Why it PAYS to Engage with Patients
This is not about data methodology, nor is it about the need to collect valuable contact information, such as the admitting department – sorry data nerds. Which isn’t to say we don’t suggest obtaining more. We recommend getting more, more, and more. However, rather than collecting data for collection’s sake, we need to talk about the long-term effects of not engaging your patients, how that lack of engagement can come back to haunt us during health plan contract negotiations, and why providers need to be the source of truth throughout. At the end of the day, any organization that lacks engagement with its patients requires influential advocates.
At the heart of everything providers do for patients, getting patients back on their feet and out the door is an integral part of their every day. However, patients must know that fact and recognize the health system is there to provide patient care no matter the circumstance. If that purpose remains unknown, the motivation and downstream effects of navigating those patients’ muddy waters and people’s abilities to voice complaints can go viral in a wrong way.
First and foremost, we want to encourage you to develop patient communication about payor relationships ahead of negotiations so that those pesky patient notifications during the throes of negotiations do not lead to scary or unwanted disruptions. To keep things simple, let’s consider dating. You don’t go straight to marriage after 10 minutes on the first date. In much the same way, you shouldn’t treat your patients like strangers – you need to get to know them before the “bad news” of a difficult payor negotiation and possible disruption to in-network access.
Let’s consider for a minute what current engagement currently looks like for your patients on a day-to-day basis. Now think about how the engagement would look during a contract negotiation, and how your organization would be at that time. If you are not actively speaking to your patients, you might as well be cold calling your distant cousin twice removed on your other brother’s side for those tickets to the Super Bowl since he knows a guy who knows a guy. Honestly, it just feels a bit disingenuous from the patient perspective. Moreover, for that reason, you must communicate to patients regularly, and you explain to them that, at the very least, their hospital or physicians are the source of information about their care, not an unknown payor. Also, further, if there is any question of fact, providers should be seen as the source of truth.
With that being said, one of the first hurdles to overcome during a negotiation is how and when to communicate with patients. While there are an art and science to patient notifications (also mandatory depending on state requirements), there is space to weave in communications (i.e., during planning for service line, hospital, or general promotions) to the three key audiences – brokers, employers, and patients – in those gaps between negotiations with different health plans. (While we are mainly focusing on patients in this article, here is a previously written blog about employer communication.)
If there’s anything to take away from this, it’s that “the truth is in the eye of the beholder.” There is a difference between what patients know and what they are told, both of which can be very different. A patient needs to know that their doctor, the one that provides them with life-saving care, has their best interest at heart. By building that trust, it creates an outlet to garner necessary support during a negotiation. Letting payors dictate their narrative to a patient allows them to become the source of truth instead, causing the opposite effect and allowing them to wear a provider down to the point that any deal, even one that could damage the financial stability of the health system, would be more beneficial than trying to get the best deal done right.
We must educate our patient audience throughout the ordinary course of the year instead of only when our negotiations come to a standstill. Even while knowing this, providers are still reluctant to engage patients without purpose. Well, here is your objective: without patients knowing that their trusted, local providers will continue to provide exceptional, high-quality care during regular and extended business hours, they will never know them well enough to feel a push to support your goals during a negotiation.
The most important thing is to be speaking with patients. While it is hard to begin that conversation, since you never know what open communication can unleash, the reality is that our initial outreach brings hesitancy, but once you do that, you have to keep the conversation going. While these types of campaigns are usual and customary, they speak to the importance of outreach during negotiation or crisis.
Now that we know peering into the abyss isn’t scary, we need to talk about the cadence of communication to patients. Typically, patients have a least one mandatory notification period about a change in network status. We suggest that you add at least two communiques prior. One, you need to prime the ask, with the main points being that this letter is informational which takes place about 60-90 days in advance of the out-of-network (OON) date. With about 45-60 days before the expiration, give an update, reassure, but also make the ask and include a call to action (CTA). Finally, as we mentioned at the beginning of this paragraph, the last communication should be 30 days in advance of OON.
While the truth is in the eye of the beholder, remember, you hold the keys to unlocking that perceived truth in patients’ hearts, minds, and ears. Plus, you need them to communicate with your other key external audiences, including employers and community leaders, to maintain the best step forward.