How Operational Analytics are Transforming Patient Access

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Highlights of this episode include:

• How Glass Raven started
• Connecting patient access directly to the bottom line
• How data-driven staffing models can improve revenue capture/reduce leakage
• How right-sizing staffing led to measurable financial improvement
• Where hospitals are leaving the most money on the table
• How finance and operations leaders can partner more effectively
• First steps hospitals can take to use its existing data more strategically

Kelly Wisness: Hi, this is Kelly Wisness. Welcome back to the award-winning Hospital Finance Podcast.  We’re pleased to welcome Peyton Fry. Labor is a hospital’s largest expense and one of its biggest opportunities for financial improvement. In this episode, Peyton, founder of Glass Raven, explains how leading hospitals are using data science and staffing analytics to improve patient access, reduce leakage, and boost revenue capture. Discover how hospitals can make better workforce planning decisions using analytics that link operations directly to financial performance. Welcome, and thank you for joining us, Peyton.

Peyton Fry: Yeah, thanks, Kelly. Happy to be here.

Kelly: We’re glad to have you. Well, let’s go ahead and jump in. So, Peyton, can you tell us how Glass Raven started and what problem in healthcare operations you set out to solve?

Peyton: Yeah, so Glass Raven was founded to– really what it boils down to is moving the needle meaningfully in patient access spaces for hospitals, healthcare systems, and outpatient groups. And it kind of emerged from my early days as a data analyst working for a healthcare system, working with ACOs, central scheduling, call centers, really just broadly working in operation spaces centered on patient access. And I think I didn’t really understand why I was successful as an analyst until I started going out on my own and having to sell myself as this consulting group, and discovering that even though our biggest tool set and kind of what we bring to the table for organizations is advanced data analytics, really, I think the value is in how it gets applied and adopted by an organization to not just automate some steps, remove some reporting problems, but really, really change the culture of an organization to really having executives down to line-level employees centered around the metrics we’re trying to move and understanding the decisions that they can individually make to really improve those pieces week over week. Because I think without that kind of vertical integration, you really don’t adopt a process. I think you just kind of talk about it.

Kelly: Well, thank you for sharing that about Glass Raven and your experience there. Many hospital finance teams don’t always connect patient access directly to the bottom line. Can you explain that connection?

Peyton: Yeah, so the connection between patient access and finance, I think, is normally talked about in a healthcare system once a year around budget cycles whether that be April or November for your team. Typically, when we work with organizations, we’re working with the operational group and how they’re going to change processes. And we talk about finance when it becomes pertinent for how are we going to incorporate new additions or programs or staffing into a budget cycle. So, I think a lot of the problem is that finance and operations don’t really talk to each other around patient access unless budgets involved. A lot of this is, I think, because there is really, really poor benchmarking availability for operational groups to kind of point to and say, “This is what our peers are doing,” or, “This is what we should be doing instead,” which makes it difficult, I think, for finance teams to decide whether to apply capital to a situation, whether to pull capital away into different directions. And patient access kind of has a– it’s a known paradox, but it’s hard to put a finger on it, which is we know that without patient access, we don’t see patients. But it’s hard to say how much money are we spending to get some sort of a return. And this is because, I think, between different organizations, you’ve got different payer mixes. Some people are trying to bring in revenue through commercial groups, and some groups are trying to manage costs for their capitated populations. So, I think it’s really difficult that I think you almost have to reinvent the wheel for every healthcare system based off your operations mix and your payer mix, to really have meaningful conversations between those two groups.

Kelly: Yeah, that makes a lot of sense. There’s a lot of moving parts there. How can data-driven staffing models or access analytics improve revenue capture or reduce leakage?

Peyton: Yeah, so having a strong data-driven process really comes down to how are you looking at staff productivity? Especially with referral management groups is where you’re going to really focus on capturing revenue from those high dollar specialties, or reducing patients from leaking out of your system to your competitors or local groups, because they just can’t get in contact with you, or they can’t find an appointment that works for them. So, making sure that you have strong trained agents on that referral team that know how to get the right patient to the right place at the right time, and then mapping that to a provider network that has capacity for those appointments that you’re trying to schedule for. So, you really need to look at it from both sides. You could have the best central scheduling referral management group in the world, but if you don’t have any provider capacity left, there’s nowhere to put them. It’s no longer worth spending money on your call center. You should be focusing on hiring more providers if you’re really trying to capture those commercial patients. On the flip side, if you’re trying to really control your managed population, if you’re doing Medicare Advantage or you’ve got an HMO, making sure that you get people into their appointments quickly to check off their measures, reach compliance with whatever government programs you’re participating in, making sure that it’s probably not necessarily capturing revenue for you, but it is protecting your margins because you are going to check all those boxes and get the maximum reimbursement you can for those groups.

Kelly: Well, thank you for sharing that with us. Can you share an example where right-sizing staffing led to measurable financial improvement?

Peyton: Yeah. For Glass Raven, our bread and butter normally is working with call center groups and central scheduling because it’s don’t have to worry so much about HIPAA compliance or getting into EHR data work, but it’s a space that a lot of healthcare professionals don’t like to work. So, there’s not a lot of expertise that sits in those spaces. It’s just a special place that’s near and dear to my heart. And working with groups and kind of getting them up to kind of industry standard basics for a call center really helps with staffing models. And focusing on the right metrics, abandonment rate, service level, and throwing out a lot of noisy metrics that are all related to those pieces can really help people focus and dial in what they truly need to handle a central scheduling call volume. And we work with groups and swiftly over like a period of six months to a year saw FTE reductions of like 40 to 50, numbers that even I wasn’t expecting going into it. But it was just having people at the wrong place at the wrong time, changing schedules around, and showing like, “We can do more with the same,” or, “We can do more in a lot of cases with less.” And so doing better staffing on call centers is often an easy place for healthcare systems that haven’t given it a lot of attention to optimize that workforce and get a lot of those dollars back.

Kelly: I love what you said about noisy analytics. That was a really good call out and I love the example. In your experience, Peyton, where are hospitals leaving the most money on the table when it comes to patient access?

Peyton: I think where a lot of the money gets left on the table is not understanding what dials they’re trying to move left, right, because often they just don’t have a lot of metrics to focus on. And so, they end up kind of doing whatever’s shiny. I think it’s really easy– in patient access spaces, I don’t know if it really necessarily looks like money left on the table because patient access by itself isn’t what’s creating your dollar revenues. Unless you’re seeing a provider, you’re not creating money as a healthcare system. You’re not getting reimbursed by the programs you participate in. So, I think a lot of the money is in cost control in patient access spaces that result in clinical work that gets done. So, I think focusing on kind of shiny technologies that maybe aren’t attached to a return on investment on the finance side, can lead to vendor agreements that don’t solve problems. They might look shiny, they might have AI in there and sound agentic, but they don’t necessarily result in more provider visits or more efficient provider visits because that’s really what you’re trying to get down to for revenue. So, I think there’s a lot of interplay with vendors and technology that don’t create returns. And again, it kind of goes back to the question you asked earlier is finance and operations, talk about it more than once a year and figure out on the revenue capture side and the cost control side for our populations, are the changes we’re making in patient access moving those needles in a way that we can track?

Kelly: Definitely. I mean, I love what you were saying about the new shiny technology and tools. I know so often we do get caught up in that and I completely agree with you. We were kind of heading with that. You talked about this a little bit. How can finance and operations leaders partner more effectively to make these improvements stick? And like I said, you did mention this, so I’d love to hear more about this.

Peyton: Yeah, so I think the way you make an improvement stick– I’ll probably answer this in two parts. There’s improvement sticking and there’s finance and operations leaders working together. When it comes to getting an improvement to stick, I think a great example is probably everyone that’s listening to this podcast has had an organizational venture on we’re going to totally revamp and send everyone to training for something like Six Sigma or Lean or we’re going to do a Myers-Briggs personality test and talk about how we do communication. And you do it, the training is exciting for like three, four weeks, and then it kind of fades. And it’s never mentioned again. Six Sigma doesn’t really take root because it’s really hard to kind of be accountable to it because there’s not a way– we didn’t measure going into it, how Six Sigma was going to move the needle. Therefore, we didn’t know how to apply it meaningfully later to get returns on the investment of these programs. And that’s a broad example that probably everyone’s experienced, but I think this is where people get in trouble when they engage with vendors and they don’t know what needle they were trying to move in the first place meaningfully. I think part of that is also there’s a lack of accountability by the vendor or the service group or the consultant around being transparent around what they expected to change and then what they changed at the end.

So, making sure that we have something that we’re going to agree on early and then we’re going to follow it from the executive level down to the people that have the day-to-day process changes, those agents, providers, front desk staff, making sure that they’re all talking about the same thing. We’re not just going to send our executives to training. We’re going to make sure that everyone, top to bottom, understands what service level is, understands what abandonment is, and then mapping that to the decisions that they can make. And then seeing that change week over week and talking about it. So, kind of having a vertical way to talk about a change that we’re trying to make and then watching it longitudinally and watching it weekly, especially early on. And ultimately, it becomes something you look at less and less because it sticks. But that’s where I would start there. Popping back to the first part of the question, how do finance and operations leaders partner more effectively. It’s kind of the same thing that we just talked about, but horizontally. Let’s agree upon a metric that’s important and that we’re both accountable for. And we both understands what decisions that we can make. Finance understands that this is our jurisdiction, operations. This is our jurisdiction. And then talking about the data and the kind of the turning points on when they’ll make different decisions one way or the other. If you don’t understand what decisions your partners can make and how they impact your operation or your day-to-day, you’re not going to talk to them. And you’re going to talk to them once a year when it’s mission critical and the house is on fire.

Kelly: Right. No, I mean, I love what you were pulling out, the accountability and the transparency between the groups. That makes a lot of sense. So, what are some first steps hospitals can take to use its existing data more strategically for access optimization?

Peyton: First steps I would say are take a look at all of your dashboards and decide if that dashboard ceased to exist. If I no longer had access to this data point or this metric, does anything in my day-to-day change? Does anything in my week-to-week, month-to-month change? If the answer is no, you have a fun fact dashboard that you should get rid of. And I think a lot of it comes down to hospitals have an overwhelming amount of data availability. EHRs are built to manage data clinically. I think I’m going to say I haven’t seen an EHR where I’ve been happy with the way that their business analytics is set up out of the box. This is where hospitals kind of have to invent it themselves. And they are handed a lot of stuff that they’re told is the tool of the trade, but it doesn’t apply to their problems. Leaders oftentimes, they have fun fact dashboards and then they just start making decisions based off their gut because leaders do know what’s important to them in their organization and they do know how to move the needle. But they end up having to kind of do it as a gut reaction, which makes it really hard to sell change because you can’t convince your peers of the same thing. So taking a look at what data is important to us really, what do we use to make decisions and just starting to strip out the rest so that you can focus on only what you’re actually going to use to make decisions and kind of identify these are the areas where we’re making our decisions off our gut and we do need data-driven decision ways to make this.

Kelly: Right, no, I love that. I mean, I think that a lot of us make decisions from our gut, but we kind of do need that data to back it up. Well, thank you, Peyton, for sharing your insights with us from wait times to revenue wins, how operational analytics are transforming patient access. If a listener wants to learn more or contact you to discuss this topic further, how best can they do that?

Peyton: Yeah, so easy way to find me is on LinkedIn. I’m at my desk most of the time working with data one way or the other, so I’ll get those notifications quickly. You can also reach out to us over our website. That’s at glassraven.health, spelled just like it sounds. You can check out kind of some of our past projects, how we do work, what we do for partnerships, easy way to find us there as well.

Kelly: Awesome. Thanks for providing that. And thank you all for joining us for this episode of The Hospital Finance Podcast. Until next time…

[music] This concludes today’s episode of The Hospital Finance Podcast. For show notes and additional resources to help you protect and enhance revenue at your hospital, visit besler.com/podcasts. The Hospital Finance Podcast is a production of BESLER | SMART ABOUT REVENUE, TENACIOUS ABOUT RESULTS.

If you have a topic that you’d like us to discuss on The Hospital Finance Podcast or if you’d like to be a guest, drop us a line at update@besler.com.

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