September 5 , 2003

PACE project rolls out to
four pilot sites

In recent months, the Patient Administrative Cycle Enhancements (PACE) project reached a major milestone, as four pilot or beta sites were rolled out using the new PACE model for outpatient registration and referral processing. The PACE model is a redesign of the front-end outpatient procedures to provide better customer service to patients and reduce payor rejections related to outpatient registration, eligibility and referral issues.

The four beta sites for the PACE rollout are Pediatric Surgery, the Orthopedic Hand Clinic, Cardiac Unit Associates and several sections of Internal Medical Associates. Nancy J. Gagliano, MD, vice president of Physician Practice Management and Service Improvement and one of the project's senior leaders, characterizes the beta tests as largely successful - with some important lessons learned. "On the whole, we were pleased with what the beta site data showed us," she says. "Office staff
are comfortable with the processes, and referrals are being made and recorded with greater accuracy."

An important part of the beta site rollout process was incorporating the use of a centralized contact center. Called the Registration and Referral Center (RRC), the contact center staff handles transferred calls from practice staff to verify patient insurance and demographic information, as well as processing referrals in advance of patient visits. The goal of the RRC is to reduce the workload of practice staff and ensure that accurate patient information is available for billing.

According to Diane Gardner, manager of Registration Services, with the four beta sites the RRC staff has processed a weekly average of 2,000 patient registrations and 600 referrals. They have received an average of 516 inbound calls and have made 994 outbound calls. And 97 percent of the calls are taken within 16 seconds, which exceeds the team's goal of 90 percent.

" The interaction between the practice staff and the RRC has been very good during the beta launch," says Gardner. "We are very pleased with this collaboration. We've also received positive feedback from patients during these interactions."

From the rollout of the four beta sites, PACE project staff members have recognized some opportunities for improvement. For example, the rate of calls transferred from practices to the RRC at the time of appointment scheduling could increase so that the RRC staff can process the patient registrations and referrals before a patient arrives at the office. Ensuring that referrals are in place, checking insurance and patient information for accuracy, and accounting for multiple insurances help reduce some of the administrative wait time for patients as they check in at practices.

The next steps for the PACE project include moving the RRC from its temporary quarters in Ruth Sleeper Hall to state-of-the-art facilities in Medford and rolling out the PACE model for all MGH and MGPO practices and ancillary areas. The PACE implementation is expected to be completed June 2004.

For more information about the PACE project, send e-mail to PACEproject@partners.org