Stacks and stacks of paperwork analyzing the high turnover rate among patient access staff may be valuable for consultants.

But ask any patient access manager a reason for the high turnover rate, and his or her answer is simple: Staff members do not get paid enough, and they have a thankless job. "I think you have to pay them more," says Tracy Walsh, LCSW, director of patient access and case management at Vail (CO) Valley Medical Center. "I'm competing with Costco. We're asking them to be the face of the organization. We're asking them to do billing, medical records, data entry, and cash collections. And in addition to that, we ask them to be professional. And it's demanding. It's 24 hours, seven days a week. You've got a lot of unpopular shifts to fill."