Whether you’re using a predictive scoring model, your own internal data, or a combination of both, segmentation can be overwhelming for healthcare revenue cycle professionals.

With so much potentially useful information about your patient population, how do you decide what to actually do with it?

Unfortunately, many healthcare organizations remain stuck at this stage. Instead of using their data to work patient accounts more efficiently or engage patients more effectively within the revenue cycle, they remain stuck in analysis paralysis – not knowing where to start.

Here are four tips we use to help clients simplify the process and get started with segmentation.


1. Start small

Typically, the word “segmentation” calls to mind large-scale, IT-intensive projects that require significant budget, time, and resources.

But in reality, segmenting patient accounts should be an iterative process.

Administrators should monitor results closely and make strategy changes as needed.  Therefore, with all of the options available, try starting with something that is easy to implement and doesn’t require significant resources.

A few examples include:

  • Changing your intake script based on service area
  • Making a letter or statement design changed based on a predictive model
  • Adjusting patient communication channel (text, call, or IVR) or timing based on a patient’s likelihood to make payment

A true segmentation strategy often starts with one small step.  The best place to start is by determining one element in your process that, if improved, would make a big impact on your bottom line.

Which brings us to our next step.


2. Prioritize your metrics and find your quick wins

If you are new to segmenting patient accounts, focus your initial efforts on the metrics that correlate directly with your goals as a department or organization. After you’ve narrowed your focus, look for quick-win opportunities to influence these metrics.

We define quick-wins as the change(s) you can make to your current process that have the shortest implementation timeline and the most significant ROI potential.

The key is to not get stuck reviewing all of the data that is available to you. Prioritize your metrics and look for the quick wins that help your strategy gain momentum.


3. Establish a baseline

Before implementing any segmentation strategy, you should be able to measure the metric you are trying to influence.

For example, if your priority is to reduce AR days and get patients to make payment sooner, what is the average number of days between a statement being mailed and a payment being received?

After you have an established baseline, and segmentation is in place, you can now measure the results of your strategy.

Have you improved patient response rates? Are patients making payment sooner?

Adjust your strategy accordingly.


4. Consider combining segmentation with visualization

I realize that some, if not most, RCM professionals do not share the same love for data analysis and spreadsheets as I do (after all, I am Director of Analytics here at RevSpring).

Therefore, you may want to consider a partner that can include data visualization with their solution offering.

Data Visualization

A dashboard that visually illustrates your data makes it easier to track the results of your segmentation strategy. Plus, it can show you where your attention should be focused in the future as you grow your strategy.


Final thoughts

Your segmentation strategy can grow based on what you learn every step of the way. Avoid being overwhelmed by starting small and staying focused on your unique goals.

But the key is to start.

An example of a more complex workflow that began with basic point of service area segmentation is shown below:

Segmentation Workflow

However, it is important to note that how much your segmentation strategy grows is dependent on the automation capabilities of your organization, as well as the automation and customization capabilities of your vendor partners.

At RevSpring, our solution set allows clients to leverage their own data (as well as predictive scores) to create custom, automated engagement strategies for each specific patient segment.

A true solution partner should not only be able to help you craft a segmentation strategy, but have a service offering that facilitates the continued  growth, optimization, and automation of that strategy.


About the Author: April Wilson is the Director of Analytic Products at RevSpring. She uses her diverse data analytics background to help hospitals measure, optimize, and automate their patient communication effectiveness and RCM business processes.

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