Answering the Call To Streamline Costs While Enhancing Our Services
It started with a simple question: Who do we use for answering services?
Medical answering services are third-party contractors that handle patient calls outside of regular office hours, with specially trained operators who can route urgent inquiries to on-call providers. Prior to our journey to become a truly unified healthcare system, Mass General Brigham hospitals’ ambulatory groups rarely coordinated with each other as they pursued and negotiated contracts with these vendors.
As a result, a seemingly simple question — how many answering services vendors are we using? — revealed a complex landscape. As a systemwide team would come to learn, Mass General Brigham has active contracts with 18 different vendors for medical answering services across our member organizations.
Some contractors are small, mom-and-pop operations. Others are more robust call centers. Most focus on managing calls and relaying messages during nights, weekends and holidays. Some hospitals use multiple answering services vendors.
Not only is the current arrangement needlessly convoluted, but it also contributes to an inconsistent experience for patients and clinicians alike.
“There’s no reason we need 18 different vendors for what is essentially a commodity,” said Cortlandt Montross, MHA, executive director of Operations Optimization for Mass General Brigham Medical Group, who leads the team working to streamline answering services across the system.
The initiative is part of Sustain, a systemwide portfolio focused on helping us achieve our sustainable financial performance goal by optimizing the way we work through resource stewardship and continual process improvement.
Although negotiations are still underway, the team expects to reduce the total number of answering services vendors from 18 to less than five companies — a move that will enhance patient experience and yield several key service improvements along the way.
To achieve this, Montross enlisted the support of systemwide colleagues with call center expertise to better understand what qualities ideal vendors would possess.
“This was where someone like John Gardner, senior director of the Patient Referral Service Center at the Brigham, was so helpful to have on the team. He really helped us understand how to properly evaluate the performance of a service like this” Montross said. “This included things like abandonment rate, which is how often callers hang up, and other quality metrics. Through this process, we found out some of the vendors could not produce the quality metrics we were looking for.”
Sandy Skinner, director of the After Hours Call Program, shared valuable insights regarding the quality and safety components, Montross added. Having an answering services partner who understands the importance of this and has specific capabilities was also a consideration.
The team also tapped the expertise of Mass General Brigham’s Third-Party Risk Management and Digital teams to vet vendors’ approaches to business continuity — that is, how they prevent and respond to service outages — and information security. If the teams identified gaps, they asked prospective vendors to implement changes to bring them into compliance with Mass General Brigham’s requirements.
In addition, consolidating these contracts will net an anticipated $400,000 in annual savings for the system.
“Including our own subject-matter experts from across our system is really what has made this project so successful,” Montross said. “Everyone had the system’s best interests in mind, and that’s truly one of the tenets of Sustain.”