Adapting Value-Based Principles to the Patient Contact Center

Dan Schulte, Senior Vice President, HGS Healthcare

Hospitals and health systems have made considerable investments in financial, clinical and technological processes that will support an evidence- and quality-based patient-centric healthcare experience. However, many healthcare leaders are overlooking one critical department in need of investment: the patient contact center. The contact center is the first impression many patients have of a hospital or health system, and will be a determining factor in their choice of healthcare. Imagine a patient who simply wants to schedule an appointment, ask a question about a treatment plan, or request a referral. Are they confronted with outdated, poorly automated selection menus? Are they routed endlessly among call service operators and forced to relay the same information over and over again?


Patient contact centers were created from a simple business necessity. Hospitals needed a way to help an influx of patients efficiently navigate through a large care environment, so the hospitals created an area where appointments, cancellations and other administrative business  could be pulled away from clinicians’ busy schedules. Hospital managers should view these patient contact centers  as legitimate business departments with the potential to create new streams of revenue, and as critical stakeholders in the transition to patient-centric care. However, if not properly aligned with the hospital’s value-based mission and vision, the patient contact center can hamper other value-based care initiatives, leaving patients frustrated and dissatisfied before they even walk through the door. If the hospital’s contact center’s business mission mainly includes sending appointment reminders and routing patients, it is being underutilized. Hospital and health system leaders should evaluate the potential for adapting value-based principles to the patient contact center, and move beyond the quantitative benchmarks as a measure of their efficacy. The Business Case for Value-Based Contact Centers Consumerism has changed the field of play for hospitals and health systems. This change has been so seismic that many healthcare leaders are looking to other industries—such as banking and retail—to uncover best practices that can be adapted to the healthcare setting. (After all, the people who shop at are the same people who shop for healthcare—and the experience of the former to some degree informs their expectations of the latter.) As a result of consumerism’s influence, healthcare organizations are competing to gain and retain patients—and first impressions are critical. That’s why a modernized contact center—measured by value-based benchmarks—is critical both for differentiating your organization and for preventing leakage. For most patient contact centers today, efficacy is measured using quantitative benchmarks—how fast calls are answered, the rate of first-call resolution, the number of agent-to-agent transfers, and so on. All of those measures are important, of course. However, these traditional, quantitative benchmarks fall short of the innovations and requirements of the broader healthcare industry’s transition to patient-centered, value-based care delivery. Modernizing the Patient Contact Center A modernized patient contact center—one that fosters value-based, patient-centric principles—enables hospitals to offer a personalized, world-class experience to a patient before the patient steps foot into the care setting, including:

  • Maximizing patient retention and patient referral revenue by making the best possible first impression with new patients and providing personalized interactions with current patients
  • Using the visibility gained through a “single front door” to create and execute much more targeted and relevant patient marketing and engagement/activation programs
  • Drastically improving operational efficiencies and reducing operational costs in the hospital or health system’s clinics and physician offices
  • Using the data captured to help develop more consistent scheduling processes and templates that can be leveraged to drive self-service scheduling and digital patient-engagement strategies

Patient contact centers should drive revenue and patient satisfaction, reduce no-shows and time spent by caregivers on reaching patients, and eliminate the need for patients to fish around for answers to their questions. If your airline carrier knows your preferred seating arrangement, or if your hotel’s concierge knows your preferred floor and newspaper, then your patient contact center should strive to have access to:

  • Patients’ upcoming and past appointments
  • Education and patient record materials in the system’s EHR and patient portal
  • Intelligent routing to the best available advocate, scheduling agent, care coordinator or case manager, based on patient data and what is known about that patient at that point in time
  • The patients’ preferred modes of communication (landline, mobile phone, text, e-mail, etc.)

The goal of contact centers should be to make the patient experience as comforting as possible through both personalization and self-service—striving for that perfect balance between automation and a live, human-touch interaction. Developing a Proactive Strategy A modernized patient contact center begins with a proactive and prescriptive strategy. The first step in the development of a contact center modernization strategy is to ensure that the structure and processes of the contact center reflect the mission and vision of the healthcare organization. The next step is to conduct a thorough infrastructure inventory. Understanding the tools and resources used by the contact center brings greater clarity and insight into how patients view the contact center, and by extension, how they view the organization as a whole. Only with a proper inventory can a solid business case be made. When evaluating the contact center, identify the low-hanging fruit and where it is most logical for the hospital to invest. Look for interdepartmental synergies. For example, if the revenue cycle of the organization can be integrated with other administrative and care portions of what is being delivered to the patient, that integration will enhance the patient experience. Finally, create a roadmap for modernization. What should the contact center look like five years from now? Critically, how should it be measured? Rather than leaning on legacy benchmarks, the modern contact center should be value-based (i.e., tied to HCAHPS and customer satisfaction scores, family surveys, on-time service delivery, patient adherence to pre-treatment instructions, resolution of all financial questions prior to treatment, lives impacted, patient recommendations, and reduction in operating expenses). Contact centers can impact the financial health of organizations; they can drive revenue, profitability and patient loyalty. Yet many organizations today fail to realize financial benefits from their contact center because they are still using legacy, reactive benchmarks to measure success. When it comes to patient contact centers, what you measure is what you get. Make sure you update your success metrics to stay in sync with the move to value-based healthcare.