A father and daughter look over a field and the blog title appears – ActiveASSIST: Financial Assistance Screening for Rural Patients

ActiveASSIST: Financial Assistance Screening for Rural Patients

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HealthWare Systems Blog

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.

According to the Commonwealth Fund’s Biennial Health Insurance Survey, as of June 2020:

    • 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.

Patient-First Technology


A father and daughter look over a field and the blog title appears – ActiveASSIST: Financial Assistance Screening for Rural Patients

Improving healthcare access with financial assistance screening for rural patients.

ActiveASSIST promotes a culture of patient advocacy by not only lowering or eliminating patients’ medical fees, but also through empowering patients with financial counseling and education. Patients who understand their own financial responsibility are much more likely to make their payments (if they can).

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.

ActiveASSIST can help you remove some of these obstacles and improve your patients’ access to the care they need.

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.


Contact us to learn more about ActiveASSIST and financial assistance screening for rural patients; plus, view our other solutions for rural healthcare facilities.


By Stephanie Salmich

Text message and email examples for a patient outreach campaign aimed at increasing mammogram appointments.

Patient Outreach Amid a Pandemic: Bring Patients Back for Preventive Care

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HealthWare Systems Blog

Patient Outreach Amid a Pandemic:

Bring Patients Back for Preventive Care

Posted on Friday, January 29, 2021

A robust patient outreach strategy may be the answer to healthcare’s latest problem resulting from the COVID-19 pandemic: Patients are missing preventive care visits at alarming rates.

Here are the statistics:

  • According to research released in May of 2020, at that point preventive screenings for cervical, colon, and breast cancer had dropped between 86% and 94% compared to the same time frame in 2017 to 2019.
  • Research reviewed by the CDC concluded that by “June 30, 2020, because of concerns about COVID-19, an estimated 41% of U.S. adults had delayed or avoided medical care including urgent or emergency care (12%) and routine care (32%).”
  • A study conducted by the University of Oregon found that 28% of families missed a well-child visit since the pandemic started; and 12% of the 7,000+ caregivers surveyed said their child missed a scheduled vaccination.
  • In its analysis of health claims clearinghouse records, HCCI determined that through “September 2020, childhood immunizations declined about 23% for the year compared to 2019.”

There are many short- and long-term consequences of a decline in preventive care.

As the CDC states, avoiding routine care may mean missed “opportunities for management of chronic conditions, receipt of routine vaccinations, or early detection of new conditions, which might worsen outcomes.” Fewer immunizations can lead to outbreaks of vaccine-preventable diseases. Children who skip check-ups miss out on social, emotional, and developmental screenings and abuse and neglect surveillance.

Financially, healthcare costs increase for patients, payers, and providers when preventive health services are not adequately utilized, and care gaps adversely affect hospitals’ reimbursement under value-based care models.

Using Patient Outreach to Bring Patients Back


It is essential that healthcare organizations communicate with their patients about the dangers of delaying or avoiding care. Potential messages may include:

  • Awareness campaigns educating patients on the recommendations for preventive care.
  • Statistics on better health outcomes for early detection of common cancers.
  • A list of preventive screenings that are covered by most health plans.
  • Appointment reminders and alerts for missed appointments.
Text message and email examples for a patient outreach campaign aimed at increasing mammogram appointments.

A patient outreach campaign aimed at increasing mammogram appointments.


Additionally, many COVID-related factors are contributing to patients’ avoidance of preventive care, and each of these could be addressed by a patient outreach program as well.

For example:

Bring patients back for preventive care with a patient outreach strategy.

  • Delays in care could be in response to stay-at-home orders and/or temporary healthcare facility closures. Create a patient outreach plan that notifies patients of your facility’s hours of operation for routine care so that they know you are both open and encouraging regular visits. This will help reduce any uncertainty they have about when to seek care.
  • Patients might be worried about possible exposure to COVID-19 if they visit a healthcare facility. A patient outreach strategy could include information on the measures your organization is taking to reduce this risk, such as your cleaning procedures, face mask requirements, social distancing rules for staff and patients, strict visitor limitations, and moving non-essential staff off site. Reassure patients of your efforts to keep them safe.
  • Patients may be experiencing unemployment, a loss of health insurance, and/or other financial hardship. Many are unaware of financial assistance programs that could help cover the cost of their medical bills or that they may qualify for another health plan. Start a patient outreach campaign that informs them of these options, especially if your health system can help them apply for financial assistance and/or health coverage!

As the pandemic continues to confuse patients about when to seek care and why, it is imperative that you reach out and communicate with them.

Patient Outreach: ActiveXCHANGE by HealthWare Systems


ActiveXCHANGE can be bundled with our messaging platform to add automated voice message (TTS), text, email, pagers, fax, and traditional mail to create a physician and patient outreach engine for alerts, reminders, requests for information, and post-acute care follow-up.

Request a live demo of ActiveXCHANGE to learn how we can help you build a patient outreach program to bring patients back to your facility and the critical preventive care they need.


By Stephanie Salmich

A patient advocate provides financial counseling, which can increase patient collections.

Increase Patient Collections Through Patient Financial Education

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HealthWare Systems Blog

Increase Patient Collections Through Patient Financial Education

Posted on Monday, February 3, 2020

Addressing patient financial education needs can help you increase patient collections. When patients understand their medical bills, health insurance, and patient responsibility, they are much more likely to make their payments.

When patients are confused about what they owe and why, they often delay payments or don’t make them at all. Too many patients experience health insurance confusion and anger and uncertainty concerning medical bills and healthcare costs.

The following solutions by HealthWare Systems can help you improve patients’ understanding of their financial responsibility and increase patient collections:


ActiveASSIST

ActiveASSIST is our financial assistance and self-pay management solution. ActiveASSIST is a patient advocacy tool that aids staff in providing compassionate and supportive financial counseling to patients.

A patient advocate provides financial counseling, which can increase patient collections.

Increase patient collections by providing patient financial education.

ActiveASSIST identifies alternative funding sources (e.g. government programs, charitable initiatives) for patients. Many patients are unaware of the various financial assistance options available, or that they may qualify. Our patient-first technology finds potential matches for them, manages the application process, and monitors documentation requirements, deadlines, and follow-up tasks.

By educating patients about their financial assistance eligibility and helping them secure funding, ActiveASSIST can leave patients with a smaller, more manageable portion of their bill to pay (or their costs may be completely covered by financial assistance).


Facilitator

As our all-in-one revenue cycle platform, Facilitator can streamline your financial assistance workflow as well.

Additionally, Facilitator generates patient estimates and determines patients’ potential out-of-pocket costs. Patients want price transparency. If patients know what costs to expect up front, they will feel better informed. They are less inclined to be upset when they receive their bill and more apt to pay it.

With Facilitator, you can also review prior balances across multiple sites, collect payments, or set up payment plans to help patients understand and resolve their financial responsibility.


February is National Wise Health Care Consumer Month. This month we are reminded of the importance of empowering and educating patients so that they can make wise health care decisions, including wise financial decisions related to their health.

This is an opportune time to implement revenue cycle solutions that will improve patient financial education and, as a result, increase patient collections.


By Stephanie Salmich

You can improve patient engagement in older patients, like this doctor talking with his patient about her health.

Improve Patient Engagement in Older Patients

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HealthWare Systems Blog

Improve Patient Engagement in Older Patients

Posted on Wednesday, August 28, 2019

You can improve patient engagement in older patients, like this doctor talking with his patient about her health.

Improve patient engagement in older patients by helping them view aging in a positive way.

You can improve patient engagement in older patients by helping them view aging in a positive way.  This coming month, “September is Healthy Aging® Month,” offers a special opportunity to do just that!

Here are a few ways you can improve patient engagement in older patients:

Celebrate aging –September is Healthy Aging® Month” is meant to draw attention to the positive aspects of aging and to assure people that it’s never too late to make healthy lifestyle changes.  Older patients should be encouraged to take control of their health at any age.

You may also wish to celebrate grandparents this next month, as Grandparents Day falls in September as well.  Remind older patients of the need to maintain their health so that they can continue to benefit their grandchildren’s lives for many years to come!  And make sure they know that this special relationship can benefit their own health, too. (Check out our previous blog on additional monthly health observances.)

Emphasize prevention, rather than reaction – Some of the most prevalent health issues affecting older patients, such as diabetes, hypertension, obesity, heart disease, malnutrition, and injuries from falls, are potentially preventable.  Yet, per the CDC, only 7% of older adults obtain all their recommended preventive health services.

Our blogs on increasing preventive screenings for men, improving male patient engagement, and increasing mammogram appointments can provide you with some excellent ideas for promoting preventive health services at your facility.

Improve family engagement – Family engagement can be especially important for older patients who may have family caregivers.  Family caregivers play a significant role in older patients’ safety and comfort.  Plus, patient and family satisfaction are related.

Address the social determinants of health – Some of the social determinants of health may affect older patients in different ways than younger patients.  For example, patient transportation needspatient housing needs, and dietary needs often change as patients age.

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.

Implement the 4M Framework – The Age-Friendly Health Systems initiative encourages healthcare facilities to embrace the 4M’s when caring for older patients:

  • What Matters – Aligning care with the patient and family’s health goals.
  • Medication – Choosing age-friendly medications that don’t hinder the other three “M’s” of the framework.
  • Mentation – Addressing dementia, depression, and delirium.
  • Mobility – Ensuring patients move safely every day.

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.


By Stephanie Salmich

A daughter and mother celebrate the health benefits of a clean home.

Spring Cleaning! The Health Benefits of a Clean Home

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HealthWare Systems Blog

Spring Cleaning! The Health Benefits of a Clean Home

Posted on Monday, April 1, 2019

Spring cleaning season is here!  This is a great time to educate your patients on the health benefits of a clean home and encourage them in their spring cleaning goals.

A daughter and mother celebrate the health benefits of a clean home.

The health benefits of a clean home are both mental and physical.


Promote the Health Benefits of a Clean Home

A clean home is beneficial to both your patients’ physical and mental health!


Here are a few of the health benefits of a clean home:

Improves respiration – Common asthma triggers include dust, pet dander, mold, and mildew.  Decluttering, dusting, and vacuuming can all help asthma and allergy symptoms.

Prevents sickness – In order to stop the spread of an illness after someone in their home has been sick, it’s important that patients thoroughly clean and disinfect (especially areas of the house that are frequently touched, like doorknobs, counters, and cellphones).

Better sleep – A National Sleep Foundation Bedroom Poll found that “respondents who say they make their bed every day are 19% more likely to say they get a good night’s sleep every night than those who don’t.”  Furthermore, at least two thirds of respondents believed clean, allergen-free air and a clean bedroom are important for a good night’s sleep and 71% of respondents said “they get a more comfortable night’s sleep on sheets with a fresh scent.”

Enhances concentration – Both children and adults can have trouble focusing on tasks when surrounded by clutter and mess.

Boosts mood – A study published in the Personality and Social Psychology Bulletin analyzed couples’ descriptions of their homes.  Women who described their homes as “stressful” (cluttered, with unfinished projects) “had increased depressed mood over the course of the day.”  Women who described their homes as “restorative” “had decreased depressed mood over the day.”

Lowers stress – Not only can having a clean home lower stress, but so can the cleaning process itself.  Some people practice meditation or gratitude exercises while cleaning.  Cleaning can also give us a sense of control over our environment.  Plus, cleaning is a physical activity, which is a de-stressor.

Provides exercise – While not recommended as a patient’s only form of physical activity, household chores can burn some extra calories and even stretch and tone muscles.

Prevents injuries – According to the CDC, more than one out of four people aged 65 and older falls each year and one out of five falls results in serious injury.  Patients can reduce some risk factors by keeping floors and stairs clear of clutter.

Provide Patient Education for Safe Spring Cleaning

Along with the health benefits of a clean home, advise your patients about cleaning safety.  Unsafe cleaning practices can lead to health risks and injury.

For example, direct them to guidelines for poison prevention (particularly related to ventilation and handling and storage of cleaning products that contain chemicals).  Or, perhaps your doctors have recommendations for chemical-free products.

Other cleaning safety considerations include proper indoor and outdoor ladder usage and appropriate disposal of expired items (such as paint, medicine, and batteries).

Equipped with this knowledge, your patients can pursue the health benefits of a clean home without putting patient safety at risk.


The social determinants of health include patient housing and living conditions.  One way to address these is to arm your patients with the knowledge they need to keep their homes safe and clean.

Many of us are extra motivated to get our homes in order when spring cleaning season rolls around.  Foster this enthusiasm in your patients now, but encourage them to also maintain adequate cleaning (and cleaning safety!) habits throughout the year.  Your patients will be grateful to enjoy the health benefits of a clean home all year round, and you can enjoy the benefits of better health outcomes for patients at your facility.


By Stephanie Salmich

Creating a culture of patient advocacy: A healthcare employee holds a patient’s hand.

4 Ways to Build a Culture of Patient Advocacy at Your Facility

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HealthWare Systems Blog

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

Creating a culture of patient advocacy: A healthcare employee holds a patient’s hand.

Create a culture of patient advocacy with Patient-First Technology like ActiveASSIST.

The American College of Physicians states that addressing the social determinants of health “is a critical step forward in solidifying physicians’ roles as advocates for patients.”  You can supply your physicians with screening tools and training to help them identify patients’ social needs and how these may be affecting their health.

Additionally, your organization can do its part in addressing the social determinants of health in your community.  For example, you may be able to reduce patient malnutrition, ease patient transportation needs, or assist with patient housing needs.

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!

Technology like HealthWare SystemsActiveASSIST and Facilitator can both identify programs applicable to specific patients AND manage the financial assistance workflow.

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.

4.) Provide Patient Education

February is National Wise Health Care Consumer Month!

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.


By Stephanie Salmich

This doctor talking to his patient is taking proactive steps toward increasing preventive screenings for men!

Increasing Preventive Screenings for Men at Your Facility

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HealthWare Systems Blog

Increasing Preventive Screenings for Men at Your Facility

Posted on Thursday, November 1, 2018

Increasing preventive screenings for men at your facility can save patients’ lives.  “Movember” is the perfect time to start working toward this goal.


Consider these ideas for increasing preventive screenings for men at your facility:


Educate your patients.  Patients may be unclear on the correct or most-up-to-date recommendations for preventive screenings and may not realize when it is time for them to start discussing these topics with their doctor.  Make sure your clinicians initiate the conversation when patients reach the proper age to begin making decisions about testing in case patients forget.

Improve patient engagement with preventive health by utilizing social media in healthcare.  Share preventive health tips, educational materials, and powerful statistics demonstrating the importance of early detection of male health issues.

(Check out our previous blog for more information on male patient engagement.)

Ensure patients are aware that most health plans are required to cover the cost of many preventive screenings (when performed by an in-network provider).  Highlight the fact that most plans cannot charge a copayment or coinsurance for these services even if the patient has not met his yearly deductible yet.  Instruct patients to check with their insurance company.  Additionally, help patients find out if they qualify for financial assistance and facilitate the application process for them.

Use their time in the waiting room as an opportunity to reach your patients.  For example, print educational materials on the back of wayfinding maps.  If you use a lobby display screen or patient notification board, feature male preventive health facts periodically throughout your rotation of announcements.  Or, incorporate moustaches into the backdrop of your screen to draw more attention to Movember and male health issues.

(Read here how one acute care facility used ActiveTRACK to promote customizable messages to patients in their waiting area.)

Accommodate your patients.  Allow for evening and weekend appointments.  Besides providing interpreters and educational materials in various languages, train staff to understand how culture affects health and healthcare decisions.  Don’t let inconvenience or cultural barriers stand in the way of accessing preventive health care.

Talk to female patients about preventive screenings for men.  Women make approximately 80% of household healthcare decisions.  Since women can have such a large impact on male health, clinicians may want to bring up the topic when meeting with female patients.  This could trigger a reminder for female patients to schedule appointments for their loved ones, or simply provide them with pertinent preventive health information to pass on to the men in their lives.

Start the Movember Healthcare Challenge at your facility.  Compete against others in your industry to raise money to improve male health through the Movember Foundation.  Raise awareness by growing a (or wearing a fake) moustache!  Use the hashtag #Movember when you share the pictures on social media.

(You can also find ideas for promoting other health observances throughout the year here, and a detailed calendar of this year’s health observances and recognition days here.)

Most of the above ideas can be implemented all year long!  Increasing preventive screenings for men is an important goal to strive toward and November is a great time to start.

This doctor talking to his patient is taking proactive steps toward increasing preventive screenings for men!

Take proactive steps toward increasing preventive screenings for men!


By Stephanie Salmich

Increasing mammogram appointments… a woman holds a sign reading “Have YOU scheduled your annual MAMMOGRAM?”

Ideas for Increasing Mammogram Appointments

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HealthWare Systems Blog

Ideas for Increasing Mammogram Appointments

Posted on Monday, October 1, 2018

Increasing mammogram appointments… a woman holds a sign reading “Have YOU scheduled your annual MAMMOGRAM?”

Take proactive steps toward increasing mammogram appointments!

October is the perfect time to focus on increasing mammogram appointments.  During Breast Cancer Awareness Month, prioritize preventive care using the suggestions below.


Consider these ideas for increasing mammogram appointments at your facility:


Educate your patients on breast cancer prevention.  Patients may be unclear on the correct or most-up-to-date recommendations for mammography screening or may have heard conflicting instructions from different organizations.  Make sure your clinicians clarify.

“Current guidelines from the American College of Radiology and the Society for Breast Imaging recommend that women receive annual mammograms starting at age 40 — even if they have no symptoms or family history of breast cancer.”

Ensure patients are aware that most health plans are required to cover the cost of a breast cancer mammography screening for women over 40 every 1 to 2 years (when performed by an in-network provider).  Highlight the fact that most plans also cannot charge a copayment or coinsurance for this service even if the patient has not met her yearly deductible yet.  Some states even require insurers to cover 3D mammograms.  Instruct patients to check with their insurance company.  Additionally, help patients find out if they qualify for financial assistance and facilitate the application process for them.

Send mammogram reminders through texts, emails, letters, postcards, and/or phone calls. A study conducted by Kaiser Permanente found mammogram reminders to be very effective in increasing mammogram appointments, especially when sent to patients whose mammogram appointments were coming due.

When patients check in, instruct registrars to ask them if they’ve scheduled their annual mammogram exam yet; and if not, have registrars try to schedule one with them.  Additionally, registrars should confirm they have the correct mailing address and phone number for the patient in the system used to send mammogram reminders.

Use their time in the waiting room as an opportunity to reach your patients.  For example, print mammogram reminders on the back of wayfinding maps.  If you use a lobby display screen or patient notification board, include mammogram reminders and breast cancer prevention facts that appear periodically throughout your rotation of announcements.  Or, use a mammogram reminder as the full-time backdrop of your screen.

(Read here how one acute care facility used ActiveTRACK to promote customizable messages, including encouragement of mammogram appointments during Breast Cancer Awareness Month, to patients in their waiting area.)

Improve patient engagement with preventive health by utilizing social media in healthcare.  Share mammogram reminders, educational materials, and powerful statistics demonstrating the importance of early detection.  For instance, according to the American College of Radiology, “mammography has helped reduce breast cancer mortality in the U.S. by nearly 40% since 1990” and “skipping a mammogram every other year would miss up to 30% of cancers.”

Accommodate your patients. Allow for evening and weekend mammogram appointments.  Besides providing interpreters and educational materials in various languages, train staff to understand how culture affects health and healthcare decisions in order to reach patients of all backgrounds.  Don’t let inconvenience or cultural barriers stand in the way of accessing preventive care.

Emphasize your goal of increasing mammogram appointments to your staff. Stratis Health suggests providing your clinicians and registrars with “missed opportunity” reports, which would demonstrate the number of patients who visited throughout the month who were due/overdue for their mammogram appointments but did not get scheduled.


October is the opportune time to launch a breast cancer awareness campaign!  Of course, the suggestions above are best used throughout the entire year to help you in your goal of increasing mammogram appointments and improving your rates of early detection to save lives.


By Stephanie Salmich

The social determinants of health are listed.

The Social Determinants of Health & Their Effect on Health Outcomes

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HealthWare Systems Blog

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.

Health Literacy – People with lower education levels are also more likely to have inadequate health literacy skills.  People who are limited in health literacy have higher rates of hospitalization and emergency room use and they use preventive care less.  (Read our blogs on reducing patient uncertainty and addressing health insurance confusion for ways to help improve your patients’ health literacy.)

Patient Engagement – A patient must have health literacy skills in order to be actively engaged in his/her healthcare.  Better engaged patients tend to see better health outcomes.  (Promoting health observances, using social media in healthcare, and educating patients about preparing for a doctor’s appointment are a few methods for improving patient engagement.)

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 listed.

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 that address the social determinants of health can create better health outcomes, reduce hospital readmission rates, and improve patient engagement while lowering no-show rates and enhancing revenue cycle management.


By Stephanie Salmich

A healthcare worker and the blog title appear: How Can Hospitals Address Patient Housing Needs?

How Can Hospitals Address Patient Housing Needs?

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HealthWare Systems Blog

How Can Hospitals Address Patient Housing Needs?

Posted on Wednesday, August 8, 2018

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)

A healthcare worker and the blog title appear: How Can Hospitals Address Patient Housing Needs?

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).

Ensuring patients go home to safe, clean environments is critical in helping to reduce hospital readmission rates, which is crucial to reimbursement.

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.


By Stephanie Salmich