Improve revenue and access to care with PwC and Salesforce

Health systems can be challenged to manage patient care access effectively, resulting in a higher cost structure and fewer patients

Our solution can help prevent patient leakage by managing both provider time and the moments that matter most in a patient’s care. This can include preventive insights, provider capacity recommendations and front door transformation. Combining these capabilities with a technology solution can enable proactive management and better patient-to-provider matches based on preferences and known clinical data.

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How patient access challenges affect health systems

New patient losses

Here, patients schedule but fail to attend their first appointment.

Unconverted referrals

The longer it takes a referred patient to schedule or attend their specialty referral appointment, the more likely it is they have taken their business elsewhere.

Failed shopping experience

This occurs when patients become frustrated with their experience while trying to find a new provider.

Excess costs

Excess costs for access operations can occur due to outdated technology, fragmented operating models, misalignment between the model and patient behavior, or a lack of actionable reporting.

Salesforce can be leveraged in a technology-enabled solution to identify and resolve these problems.

Common drivers of patient access challenges

Inefficient load balancing

Many health systems lack the business intelligence and technology to help staff manage schedules to remove holds and fill openings. Effective schedule management can reduce lag times by up to 50%.*

*Based on PwC client engagement work.

Insufficient time for new patients

A majority of electives in most health systems result from new patients, yet many specialists see 20 - 60% fewer new patients than their target,* often creating gaps in efficiency since new patients are at higher risk of abandonment.

*Based on PwC client engagement work.

Lack of process automation

Health care systems who have not deployed process automation often miss out on the potential for improved outcomes such as reducing referral distribution or navigation operational expenses by 25% to 40%* while improving referral conversion rates.

*Based on PwC client engagement work.

Fragmented operating model

Decentralized functions such as scheduling, template management and referral management can limit health systems’ ability to manage provider time, realize scale efficiencies, and deliver a consistent patient experience.

Complex template and scheduling rules

Inefficient scheduling practices such as overuse of blocks, delayed block releases, inappropriate session limits, fragmented scheduling rights and “side-of-desk” management can create unnecessary complexity. These challenges can lead to 7% or more* of provider time being lost, often delaying care and leaving patients waiting for months.

*Based on PwC client engagement work.

What capabilities can our solution enable?

When activated within healthcare environments, our human-led, tech-powered approach can:

Provide intelligent provider search and match for appointments incorporating EHR data and patient preferences

Our proprietary technology can: 1) identify optimal provider matches based on important factors such as appointment availability, geographic proximity, network affiliation, and patient preferences; 2) streamline referral processes with the enhanced user interface, designed to facilitate effective and prioritized referral management and 3) empower your organization with data-driven decisions and superior patient care coordination, helping you to enable a new standard in healthcare excellence.

Integrate referrals and consumer analytics to actively manage the network

Leverage our advanced PCP and Specialist dashboards to gain valuable insights into provider referral behaviors. View key performance indicators (KPIs) for referrals, which can be segmented by providers, service lines, and affinities. This powerful tool can help healthcare leadership make informed decisions, improve referral patterns and enhance overall service delivery.

Reduce network affinity degradation through automated referral audit tools

Programmable alerts set to specific engagement triggers help indicate divergences in provider referral behaviors and are used to track progress. Built-in processes and tools help evaluate engagement triggers and initiate service line audits. The Individualized Provider Dashboard can provide easy access to provider referral history for investigation.

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Matt Gretczko

Matt Gretczko

Principal, PwC US

Alex Marsden

Alex Marsden

Principal, PwC US

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