Gastroenterology Coding Alert

Tip: Keep a list of patients with chronic patients who don’t have upcoming appointments.

If you’re like most gastroenterology practices, you’ve likely heard from a fair share of slick digital marketing consultants who are trying to sell you the latest and greatest ways to attract new patients. Don’t take this bait until you tap the full revenue potential of patients already established with your practice.

There are certainly lots of reasons to invest in marketing tactics that go trawling for new patients. You may be a brand new practice, for example, or you may have opened a new location. Even if you’re an established practice, you may occasionally need to find new patients to quickly fill up the schedule for an associate who has just joined. But if you’re like many practices, you could benefit from a marketing strategy called patient reactivation.

Like most medical practices, you probably have a few hundred patients in your database who suddenly stopped scheduling appointments “even though they have conditions which should be reassessed every several months or take chronic medication and should be monitored for drug related side-effects,” says Michael Weinstein, MD, president & CEO of Capital Digestive Care, Silver Spring, Md. These dormant patients represent untapped revenue, and if you could find a way to bring them back to your practice, you’d capture an instant growth opportunity.

1. Patient reactivation costs less than attracting new patients.

Estimates vary widely, but there’s no doubt that it costs more—at least five times more, according to a recent Harvard Business Review article—to attract a new patient than it does to keep an existing one. Reactivation is like harvesting from your own orchard, rather than finding land, planting seeds, and waiting years for the trees to grow. And adding a patient reactivation strategy will save you more than just money. Even the simplest marketing strategy takes time and effort, which your busy practice may not have. “We began looking at ways to increase patients through marketing, but this would take months to have a real benefit,” says Anne Pointer, a practice administrator in St. Louis, Mo. When her practice decided to focus on reacti­vation instead, “within the first month we saw 35 reactivated patients for much less than any marketing plan,” she says.

Pointer runs an eye care practice, so her patient reacti­vation strategy focuses on contacting patients who have missed the glaucoma checks they should be getting to maintain healthy site. Her reactivation service queries her practice’s EHR for ICD-10 codes that indicate diagnoses that have regular checkups in their clinical guidelines.

Most specialties have established patients who should be seen regularly to monitor chronic conditions or reduce the risk of a disease going undetected. For example, a reacti­vation strategy for a gastroenterology practice might query the EHR for patients 50 years or older or those who are at risk for colorectal cancer to make sure they are up to date on medically necessary colonoscopies. Or, a query may examine diagnosis codes for celiac disease, IBS, or other chronic conditions and then cross check the medical record to make sure the disease is being managed properly and that the patient has made the necessary follow-up appointments.

Tip: Compile a list of patients with specific diagnosis codes that have not been seen lately and do not have an upcoming appointment. Then contact that patient and explain that they were diagnosed with an issue that requires regular monitoring by a doctor and to please get in touch with your office (and be sure to document that you made contact). Pointer’s practice uses software and a call center to accomplish this, but you can do the same thing manually if you have the time and staff bandwidth.

Two additional benefits: You’ll find out if a patient is continuing care with another practice. If that’s the case, you can note it in your system and move on. It also sends patients the message that you care about their health, first and foremost, even if they don’t plan on returning to your practice.

2. Patient reactivation potentially boosts revenue.

Reactivating dormant patients does more than fill your schedule with those that have simply forgotten to keep up with their care. Sending recall notices towards the end of the year reminding patients to use their benefits works, so take it a step further. The rise in high-deductible health plans (HDHP) can open up opportunities for you to engage with dormant patients—and get high revenue returns. Some patients in their early 60s delay important (but not urgent) services because they haven’t met their deductible and will have to pay out of pocket. When they become Medicare-eligible, cost is no longer a factor. Your reactivation strategy should include running a monthly report on your EHR that identifies all patients who are 3 months younger than 65 (when they’ll become eligible for Medicare). Reactivate these patients, and you’ll enjoy high returns on that patient pool.

3. Patient reactivation prepares you to thrive financially under MIPS and other value-based reimbursement models.

By reaching out to patients who have fallen off the radar, you promote better patient population care – which CMS will reward. Instead of waiting for a patent to call on their own when they have a major issue, reactivation will allow you to provide better care on a more regular basis. Your EHR and PM system should allow you to target the patient type you want to reactivate by diagnosis and time-frame.

A reactivation strategy will also help you thrive with MIPS and quality-based payment systems. Remember, your MIPS scores will eventually show up in CMS databases and in searchable sites for beneficiaries like Physician Compare. And if you don’t participate much in Medicare, you’re not exactly off the hook—private payers will follow Medicare’s lead, as they always do.

4. It will reduce your risk of malpractice.

Many conditions require ongoing care. If you don’t make every attempt to provide that care, you could be held liable for any adverse outcomes a patient may have. A patient reactivation strategy can lay the groundwork for better documentation—proof that you attempted to reach the patient.

Should You Outsource Reactivation?

In today’s practices, overburdened staff often doesn’t have the time to deploy a consistent reactivation strategy. “We always planned on compiling a list and contacting each patient, but the day-to-day of the practice always pushed it to the back burner,” says Pointer. “When we look back, we never routinely contacted patients to attempt to reactivate them.”

If you choose to outsource your patient reactivation strategy, it can free your staff from the constant details of recalls, the revenue drain of no-shows, and time spent on administrative details like appointment reminders. They’ll be free to focus more on face-to-face communication with the patients in your office, and to attend to higher-level patient engagement tasks. “It was too hard to follow up on each patient and the number of times it took to reach them,” Pointer relates. “We were calling patients 5-7 times before reaching anyone to schedule an appointment.”

There’s a variety of third-party services on the market today that will assist you with planning and executing a reactivation strategy. If you’re looking for one:

• Seek a service that employs real, live people, not one that makes robo-calls.
• Look for a call center specific to your medical specialty.
• Pay attention to how you’ll be charged. Pointer’s practice is only charged if and when the reactivated patient shows up for the appointment.
• Verify communication. Any third-party service should be sending you reports of who was called and what the results were. They should let you know if a patient has switched practices, moved, or confirmed that they won’t be returning to your practice.