Digital plus human ingenuity helps value-based care client streamline outreach for rapid growth
The Challenge
When a major physician-led value-based care organization began searching for a partner in early 2022 to help create a scalable, world-class clinical contact center to accommodate growth, they chose EXL Health. Our expertise in call center operations, experience in mitigating outsourcing risk, and deep domain experience contributed to their decision.
Prior to awarding EXL the work, the client was in a rapid expansion mode, expecting to hire 45 FTEs to serve in contact center, coding, and data entry positions. The organization would also require a robust, digital data management platform to automate workstreams and support analytics going forward. Due to timelines dictated by Medicare, the entire ramp-up would have to occur within six months.
The Solution
EXL quickly assembled resources to address the client’s needs on several fronts. We conducted a current-state process and technology review to identify needs, gaps, and opportunities. Based on the findings, we developed a technology roadmap and began recruiting, training, and nesting a skilled clinical and administrative staff leveraging our proprietary Healthcare Academy. Our initial team included 10 FTEs for call center support to start, with a small team of coders, and four RN-quality review nurses to assist in audits.
Outcomes
The program went live in January 2023. The technology changes implemented since the program began have leveraged human ingenuity across the client’s clinical engagement spectrum and contributed well to a positive work culture. Initial results include:
- Overall increase in patient care gap closure
- Exceeding expected chart reviews per day
“The quality of work that the EXL team has provided is outstanding, with their audit scores consistently in the 93-100% range.”
– Clinical Operations Manager, Leading U.S. Physician-led Value Based Care Organization
In all, the client has achieved the desired scalability and lift they anticipated from their investment and remains poised to embrace rapid growth for the practice moving forward.
To learn more about EXL Health or to start a discussion, please visit EXLservice.com/health.