Clarifire Conversations

Three Patient Experience Leaders walk into a restaurant.  The waitress asks, “What are you having today?” They all responded in the same way, “I’d like the Patient-Centered Culture, Service Excellence, and Real-time Technology.” The waitress looked perplexed.

If only these items were made to order like a great meal at your favorite restaurant.  Creating a positive patient experience would be easier for large healthcare systems where value-based models are driving structure, profit models and clinical standards.

Earlier this year, the mortgage industry anxiously awaited the final confirmation of industry veteran and former Federal Housing Administration (FHA) Commissioner Brian Montgomery. Montgomery is well versed in FHA issues and brings deep industry expertise to a role held vacant for too long. At a time when servicers have a real opportunity to effectuate organizational change through innovation, Montgomery may be just the ally needed in 2019.

Rounding has proven to be an effective practice in determining the level of patient satisfaction and improving the overall patient experience.  Many organizations will purchase a rounding solution to support and analyze rounding activities. Did your organization make the investment, but you haven’t seen an increase in HCAHPS scores?  Were you able to sustain the scores from previous years?  If you answered no to those questions, does that mean you bought the wrong solution?

Industry experts say mortgage servicing is a “bright spot” for mortgage revenues. While slowing home price growth and compounding interest rate hikes may be challenging origination profits, mortgage servicing appears to be benefiting from the current landscape. This environment offers an incredible opportunity for mortgage servicers to invest in retooling and retrofitting their solutions, compliance and rules systems. Putting revenue to work in technical infrastructure also adds scalability and efficiency that can be leveraged when the market changes for the worse.  With many predicting a possible recession at the end of 2019 these benefits may be realized sooner than we think, and will help avoid having to staff up or add manual processes if the landscape changes faster than servicers can effectively respond.

Mortgage servicers, who continue to face scrutiny from oversight agencies, may have even more on their plate in the new year.  The Bureau of Consumer Financial Protection (BCFP) examiners continue to identify errors in servicer handling of trial modification conversions. The issue was significant enough to gain mention in the BCFP’s most recent Supervisory Highlights report and will almost certainly remain an area of focus during future supervisory examinations. Being subjected to penalties, fines, or even enforcement action can be extremely costly for servicers.  Conversely, errors in loss mitigation workflow can be easily avoided with the right workout rules management and automated workflow approach.

HCAHPS – who knew that six letters could have such an impact on an organization? Low HCAHPS scores can result in a  loss of revenue, an unfavorable reputation in the community, public reporting of unsatisfactory scores, and potential downsizing of programs and/or employees.  Are your patient satisfaction scores lower than you expected?  It’s time to take a look at the consistency of your nurse leader rounding.

The Federal Deposit Insurance Corporation (FDIC) is the latest regulator to express concern over the rise of nonbank servicing. For nonbank mortgage servicers, the growing attention from regulators and other industry stakeholders, that  include Ginnie Mae, whose concerns we spotlighted recently, could mean policy changes are on the horizon, as well as heightened scrutiny of rules and operational processes that align  with mandated metrics.

Servicers should expect to face tougher scrutiny from Ginnie Mae in the coming months and year ahead. As the interest rate and lending environment has evolved, the government-backed mortgage-backed security (MBS) guarantor has expressed increasing concern with liquidity management. Agency representatives have hinted at new standards, tougher evaluations, policy changes, and credit ratings in the works. With enhanced oversight seemingly imminent, servicers should ensure they have existing requirements under control and be prepared for a ramp up in associated agency rules, operational disruption, and the need for workflow automation.

Has the following situation ever happened at your hospital?  A patient, named Bob, comes in for heart surgery over 20 years ago.  Since then, he comes in as needed for “tune ups”.  Over the years, Bob has become very familiar with his care team.  It’s now that time for Bob to come in for his latest procedure.  When Bob arrives, his care team discovers that due to an error in ordering that they didn’t have the right supplies in the room for him.  The care team could not provide Bob with the care he needed, in that place, at that time.

Improving Patient Experience remains top of mind for most healthcare executives, but strategies and best practices are still being discovered and vary between organizations.  Two evidence based strategies often used to increase low patient experience scores are Hourly Rounding and Bedside Shift Reports.

The Federal Reserve has given mortgage servicers a long and gradual runway to adapt to the realities of a higher interest rate environment. As consumers experience an increasing cost to carry debt, are faced with the inability to refinance into a lower interest rate mortgage, or find themselves faced with an increasing adjustable rate mortgage payment, we can expect to see a rise in delinquency, default and loss mitigation activity. 

Interest rate increases, natural disasters, and seasonal changes can cause dramatic swings in delinquencies, oftentimes making it difficult for servicers to accurately forecast an uptick in foreclosure volume ahead of time. An annual September spike in mortgage delinquencies is one of the more predictable industry trends; however, this September’s figures, which were published a few weeks ago, may have caught some servicers by surprise, and could indicate a hefty ramp up in loss mitigation efforts is on the horizon.

Tis the season for cooler temps, pumpkin spice, time spent with friends and family….and the flu.  It’s the dreaded three letter word that we all want to avoid this season. According to the CDC, over 80,000 Americans died of influenza and its complications during the 2017-18 season.¹  This surpassed a previous recorded all-time high dating back more than three decades at 56,000 deaths.²

Nearly 21,000 U.S. healthcare organizations and programs are accredited and certified by The Joint Commission, making it a recognized symbol of quality nationwide.  It’s their vision that providers deliver safe, quality healthcare at the best value for all.  They determine this through regular, unannounced accreditation surveys¹. Think the comprehensiveness of a final exam with a pop quiz schedule.  How do you cram for that?  You don’t.  You plan!

Is hurricane season over? Not if you’re a loan servicer. Given the skyrocketing amount of devastation caused by hurricanes, wildfires, flooding and other natural disasters, loan servicers are faced with developing a complete process for relief that begins when disaster strikes. Historically, disaster relief was an infrequent and isolated issue, allowing servicers to manage assistance on a manual, ad hoc or one-off basis. In today’s environment, the volume of natural disasters, the geographic breadth, and extent of recent changes to investor requirements, make this approach a risky venture.

There are many issues defining the landscape of healthcare for 2018. According to the PwC Health Research Institute, strategic patient experience and tackling the opioid crisis are among the top 12.¹ Opioid use has been a hot topic of concern for decades. However, with the latest staggering statistics on opioid addiction and related deaths, finding a solution to the crisis has come front and center.

With the rise in value based models driving hospital reimbursements, a patient’s perception of care can have an impact to a hospital’s bottom line. There is concern that in tackling the opioid crisis there could be a negative impact on survey scores. So how do healthcare providers handle these two issues when they become competing priorities?

What does it mean to be disaster ready? As a servicer you’re already juggling a variety of change initiatives at any given time, with unreasonably thin margins and minimal resources. Beyond basic system enhancements to your loan servicing system…

The end of this year’s hurricane season is less than two months away; however, with hurricane Florence barely in our rearview, are your operational processes in check to meet disaster relief requirements? If not, they should be.

Last year’s federal aid for natural disasters was nearly tenfold that of the previous year. Hurricanes Harvey, Irma and Maria alone are said to have affected approximately eight percent of the population in the U.S. The Federal Emergency Management Agency (FEMA), who provides assistance in the event of all natural disasters, reported that more than 25 million people were impacted by hurricanes, flooding, or wildfire in 2017, and close to five million households applied for FEMA’s Individual Assistance program requesting direct support.

One can only begin to imagine how many homeowners have contacted their mortgage servicer for information and participation in relief programs. Although the servicers' phones start to ring as soon as there’s a Presidential Disaster Declaration, the real test of readiness occurs when borrowers are unable to make payments and need to understand their options for financial assistance.

Waking up each morning after a restful night’s sleep, is a great way to start the day.  You’re energized and ready to tackle what comes your way.  However, if you are a nurse leader the stresses of the job may make getting a good night’s sleep a little harder.  We’ve asked nurse leaders what’s keeping them up at night and here’s what we’ve heard.

Despite the fact that OAS CAHPS are still voluntary, their eventual mandate could be right around the corner.  To achieve top scores, it’s not as straight forward as just focusing on clinical outcomes.  When patients are looking at where to have a procedure, they are looking beyond just competency.

While nearly all government-backed mortgage guarantors provide a wide range of disaster relief programs, perhaps none are quite as unique and diverse in their offering as the Small Business Administration (SBA). Most mortgage lenders and servicers have been working hard to stay abreast of updated disaster relief requirements for Fannie Mae, Freddie Mac, the Federal Housing Administration (FHA), the Department of Veterans Affairs (VA) and the US Department of Agriculture (USDA), but not as many are aware of the extensive options available to SBA customers, not to mention that the SBA administers their programs directly.

The roots of patient rounding can be traced back to a medical center in Birmingham, AL in the late 1980s². After many years of this concept in practice, studies have shown that it has a direct correlation to improving patient experience. With patient experience scores having an impact on hospital revenue, conducting daily patient rounding is becoming a priority. However, simply completing the round isn’t enough.

Two years ago, the Bureau of Consumer Financial Protection (BCFP) finalized an expansion of successors in interest (SII) protections as part of a larger package of new mortgage servicing rules. While the majority of the final rule required implementation last year, the successors in interest provisions only took effect a few months ago. The BCFP completely re-envisioned the coverage of SII and it is imperative mortgage servicers understand their extended compliance responsibilities in order to avoid having costly errors uncovered in regulatory supervision.

Just last week, Freddie Mac issued a press release advising mortgage servicers to prepare to assist borrowers whose homes or places of employment were impacted by Hurricane Florence. Likewise, they directed homeowners to pursue disaster relief once out of harm’s way. Freddie Mac said, “We strongly encourage homeowners … to call their mortgage servicer … to learn about available relief options,” adding, “we stand ready to ensure that mortgage relief is made available.”  

Post-discharge calls aid in safe patient transitions, help prevent readmissions, and improve patient satisfaction.¹  In addition, academic studies show that there is a positive correlation between post-discharge calls and HCAHPS scores.² Furthermore, a study from the Beryl Institute shows that advanced analytics can provide robust information allowing hospital systems to take actionable steps for operational improvements, resulting in improved patient outcomes.³ Based on these findings, we know that post-discharge follow-ups are a key part of not just the patient experience model, but the entire continuum of care.