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White Paper
Playing to Win in 2022 in Healthcare Finance: How to Tackle Lower Volumes, Higher Costs, and Big Competition

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Success Story
Innovative Care Management Program Avoids Nearly $16M in Costs and Transforms Lives of Super-Utilizers

Nearly 60 percent of patients who visited The Queen’s Medical Center’s emergency department (ED) in Hawaii were experiencing homelessness—and some visited the ED every day. A disparate number of resources went towards treating these patients, and they would have received better care for their needs outside the ED. To improve patient outcomes and reduce costs, The Queen’s Health Systems developed a program to improve outcomes for this unique patient population, leveraging its analytics platform, payer data, and patient flow data to evaluate the system’s success and efficiency.

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Insights
Deliver a First-Class Patient Experience with Five Financial Tactics

Healthcare organizations continually strive to improve each patient’s experience to ensure quality care delivery and qualify for financial reimbursements. Health systems try to optimize the patient experience through traditional methods, including better access and appointment reminders. However, organizations can improve the patient journey and deliver a first-class experience by taking a different approach—by targeting the following five aspects of the billings and collections process, providers can proactively inform patients about their financial expectations and avoid surprise bills.

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Insights
A Five-Step Audit for Peak Charge Capture Performance

As health systems strive for financial growth and stability in a pandemic and shifting healthcare market, leaders often overlook a key opportunity to maximize profit margins for services rendered—a charge capture audit. A charge capture audit takes a deep dive into the charge capture process, exposing root causes of costly errors and suboptimal processes. These five steps derive critical insight to help health systems apply interventions and restore revenue integrity.

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Success Story
Population Health Analytics Enables Improved Quality Increasing Revenue by Nearly $1M

Advanced payment models incentivize Accountable Care Organizations (ACOs) to deliver high-quality care and close gaps in care for members, thereby earning shared savings and increasing profits. However, in order to succeed and identify gaps in care, ACOs must be able to rely on solid data and analytics to avoid losing income that could be invested back into patient care. Utilizing its analytics platform and a quality measures solution has allowed Hospital Sisters Health System (HSHS) to close care gaps, improve ACO quality measures performance, and enhance reporting accuracy and effectiveness.

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