At one of our ophthalmology group clients, the group practice seems busier than ever, but they felt that somehow, they were not making more money. The leaders wanted to address this situation.
Upon engaging with them, we ran our analytics as a first step (always our first step).
After a brief analysis, it turned out that while the practice “seemed” busier than ever, in reality, they had the following issues:
- Low provider utilization
- Low equipment utilization
- Underutilized production capacity across offices
- Subpar return on investments compared to high monthly expenses (salaries, G&A etc)
Low provider utilization
The problem with low provider utilization existed because there weren’t enough appointments in a day. As a commercial practice that typically books patients for 15 min appointments, each optometrist was supposed to see 25-30 patients per day. However, there were never 25-30 appointments per provider per day. Average utilization was not even 60%.
On top of this, their patient population also had a pretty high no-show rate. No one had measured the no-show rate of the practice. We did a quick analysis of the no-show rates based on trailing 12 months. The practice was averaging 35% no-show rates.
This meant that for their ophthalmologists or optometrists to see and bill for 30 patients a day, they would have to book 45+ patients per day.
The solution was simple – our client needed more appointments booked per day.
Low equipment utilization
Our client also had several ophthalmic testing equipment in their eye care locations. We looked at the investments in all ophthalmic equipment that our client had made for testing purposes. Based on our analysis, those equipment never crossed a utilization rate of 25%. In other words, the return on equipment investment was sub-par.
There was no dedicated effort to book tests per day or per week. The equipment went underutilized. Meanwhile, the providers would direct their patients randomly during the day to get tests done (based on medical necessity). While testing patients for medical necessity isn’t an issue per se, it did require breaking the predefined workflow for the day. The ophthalmic technician would have to make the next patient wait while conducting the ordered tests on the current patient. This, in turn, delayed all future appointments of the day.
Net-net, there wasn’t really a system in place. We posited that instead of testing patients ad-hoc or on-demand, if the patients were scheduled on a separate day, this would improve the utilization of the equipment and at the same time, would also not delay the remainder of the patients.
Underutilized production capacity across offices
Our client had 3 office locations that were operational 9-3:30 PM 5 days a week. While that worked fine for some of the optometrists and ophthalmologists, the reality was that the real estate was being utilized for only 5-6 hrs per day. Meanwhile, a majority of the patients were not able to get appointments based on their preferences – after working hours. This was evidenced even further by the fact that early morning appointments were the highest in demand. Their front desk always got requests for late afternoon / after work appointments.
Looking at it from a real estate utilization point of view, our client would have been better served by keeping offices open beyond normal business hours. That way, they could have captured a lot of patients that wanted late afternoon appointments that did not force them to take time off of work.
All patients know that eye care appointments tend to be on the longer side – especially if your eyes are dilated. This, added to the facts mentioned above compounded the situation.
We proposed that as an immediate first step, the number of appointments per day be increased by at least 50%. This would at least address the provider underutilization issues. Nisos Health ran a “not seen in 6 campaign” and added 5,200+ recalled patients in 2 months (118% increase).
We started by attaching our EzHealthCRM to our client’s EMR. This allowed us to define segments of patients that were “not seen in 6 months” very easily. Once we had that defined, we divided our patient segments further. This allowed us to separate the patient mobile numbers from the landline numbers. After this, we created campaigns in our EzHealthCRM software and executed them via web texting and calls from our patient contact center.
We assigned all those patients to our patient contact center agents using EzHealthCRM. The first step that our patient contact center agents took was using our EzPatientEngage software. They sent automated, yet personalized SMS blast and left automated personalized voicemails. In addition to this, they called each patient as well.
Overall, the strategy was executed such that each patient was contacted 4 times per month – either via SMS, automated voicemail or a call.
Results? Our client saw a 118% increase in appointments within 2 months