Rev Cycle Management

ACHIEVING REVENUE GOALS BY LEADING PEOPLE AND PROCESSES WITH TECHNOLOGY & CHANGE

OUR SOLUTION

• Led sessions to identify issues, collect data, and articulate the problem and opportunity statements
• Facilitated team and skill building to instill the need for problem-solving and change
• Defined metrics and weekly goals to meet cash requirements
• Put follow-up mechanisms in place to manage the Revenue Cycle processes while encouraging compliance with complete and accurate workflows

OUR IMPACT

• Increased Press Ganey Employee Engagement scores
• Reduced AR Days from the 80’s to the 50’s and AR Balance by over 30%, from $90m to $60m
• Received four-star rating by CMS
• Improved EHR documentation for accuracy and completeness
• Increased transparency and reporting mechanisms using a combination of vendor and client-generated reports & dashboards

THE CHALLENGE

• State and regional hospitals have different EHR, billing and reporting systems
• High percentage of Medicare and Medicaid patient payer mix
• Limited resources available for management and staff training
• Staff not using EHR system as designed, reverting to old/manual workflows
• Communication challenges existed between internal Revenue Cycle departments

Partnering for the Solution

HSi provided a senior-level, objective and knowledgeable resource to guide stakeholders on the need for improvement and change. Meaningful discussions were facilitated to identify the helping and hindering forces causing the existing challenges. By developing action plans to address the risks and leverage the opportunities, HSi helped the client to implement both qualitative and technical solutions through facilitated acceptance and involvement to ensure overall effectiveness. Having an expert-level understanding of the EHR’s capabilities along with the necessary data reflected in revenue reports, our client was able to request appropriate system changes and leverage the technology to help them achieve goals and objectives beyond what they initially envisioned. Paying attention to the organization’s interpersonal relationships, processes and structures allowed the client to accomplish financial goals while enhancing the departments’ working relationships and optimizing their technology and reporting tools. Our client can track activity and results over time to measure their operational effectiveness. By applying a balanced approach of focusing on people, processes and technology, the framework for increasing workflow proficiency and high performance is now being maintained through a replicable process.

Understanding the Challenge

Our regional health system client consists of Acute Care and Critical Access Hospitals along with clinics who belong to an overarching health system. With corporate on different EHR systems and the client needing to report data up to the corporate structure, our client needed assistance in USING the EHR system, comprehending the DATA and navigating the complicated waters of their inpatient and ambulatory billing system all while needing to feel competent and confident with their reported data. Performance goals were undefined and not measurable. Staff closest to the daily work didn’t know what was currently happening and why. Each hospital within the region defined their own workflows, processes and reporting needs. Even while working harder, tasks and goals were not being completed. Supplementing the overall problem, a knowledge deficit of the EHR’s features and functions were creating process problems and technical difficulties.

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