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Using the Healthcare Contact Center to Reduce Readmissions: Case Study

Healthcare contact centers have migrated through a series of phases in response to both environmental realities and organizational priorities. Whether to align newcomers with a well-matched primary care physician, reduce avoidable readmissions, provide virtual visits, or to create easier patient access at the beginning of an “always” experience; giving “phone hugs” to patients has never been more timely or more important. This article focuses on the maturity progression of healthcare contact centers. It will equip readers with a sense of their place on the continuum and illustrate opportunities to deliver on the mission of every patient receiving the best possible care.

Helping Reduce Readmissions

Reducing avoidable readmissions is a timely and tangible opportunity for contact centers to make a measurable difference. It improves patient care and strengthens the bottom line. The Affordable Care Act began reducing payments to hospitals for excess readmissions effective for discharges beginning on October 1, 2012. Leading healthcare contact centers began to reposition themselves as a solution for reducing avoidable readmissions. Here’s an example:

A leading Midwest Health Network was fined $2.5 million for excessive preventable readmissions. The contact center became an intentional, centralized resource for readmission reduction. Their readmission rate declined from 25% to 15% and the $2.5 million fine from CMS was reduced by $1.9 million over two years. At discharge, this contact center asks patients for permission to contact a family member or caregiver, and to store that information in their patient record—to be accessed when it’s time to make certain they are able to get to their follow-up physician appointment. This approach has enabled them to raise their kept appointment rate for post-discharge physician visits to an enviable 87%.

This blog post excerpts an article in the Q1 2017 Provider Advisor, where we discussed the value and effectiveness of contact centers for healthcare organizations.

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