Appointment adherence initiative:
Includes phone calls to remind patients of appointments or to permit rescheduling (Measurable) 84-90% appointment adherence rate for those patients receiving phone calls.
Offering meal coupons for patients having lengthy appointment or scheduled for diagnostic testing and needing to wait for test results or another appointment.
Special event activities
Operational change: For working patients, the need to access care providers during non-traditional hours.
NP changed work hours to 8:00 a.m. – 6:30 p.m. – 4 days/week – appointments offered before & after work for patients requesting these hours. Twice monthly late afternoon & evening hours – MD and NP with support staff to accommodate patients: these hours 3:00 p.m. – 7:00 p.m
Provider also lists staff restructure however NQC should note that this literally happened a week ago so this is more of an Action Plan than it is a tested and proven method of keeping consumers retained in care. In fact, we will be reviewing the data closely to see if restructuring has any impact at all.
Developments of trust levels preclude fallout from care.
After three telephone attempts made to get client in for health care services a formal letter is sent detailing intent to discharge from care with potential agencies listed for follow-up health care. They call immediately for an appointment.
Support network development including support groups, socialization, education opportunities, etc.
- Informal interviewing of patients to determine barriers - as they see it:
- Lengthy wait times at the appointment – waiting for all the components (registration to discharge) to be completed.
- Patients being enrolled in insurance plans – especially the Medicaid HMOs – that we do not participate with as a medical center or as a provider.
- Patients lack of familiarity with insurance rules – eq: referrals; co payments, etc.
- Availability of public transportation
- Lengthy wait times for appointments for transportation
- Missed rides and difficulty rescheduling
- Promptness of other providers submitting requested medical documentation of care provided – this impacts the continuum of care and often results in duplicative testing.
Uncompensated Care (UCC) approvals:
- Delays in patients providing the supporting documents which permits the registration/admission personnel to approve the UCC status. Without a method of paying for care and treatment being approved, there are appointment delays and diagnostic testing delays.
- Insurance changes – Medicaid, etc.
- Co-pay institution (in general)
- Necessity for referrals from PCP
- State of current economy
- Behavioral health/substance abuse co-morbidity.