One-to-one assistance boosts charity applications

Department: Patient Financial Services, Oakland Medical Center

Value Compass: Service, Affordability 

Problem: In April 2011, the department had a low 58 percent completion rate for financial service forms, which are given to patients who can’t afford treatment. The forms are used to apply for charity care through the Community Benefit program. Qualifying patients are referred to Medi-Cal. 

Metric: Percent of forms completed and amount of charitable care awarded. 

Union co-lead: Angelica Hernandez, Intake Clerk, member of OPEIU Local 29 

Management co-lead: Paul Coates, manager of Patient Financial Services 

Small tests of change: The team observed that shift changes often led to incomplete or unfinished forms because incoming financial counselors couldn’t always understand the notes of outgoing counselors. Sometimes patients were discharged before the forms could be completed. UBT members agreed on a uniform note-taking system for every patient, reducing confusion. In addition, a financial counselor was assigned to every patient referred to the Financial Services Department. The counselor tracked the patient’s forms until they were completed. 

“We decided to make sure we touched every single patient that was uninsured or underinsured,” says Paul Coates, the department manager.   

“It helped us, and it helped patients rest because we didn’t need to visit them as often to ask about their forms,” notes Angelica Hernandez, union co-lead. 

Result: Form completion rates have steadily increased to 98 percent, which has held steady from June 30 through December 2011. The department is on track to easily meet its goal of awarding $6.275 million in charity care for 2011. 

Next step: The department already has started teaming up with the Admitting Department to help it meet its goals for connecting patients with financial services. Admitting staff email or call the Financial Services Department as soon as they know a patient can’t pay for care, and counselors meet with the patient. 

“We are pleased with the way it’s working; we’re branching out,” Coates says. 

In recognition of their efforts, Coates and Hernandez were invited by Kaiser to attend an Institute for Healthcare Improvement conference in Florida in December 2011. Hernandez couldn’t attend, but a co-worker went in her place. They’ll report back to the department on what they learned, and what they taught others. 

Biggest challenge: Building trust within the nine-person UBT took time and sensitivity, Hernandez says. The UBT was formed about 18 months ago. “There’s a lot of communication, everyone throws in their ideas, and we agree on which ones to try,” she says. “At the next UBT meeting we ask, ‘Did this work?’ If the thumbs-up vote says yes, then we stick with it.” 

Side benefit: Good departmental communication spills over to every aspect of work, with employees helping each other out in numerous ways, Hernandez says.