Tribhuwan works in Database Administration where he leads a group of database professionals.
Solomon’s career development is building with each new day at HealthWare Systems. Tribhuwan says his, “dream of leading a team of database experts and providing sound database background processes to different applications was fulfilled at HealthWare Systems. The company offered me a way to learn different platforms and provided resources for my success.”
Tribhuwan says that at HealthWare Systems, “the voice of any person can be heard effectively without repercussions. An employee could walk up to the owner of the company to discuss things and they are open to it. Human Relations is more of a friend than a machine for onboarding. The budget is flexible, and the company is open to buying resources that help employees.”
Solomon is helping the company reimagine the patient experience by living out his passion. Tribhuwan is passionate about, “making a difference in the lives of patients,” and had been even before starting at HealthWare Systems. He knew he was perfect for the job.
Solomon has worked on many projects throughout the years at HealthWare Systems. One project he highlights is the Patient Encounter System, also known as Facilitator. “Facilitator has been my favorite project,” says Tribhuwan.
Facilitator is a platform that streamlines pre-arrival workflow, prior authorization, medical necessity checking, insurance verification, appeals management, financial assistance screening, release of information, and more.
“I was very new when this project started and learned how hands-on the owner of the company was. It was very comforting to see my boss being there for me during the entire process. The structures and logistics which were designed for this project are still working reliably across different hospital systems and collection agencies,” Tribhuwan shares.
It’s employees like Solomon who allow HealthWare Systems to live up to such words as trustworthy, simplicity, and agility.
Thank you, Solomon, for sharing your experience and being a valued member of the HealthWare Team! We look forward to your continued success and accomplishments.
ActiveASSIST: Integrating Presumptive Charity and Propensity to Pay Solutions
Posted on Tuesday, August 3, 2021
ActiveASSIST is fully integrated with presumptive charity and propensity to pay solutions to help identify candidates for financial assistance.
ActiveASSIST is fully integrated with presumptive charity and propensity to pay solutions to help identify financial counseling prospects and to guarantee that all patients are provided the same fair and level assessment during financial assistance screening.
What is ActiveASSIST?
ActiveASSIST is our real-time financial assistance screening and workflow management solution. Our solution is designed to:
Identify patients who may be candidates for financial assistance.
Find alternative funding sources for patient accounts.
Segment and prioritize patient accounts based on propensity to pay.
Provide payment collection options based on each patient’s situation.
How Does ActiveASSIST Utilize Presumptive Charity and Propensity to Pay Solutions?
Presumptive charity solutions determine the likelihood that a patient will qualify for financial assistance based on factors such as demographic data, household size, income, and charity approvals previously made by the hospital.
Propensity to pay solutions assess patients’ ability to pay, identifying which patients are likely to make a payment and which patients should be extended financial assistance options.
Combining these solutions with a basic questionnaire integrated into the (pre)registration process, ActiveASSIST can identify a likely financial assistance prospect and route the patient history, visit information, and electronic application forms to internal counselors or hospital-approved vendors for follow-up.
The following ActiveASSIST features enable you to more effectively manage your self-pay patient population and financial assistance workflow:
Quick Screens – Basic questionnaires combined with the presumptive charity result identify likely prospects for financial assistance early in the revenue cycle.
Plan Code Recommendations – Recommended plan codes are presented to the registrar according to business rule selection and prioritization based on the “payer of last resort.”
Calculation of Charitable Co-Pay
Full Assessments – Comprehensive patient interview captures detailed information in the facility, in the field, or at contracted vendor locations.
ActiveASSIST not only determines which patients are candidates for financial assistance, but also manages financial assistance workflow to ensure that patient accounts and financial assistance applications progress at an acceptable pace. ActiveASSIST can monitor and enforce specific documentation requirements for each financial assistance program and flag and assign deficiencies to associates for resolution.
The Benefits of Presumptive Charity and Propensity to Pay Solutions
Implementing financial assistance screening technology that integrates presumptive charity and propensity to pay solutions provides numerous benefits, including:
Removing guesswork from financial assistance and patient collections activities.
Streamlining financial assistance and patient collections decision-making.
Directing patient collection efforts toward those most likely and able to pay.
Contact us to learn more about how ActiveASSIST utilizes presumptive charity and propensity to pay solutions to help your patients obtain financial assistance and help you reduce uncompensated care; or, view a short demo here.
ActiveASSIST: Financial Assistance Screening for Rural Patients
Posted on Monday, May 17, 2021
Patients are now responsible for a larger portion of healthcare costs than ever before. Even those who have health coverage may be considered “underinsured” due to high cost-sharing plans that leave them with significant out-of-pocket expenses they often cannot afford to pay.
12.5% of U.S. adults ages 19 to 64 were uninsured.
43.4% of U.S. adults ages 19 to 64 were inadequately insured
(uninsured, underinsured based on out-of-pocket medical costs compared to income, or experienced a gap in coverage).
Rural patients are more likely to be uninsured than are non-rural patients.
The financial viability of rural healthcare facilities will depend on their ability to find alternative funding sources for the medical bills that their patients may not be able to pay.
ActiveASSIST: Financial Assistance Screening for Rural Patients
ActiveASSIST is HealthWare Systems’ financial assistance screening tool and workflow management solution. ActiveASSIST identifies potential funding sources for patient accounts prior to their date of service and ensures the provider is payer of last resort by exhausting all other options first.
ActiveASSIST streamlines and automates the financial assistance process by:
Utilizing business rules to determine which patients are most likely to qualify for charitable assistance.
Simultaneously pursuing multiple assistance programs for these patients.
Pre-populating patients’ application forms with their data.
Providing real-time updates, while monitoring progress and documentation requirements.
Tracking follow-up tasks and escalating accounts that are not advancing at an acceptable pace.
Implementing ActiveASSIST at your facility does not require you to hire additional employees – our solution is designed to enable your internal staff, on-site vendors, and/or off-site and field associates to manage your self-pay and underinsured patient population.
Improving healthcare access with financial assistance screening for rural patients.
ActiveASSIST aids staff with follow-up and counseling discussions, helping them provide compassionate, supportive guidance and providing payment collection options based on each patient’s situation.
Improving Healthcare Access for Rural Patients
Many rural patients face unique barriers to healthcare access, which may include living long distances from healthcare facilities and specialists, poverty, provider shortages, and rural hospital closures or service cutbacks – and each of these has been exacerbated by the COVID-19 pandemic.
As mentioned, rural patients are also more likely to be uninsured than are non-rural patients. Unfortunately, insufficient health coverage is a major barrier to healthcare access and can cause patients to delay or avoid medical care altogether.
With ActiveASSIST, you can both alleviate your patients’ financial burden and enhance the financial outlook of your own organization to ensure you remain open and can continue serving your patients and community.
Provide technology information –A 2018 AARP survey found that 76% of U.S. adults age 50-plus want to stay in their own homes as they age. Many older patients also want and believe they need access to health technology in order to manage their own healthcare. Educate patients and their families about technology that can help them achieve these goals and keep them safe.
According to the Population Reference Bureau, there were 46 million Americans (15% of the population) aged 65 and older in 2016 and that number is expected to more than double by 2060, to over 98 million (24% of the population).
As the American Hospital Association pointed out in its publication “Creating Age-Friendly Health Systems,” improving care for older patients now can put your hospital “ahead of the curve” as the healthcare market shifts to accommodate our aging population.
September is the perfect time for exploring new policies that will improve patient engagement in older patients and ensure they have the best possible care at your facility all year round.
4 Ways to Build a Culture of Patient Advocacy at Your Facility
Posted on Wednesday, February 6, 2019
How can a healthcare facility practice patient advocacy? Of course, patient advocates offer wonderful support to patients. But providers can create a larger culture of patient advocacy at their facility as well by tackling a few key areas.
Here are 4 ways hospitals can support their patients and build a culture of patient advocacy:
1.) Address The Social Determinants of Health
Create a culture of patient advocacy with Patient-First Technology like ActiveASSIST.
Supporting your patients’ social needs is an incredible form of patient advocacy. It can also lead to better health outcomes and lower healthcare costs for your facility.
2.) Offer Financial Assistance Screening
A lot of patients don’t realize that financial assistance may be available to them. Many hospitals have changed their financial assistance policies to include not only the uninsured, but the underinsured as well.
Notifying patients of which programs they could qualify for demonstrates a great deal of patient advocacy. What really goes above and beyond, though, is facilitating the entire financial assistance process on behalf of your patients!
By exhausting all other payment options first, you also ensure the provider is payer of last resort.
3.) Alleviate Stressors Surrounding Costs and Payment
Larger-than-expected or difficult-to-decipher medical bills, as well as health insurance confusion, are major sources of frustration for patients. They can also result in unpaid medical bills and medical debt, or cause patients to forgo some health services altogether.
Reducing patient uncertainty concerning the financial aspects of their care would help you foster a culture of patient advocacy. Ensuring patients are financially cleared before arrival, generating estimates and identifying potential out-of-pocket costs, and setting up payment plans are all ways you can assist patients in this area.
What a perfect time to share educational materials and classes related to health insurance and financial assistance with your patients. Perhaps the best way to advocate for your patients is to help them develop the skills they need to advocate for themselves!
Each of these areas provides you with excellent opportunities for patient advocacy. Plus, there is a bonus: supporting any of these endeavors can ultimately improve your bottom line as well.
Practicing patient advocacy will help you support your patients, improve the patient experience, and offers financial benefits for all parties involved. Developing a culture of patient advocacy can truly pay dividends.
The Social Determinants of Health & Their Effect on Health Outcomes
Posted on Friday, August 17, 2018
The social determinants of health are increasingly on the radar of health professionals and health systems. The National Academy of Medicine (formerly the Institute of Medicine) even recommends this information be included in patients’ medical records.
Hospitals can utilize screening tools to collect patient data concerning the social determinants of health. While a provider may not be able to resolve all social issues faced by a patient, identifying them can help inform healthcare decisions. (Providers should also have a list of resources that attend to social needs available to provide the patient when asked.)
When health systems consider the social determinants of health when caring for their patients, all parties benefit. Patients have better health outcomes, communities improve, and health systems become advocates for their patients (improving patient satisfaction) while saving money. The social determinants of health not only impact the health of patients, but also the health of a hospital’s revenue cycle.
Social factors that influence patients’ health & healthcare decisions include:
Employment – A good job can provide a patient and his/her whole family with health benefits and insurance. Unemployment negatively affects physical and mental health.
Income – A steady paycheck allows a patient to pay for many of the other factors in this list, such as adequate housing, nutrition, and transportation, as well as healthcare costs. (Financial assistance screening tools can help patients find out if they qualify for charitable programs to help offset the cost of care, and enable hospitals to facilitate the application process for their patients.)
Housing – Poor living conditions increase the risk of infectious disease, injury, chronic illness, pest and mold problems, and indoor air pollution. And each year, 1.48 million Americans have no home at all. (Here are some examples of how hospitals can help meet patient housing needs.)
Violence – The area in which patients live also can affect their exposure to violence or abuse. Victims or witnesses to acts of violence may experience mental, physical, and/or economic consequences that affect their overall health.
Nutrition – A lack of consistent access to healthy food can negatively impact health outcomes and increase the risk of many adverse health conditions. Over 12.7 percent of U.S. households were affected by food insecurity in 2015. (Read our previous blog for more information on how to reduce patient malnutrition.)
Transportation – Access to reliable transportation can govern a patient’s access to medical care. Approximately 3.6 million Americans miss or postpone medical care due to transportation issues. (Check out these ideas for addressing patient transportation needs.)
Social Support – As reported by NPR, in a recent nationwide survey conducted by Cigna “nearly 50 percent of respondents” said “that they feel alone or left out always or sometimes.” Two in five respondents “felt like ‘they lack companionship,’ that their ‘relationships aren’t meaningful’ and that they ‘are isolated from others.’” Patients who feel unsupported are more vulnerable to poor health outcomes. (Read how physician empathy can generate better health outcomes.)
Language/Culture – Culture influences our beliefs about health and healthcare. A patient’s ability to communicate with health professionals may be impeded by language barriers.
Education –According to the CDC, people with higher levels of education are more likely to choose healthy behaviors and refrain from unhealthy ones. People with lower levels of education are more likely to be obese and more likely to smoke.
Sex/Gender – Many health conditions affect men and women differently and certain treatments may be more or less effective depending on the sex of the patient. Plus, men are less likely than women to see a doctor for a specific health concern, preventive healthcare, or a standard annual exam. (Consider these tips for improving male patient engagement.)
The social determinants of health are key to improving health outcomes and the revenue cycle.
It’s not difficult to imagine how the above factors might influence one another. The social determinants of health are interconnected and work together to impact a person’s health and healthcare decisions.
Patients whose social needs are unfulfilled are more likely to utilize healthcare resources at a higher cost (including the Emergency Department), be readmitted, miss appointments, and have poor health outcomes.
Hospitals can significantly improve the health of patients suffering from housing instability by actively addressing patient housing needs. A patient’s living situation, conditions, and location affect many aspects of health. Poor housing quality increases the risk of infectious disease, injury, chronic illness, pest and mold problems, and indoor air pollution. Neighborhood conditions are related to rates of violence, crime, noise, and opportunities for physical activity.
Improving patient housing situations can result in better health outcomes and quality of life for patients and their families. Plus, there are financial incentives for addressing patient housing needs. According to the American Hospital Association’s Social Determinants of Health Series:
“The economic benefits for hospitals can be significant, since homeless or unstably housed individuals are more likely to be uninsured, be hospitalized more frequently, have longer lengths of stay in the hospital, be readmitted within 30 days and use more high-cost services. Reducing homelessness and other forms of housing instability—through case management, supportive housing (supportive services combined with housing), housing subsidies or neighborhood revitalization—improves health outcomes, connects individuals with primary care and reduces these high levels of utilization. When hospitals and health systems focus their resources on housing supports and case management, the cost savings can offset the expenditures by between $9,000 and $30,000 per person per year.” (p. 8)
Hospitals can significantly improve the health of patients suffering from housing instability by addressing patient housing needs.
Here are a few ways hospitals can address patient housing needs:
Contribute to neighborhood improvement projects. Collaborate with your local government and other organizations that hold a shared interest in the state of your community. Get involved or make monetary donations to make a difference.
Provide home assessments and patient education for vulnerable populations. For example, the Seattle-King County Healthy Homes Project targeted low-income households with asthmatic children. The initiative sent a nurse and community health workers to patients’ homes to educate the families about asthma and self-management and to identify and address environmental triggers (with resources like bedding covers, vacuums, and cleaning supplies). The goal was to improve health outcomes for patients with asthma and to reduce the use of healthcare services such as urgent care.
Set up a home repair referral program. Don’t stop at simply assessing patients’ homes for health and safety risks; refer them to a local business that can take care of necessary home renovations for them. Establish partnerships with businesses who will offer their services at a reduced rate to your referrals or find charitable organizations like veterans’ clubs and churches that may have volunteers who could do the work for free. The One Touch e-referral program has seen success in linking government and nonprofit groups like Habitat for Humanity to create healthier homes.
Bring care to homeless patients via a mobile health center. Visit shelters, churches, and community centers and offer primary and preventive health services to at-risk patients. (Take a virtual tour of the Calvert Health System Mobile Health Center.)
Create a transitional arrangement for homeless patients whose conditions require they be discharged from the hospital, but who are not yet well enough to go back to a shelter or live on the street. St. Joseph Health created a Medical Respite Program consisting of 15 beds set at three different locations to meet this need. As its website explains, these beds are for homeless patients “who are being discharged from the hospital, and who need the opportunity to rest in a safe, healing environment while accessing medical care and other supportive services post-hospitalization.”
Invest in your own affordable patient housing. According to its website, Bon Secours Baltimore “has developed and now owns and operates more than 720 apartment units for low- and moderate-income seniors, families and people with disabilities.” The heath system has committed to “revitalize West Baltimore.”
Compile a list of affordable patient housing options near your facility. UW Medicine created a list of both short-term and long-term housing options to help patients, as well as their family members and caregivers, find lodging. Some of their local hotels even offer a discount to patients’ families and a shuttle service to and from the hospital.
Many of the above ideas for addressing patient housing needs are suggested by and discussed in further detail in the AHA’s guide, “Housing and the Role of Hospitals.” This guide also outlines steps hospitals should take when determining which method(s) would best address the patient housing needs in their own communities (p. 10-11).
Patient housing instability is one of multiple interconnected social factors that affect health outcomes and healthcare costs. Along with patient housing needs, health systems should attend to other social determinants of health by, for example, addressing patient transportation needs and working to reduce patient malnutrition.
Reducing patient uncertainty should be a high priority item for healthcare providers. Feelings of uncertainty can affect the patient experience and lower patient satisfaction.
Most of us are uncomfortable with uncertainty and many visits to healthcare facilities are made with the purpose of diminishing it. Patients seek out your facility hoping to find answers to health questions; the last thing they are looking for is even more confusion.
Reducing patient uncertainty can vastly improve the patient experience.
Below are 6 areas that can either increase or decrease patient uncertainty.
By reducing patient uncertainty through addressing these areas, providers can greatly improve the patient experience:
For example, a study published in the journal Health Communication found that video biographies for primary care physicians were more effective in reducing patient uncertainty than the standard text biographies that most providers post on their websites.
2. – Wayfinding:
Navigating their way around an unfamiliar building can increase patients’ anxiety over their hospital visit. Wayfinding solutions (such as digital signage, mobile apps that guide patients around your campus, and touchscreen kiosks that print wayfinding maps) can ensure that patients and their visitors don’t get lost, all while reducing patient uncertainty about finding their destination.
3. – The Waiting Room:
The waiting room offers numerous opportunities for reducing patient uncertainty surrounding many topics. In the waiting room, uncertainty about wait times can be just as frustrating as the actual waiting. Patients’ family members face uncertainty as well, about how long they’ll be waiting, about the details of a procedure, and about the outcome for their family member.
Patients should not have to face uncertainty regarding whether their doctor has all the information he/she needs to properly care for them. Yet, only 46% of hospitals had required patient information from outside providers or sources available electronically at the point of care according to research posted by the Office of the National Coordinator for Health Information Technology.
Researchers have created a new tool called the Uncertainty Scale to measure patient uncertainty and predict hospital readmissions. Some of the major themes they’ve found in their work include patients’:
“Lack of clarity regarding self-management, such that patients are unsure how to deal with symptoms at home”
“Lack of self-efficacy, manifesting as patients not knowing where to go for help for certain symptoms”
“Lack of clarity about the decision to seek care, meaning that patients do not know which symptoms are serious enough to warrant seeing a health professional”
Uncertainty is unfortunately a common experience in healthcare for those with undiagnosed conditions and symptoms for which an explanation is unclear. The six areas outlined here are within your control; by reducing patient uncertainty in these areas, your facility can greatly improve the patient experience.
Improved access to transportation benefits patients, health facilities, and communities. Health systems that address patient transportation needs are advocates for their patients, produce better health outcomes, lower readmission rates, reduce no-show appointments, and improve the general health of the community.
Efforts should begin with screening patients to determine their need/eligibility for transportation or other financial assistance.
Here are some specific ways your facility can then help those patients and create better health outcomes:
Educate Patients About Transportation Options
Compile a resource list of patient transportation options available in your area. For example, many senior centers and churches provide free or low-cost transportation and Pace offers a “Call-n-Ride” service in the Chicago suburbs for as little as $2.00. What affordable local transportation options could you suggest to your patients?
Promote patient transportation options through flyers, posters, or digital signage at your facility. If you use a lobby display screen or patient notification board, include notices for patient transportation options that appear throughout your rotation of announcements.
Participate in local government and community planning projects. The American Hospital Association suggests hospital representatives “participate in local or regional transportation planning initiatives and educate decision-makers about how health can be affected by transportation” to encourage the development of new patient transportation options (such as more walkable routes, bike lanes, bike-sharing programs, bus or shuttle services, etc.).
Alleviate Patient Transportation Needs by Bringing Care to the Patients
Invest in a mobile health center, as Calvert Health System has; the Calvert Health System Mobile Health Center brings primary and preventive health services to patients by visiting churches and community centers.
Create a prescription delivery or mail service, or provide pharmacy services on site to cut travel for patients, as the American Hospital Association advises here (p. 12).
Provide more telehealth opportunities and encourage use of the patient portal for minor questions.
Make a commitment to address patient transportation needs using the suggestions above, and your patients, community, and facility will all enjoy the benefits of better health outcomes.
You can read in further detail how the health systems mentioned above (Grace Cottage, Taylor Regional, Denver Health, and Calvert Health) address patient transportation needs in the case studies provided by the American Hospital Association.
Taking Steps to Reduce Patient Malnutrition is Critical to Health Outcomes
Posted on Wednesday, March 7, 2018
When we look at the statistics, the importance of taking steps to reduce patient malnutrition becomes clear. A study of 818 inpatients published in Clinical Nutrition found that up to one third were malnourished, resulting in “poor hospitalization outcomes” such as increased mortality rates and higher costs of care.
“Malnutrition is associated with many adverse outcomes, including an increased risk of pressure ulcers and impaired wound healing, immune suppression and increased infection rate, muscle wasting and functional loss increasing the risk of falls, longer length of hospital stay, higher readmission rates, higher treatment costs, and increased mortality.”
The authors of the article point out that malnutrition is often overlooked, despite its dire consequences and the startling number of patients who suffer from it. Per research cited in the article, it is estimated that in developed countries at least one third of patients are malnourished to some degree at the point of admission; during their hospital stay, the nutrition of about two thirds of these patients will worsen if untreated; and about one third of patients who are not malnourished when admitted may become malnourished during their stay.
Fortunately, hospitals can prevent many of the negative effects of malnutrition. The authors of the article in the Journal of the Academy of Nutrition and Dietetics suggest healthcare facilities apply the following six principles to nutrition care in order to reduce patient malnutrition:
Reduce Patient Malnutrition
1 – “Create an institutional culture where all stakeholders value nutrition” – Administrators and all healthcare professionals (doctors, nurses, physician assistants, pharmacists, dieticians, etc.) must collaborate.
2 – “Redefine clinicians’ roles to include nutrition care” – Provide clinicians with nutrition training and continuing education.
3 – “Recognize and diagnose all malnourished patients and those at risk” – Every hospitalized patient should be screened according to a standardized procedure.
4 – “Rapidly implement comprehensive nutrition interventions and continued monitoring” – Immediate nutrition interventions must be a high priority; consumption must be monitored and adjusted as necessary.
5 – “Communicate nutrition care plans” – Ensure patients’ nutrition care plans are updated in the EHR and all healthcare professionals are informed.
6 – “Develop a comprehensive discharge nutrition care and education plan” – Communicate the nutrition care plan to the patient and caregivers, provide them with nutrition education, and follow up to check adherence to the plan.
Reduce patient malnutrition to improve health outcomes.
A piece featured on the Hospitals & Health Networks website proposes that “before implementing interventions, a hospital must first visualize food as medicine to realize the impact that food can make in the community.” This article provides many ideas for hospitals looking to serve their communities and reduce patient malnutrition (such as establishing on-site gardens, healthy cooking classes, food pantries, and food pharmacies).
March is National Nutrition Month®, an education and information campaign created by the Academy of Nutrition and Dietetics. This is the perfect time to start implementing the above principles at your facility and take steps to reduce patient malnutrition. You can also promote healthy eating habits for your employees and patients using the tools the Academy of Nutrition and Dietetics provides here.