but they are especially challenging at the start of a new year. One minute, consumers are celebrating the holiday season; the next, they are facing a deductible that is likely $1,992 for an individual plan and $3,811 for family coverage.

IRG adopted a mobile pay platform, PatientPay, that incorporates text-based bill notification and payment. The platform meets patients where they are using the device consumers rely on most: their smartphone. Today, 85% of American adults own a smartphone, and recent surveys show patients want to pay their medical bills digitally. In fact, one out of three patients say they would pay their bill using digital options if given the chance.

The mobile pay platform sends a secure text message to patients as soon as their bill is ready to view. With one touch, patients can access their account directly, without the need to enter a username or remember a password. The platform integrates with IRG’s EMR and billing system to make account reconciliation easy and ensure account balances are updated in real time across systems.

Within minutes of sending its first texts, we received a payment from one of our patients. Almost immediately, IRG doubled its daily cash collections while significantly reducing calls to customer service for assistance with account management.

Today, 60% of our patients who receive a text notification of their bill make a payment. It’s a rate that not only helps IRG overcome sluggish cash flow when deductibles reset, but also positions our group to expand its geographic footprint and introduce new services, like rehabilitation for patients suffering from traumatic brain injuries, concussions, and cognitive challenges.

Lessons learned

The shift to digital patient financial engagement paid big dividends for IRG, but long-term success involves more than a “set up and go” approach. Here are four lessons learned in making the shift to digital bill notification and payment in a physician group.

Take time for pre-go-live education for front-line staff and clinicians. Understand that the questions your team might have could vary based on geography and patient demographics. Some markets may be comfortable with a quick launch; others will require more education prior for a smooth transition. Key to this education: Make sure your team understands the benefits of mobile pay for patients, staff and the physician group as a while.

Draw a dividing line between clinical care and payment. Clinicians should not have to spend time and energy on administrative aspects of care like prior authorizations, insurance verification and paperwork. Similarly, they should not be a patient’s point of contact regarding the costs of their care. By automating bill notification and payment and making it easy for patients to view and manage their accounts, this helps avoid scenarios where therapists find themselves talking with patients about money. It also protects the patient financial experience—critical at a time when more than half of patients say a negative financial experience has prompted them to leave a bad review of their provider.

Invest the time saved via digital payment inservices that add value for patients. For instance, at IRG, the move to a mobile payment platform enables staff to devote more time to value-added activities like patient education and customer relationships.

Pay attention to the number of automated touches patients experience. As you add digital touchpoints for payment and account management, evaluate how often patients receive digital prompts from your practice and have a solution, like PatientPay, that can dynamically manage the billing communications for you. For example, do patients already share information about chronic conditions digitally? Do they receive texts or emails asking for feedback on a recent visit? This is an area IRG continually assesses. When the number of digital requests feels excessive, leaders look for opportunities to turn off some of these notifications to protect the patient experience.

By investing in a patient-centric approach to tech-enabled financial engagement, physician groups can overcome the beginning-of-the-year revenue slump and position their practice for success in the year ahead.

Shannon O’Kelly is president and CEO, IRG Physical & Hand Therapy Services, based in the Pacific Northwest, and is the owner of Innovative Mill Work Solutions and Rehab Strategies.

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