How Patient Satisfaction Impacts Healthcare Reimbursement: A Focus on Revenue Cycle Management

Jun 7, 2024 | Blog

medical doctor looks at smiling patient

The healthcare industry continues to move toward a value based care (VBC) model where patient satisfaction and experience with care factors into payer reimbursements. This relatively recent shift in the healthcare payer model prioritizes the patient’s health over the quantity of medical services, with a goal of having a measurable impact on the health outcomes of every individual served by the practice.

In the value based approach, smooth RCM operations leading to higher patient engagement and satisfaction can have a direct impact on the level of payer reimbursements and overall financial health of the practice.

Since almost one third of revenues collected in healthcare come directly from patients’ copays and deductibles, it’s crucial to communicate accurate patient balances in a friendly clinic environment to encourage prompt payment.

With these factors in mind, healthcare providers are looking to improve patient experience in every way possible.
By streamlining revenue cycle management (RCM) for increased patient satisfaction, healthcare providers can experience more efficient operations, a reduction in errors, improved patient engagement, and ultimately, secure higher reimbursements.

Understanding the Link Between Patient Experience and Reimbursement

The connection between a patient’s experience and payer reimbursement lies in the methodology of the value based care model as described below. These models shift the focus from fee-for-service to rewarding providers for delivering quality care and positive patient outcomes.

Here’s how patient satisfaction factors in with healthcare reimbursements:

Value-Based Care Program (VBC) in Healthcare

The VBC program, implemented by the Centers for Medicare & Medicaid Services (CMS), ties a portion of Medicare reimbursements to patient experience surveys, like the Consumer Assessment of Healthcare Providers and Systems (CAHPS). Higher patient satisfaction scores based on communication, pain management, cleanliness, and other factors translate to increased reimbursements for hospitals.

Patient Loyalty and Practice Retention

Satisfied patients are more likely to return to the same healthcare provider for future needs, leading to continuity of care and compliance with physician recommendations for better health outcomes. This could result in better health, as an example, from consistent chronic care management and disease management.

A patient who is satisfied with their physician and clinic experience is more likely to respond to the physician’s advice, follow up with prescriptions and appointments, and experience better health outcomes.

Returning patients supports a more stable revenue stream from a consistent panel. Conversely, negative experiences can lead patients to seek care elsewhere, potentially impacting a provider’s overall patient volume and revenue.

Positive Online Reviews for Providers

The level of physician’s care is not the only aspect of a patient’s perspective of their clinic experience. The entire process of care, from scheduling to billing, affects the patient’s view of the clinic and provider.

Patients increasingly rely on online reviews to choose healthcare providers. Positive reviews stemming from a smooth registration and billing experience, plus clear communication on schedules and follow-up can attract new patients and help the practice grow.

Optimizing Revenue Cycle Management (RCM) for Patient Satisfaction

Knowing how patient satisfaction impacts healthcare reimbursement, let’s explore how to optimize RCM processes for a more patient-centric experience.

Streamlining Patient Scheduling and Registration

The revenue cycle begins with the initial patient interaction. Offering online scheduling tools, appointment reminders, and ensuring efficient registration processes with minimal wait times set the tone for a positive patient experience. Insurance verification and preauthorization is important for the patient experience to be smooth.

Prioritizing Accurate Medical Coding and Billing

Errors in coding and billing can lead to denied claims, delayed payments, and frustrating billing disputes for patients. Investing in accurate coding practices and robust quality assurance programs minimizes such errors and ensures patients are billed correctly.

Transparency in Patient Billing and Collections

Patients dread surprise medical bills. Implementing clear and upfront communication about costs is the key to better patient collections and less billing disputes. This could involve providing patients with estimated out-of-pocket costs before medical services are rendered, offering multiple payment options, and establishing clear procedures for discussing financial assistance programs.

Efficiency in Patient Collections

While collecting outstanding patient balances is essential, the process should be respectful and patient-centered. Offering flexible payment plans, online payment portals, and clear communication strategies for resolving medical billing issues can improve patient satisfaction during the collections process.

Learn how UnisLink’s advanced technology drives higher patient collection rates.

Investing in Patient Communication

Clear and timely communication with patients throughout the revenue cycle is key. This includes providing patients with clear explanations of charges, updates on claim status, and readily available resources to answer questions and address concerns.

Focusing on the Care, One Patient at a Time

By streamlining and automating many of the RCM administrative tasks, the providers’ patient-facing team can focus on welcoming patients at registration and following up for future appointments. With efficient RCM operations, more staff time can be placed on patient engagement, managing billing concerns, and providing an overall caring service.

Leveraging Technology for Improved RCM and Patient Experience

Technology can play a pivotal role in streamlining RCM processes and improving patient satisfaction with their clinic experience.

Here are some key tools to consider:

  • Electronic Health Records (EHR) Systems: EHRs allow for seamless capture of patient data electronically, minimizing data entry errors and ensuring accurate coding and billing.
  • Patient Engagement Tools: Online portals and mobile applications can empower patients to manage their appointments, access invoices and statements, and make secure online payments, fostering a sense of control and convenience.
  • Outsourcing End-to-End RCM Services: Working with an expert medical billing services company that seamlessly interfaces with the practice EHR/PM can automate a host of RCM tasks, such as claims scrubbing, submission, and denial management, freeing up staff time to focus on patient interaction.

UnisLink Prioritizes Patient Satisfaction with Advanced RCM Communication Tools

UnisLink recognizes the importance of patient satisfaction in medical collection rates and payer reimbursements. That’s why our UnisLink Intelligent Care Management System (iCMS™) improves patient engagement while reducing costs. iCMS™ integrates seamlessly with the most common EMR/EHR systems to deliver advanced engagement capabilities that improves quality measures and positively impacts the bottom line.

Contact us to discuss this topic and request an RCM consultation for more information on how your practice can improve its financial outlook.