COVID-19 has resulted in an unforeseen and dramatic drop in revenue for U.S. hospitals. In some instances, upwards of 60% of visits have been cancelled or need to be rescheduled. It is evident that health systems must become proactive to ensure they have the greatest chance of bouncing back quickly (and having a V-shaped financial recovery) but also to ensure their patients receive the care they need, when they need it.
Recent Developments
One way organizations have attempted to be proactive over the past number of weeks is by quickly rolling out telehealth strategies to ensure continuity of care. However, not every visit can be done virtually. As we look ahead, many warn of the onset of a huge bottleneck of appointments due to recent events. This is likely to result in unparalleled demand and pressure on health system’s resources and facilities.
With this on the horizon, we must think about the future of patient access and our approach to revenue cycle activities. Having worked for over 35 years in patient access, primarily in the design and implementation of Electronic Scheduling Protocols in Epic, I believe there are several key approaches that health systems should consider as they look forward.
Key Approaches:

To increase capacity in the months ahead, organizations have options: they may expand schedules by opening their practices on weekends and evenings, utilize their APPs (Advanced Practice Providers) to the top of their licensure, adopt group appointments, and reduce administrative and/or research time.
In order to eliminate or reduce time spent on reviewing a provider schedule to determine which patients could be seen virtually and/or by an APP, you should consider developing algorithms to support your scheduling teams to make the determination. This not only assists during this unprecedented time but will increase efficiencies into the future. The process of making this choice should be led by a working group that can identify future optimal templates, which may result in a reduction in visit type lengths.
Pre-Access Administration:
Undoubtedly, template optimization efforts should be further supported by an organization’s pre-access administrative function. . Administrators should be given the tools and technologies to help reduce no-shows, ensure scheduling accuracy, reduce denials and to secure authorizations in a timely manner.This function has now become more critical than ever, as organizations attempt to recoup lost revenue.
This may be achieved by deploying an innovative approach to support models. For example, training, quality and workforce management, all of which can help to ensure administrators have the tools and knowledge necessary to succeed. Leadership may consider new strategies by extending hours of operation to include scheduling appointments during evenings and weekends, adopting proactive outreach programs to let patients know that you are open for business and/or appointment confirmation to assist with decreasing no-show patients.
Formulating an effective plan will help organizations alleviate revenue gaps and set themselves up for strong future financial performance.

Dana Cameron is a Senior Consultant for RelateCare. Prior to joining the company, Dana worked at the Cleveland Clinic for 35 years as Lead Systems Analyst, instrumental in the design and implementation of Electronic Scheduling Protocols. Currently, Dana is Lead Designer for RelateCare where she leads complex change management projects centered around coordination of care models with emphasis on patient access. Dana’s areas of expertise encompass optimizing patient access pathways, process mapping and designing future state, streamlining scheduling practices and data analysis. She holds various Epic certifications.