Finding $5.7 Million with a Healthcare Data Warehouse

Recapture billings with a healthcare data warehouseWith the rising cost of health care, government-imposed mandates to demonstrate quality care, and ever-decreasing reimbursement rates, hospitals are finding themselves in need of creative ways to increase revenues.

Minnesota-based North Memorial Health Care is no exception. The organization’s “creative way” is to focus on analytics–what it believes will be the key to financial viability in today’s healthcare landscape. Time and again, when faced with a need to improve a process, North relies on data from its data warehouse.  The most recent application of data leverage happened to be within the revenue cycle, namely professional billing.

North leadership was certain charge capture of professional services could improve.  One on hand, physicians felt that captured charges underrepresented services rendered, while, on the other hand, professional coding resources felt overwhelmed by the manual effort to identify and capture charges. The healthy tension among these varied perspectives culminated in the formation of a workgroup tasked with process improvement for professional billing.

In April 2013, Health Catalyst partnered with North Memorial to develop the Health Catalyst Professional Billing Advanced Application built on our Late-binding Data Warehouse platform.  The application automates data capture previously done manually by the coding staff.  The development process was completed in six weeks. The solution is a perfect marriage of technology supporting workflow processes to become a natural part of billing.

The results to date include:

  • 6% increase in notes that had sufficient clinical data for billing
  • 25% improvement in professional coder efficiency, and
  • A potential to reclaim more than $5.7 million over the next three years.

J. Kevin Croston, MD, chief medical officer at North Memorial, commented that the organization selected Health Catalyst in part because Health Catalyst’s systems are built on open architecture that’s easily customizable. But the hospital’s manager of professional coding, Nancy Young, has a different takeaway; Young feels that she finally has the tools she needs to really get her job done.

While I’m pleased with the results listed above, what I find even more exciting are future additional benefits. The automation of manual data provisioning frees up time for Young and her staff to work with physicians to improve the clinical documentation process through education. The application allows Young to work directly with clinicians to show them the volume of clinical notes that go unbilled due to insufficient clinical documentation. Armed with trusted information, Young and team can analyze inefficiencies with documentation so they know where to focus the next effort of improvement. This improvement effort channels the former tension into a powerful symbiotic energy between executives, clinical staff, and professional coding staff.

Click here to read the whole story about how North Memorial Hospital is using the Health Catalyst Late-binding™ Data Warehouse and Professional Billing Advanced Application to reclaim previously unbillable charges.

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