A Vitalware Case Study: Midland Health

A Move to Outstanding Mid-Revenue Cycle Efficiency

Midland Memorial Hospital was established by prominent community leaders with one mission: “To make quality healthcare available to all residents of Midland County, Texas.” The hospital opened its doors on July 11, 1950, as a community-owned 75-bed facility, serving the nearly 22,000 people who resided in Midland County.

In the decades that followed, Midland expanded its reach and versatility to meet the needs of a growing, dynamic community. The center now boasts two different locations and around 500 beds. Midland remains committed to West Texas friendliness, community, and healthcare delivery while being careful stewards of their resources.

Their aim is still the same: to make the Midland community the healthiest in all of Texas. To achieve this goal and continue delivering high-quality care, Midland Health holds all facets of its operation to the highest standard — including revenue integrity.

Revenue Integrity Goals

Rhonda Lupardus, Chargemaster Reimbursement Manager at Midland, summed up her revenue team’s biggest challenge concisely: “For me, it’s charge capture, all day long.” For Rhonda and Midland, this means:

• Finding root cause solutions to multi-cause revenue integrity issues
• Improving charge capture results across the facility
• Achieving significant reductions in re-billing and claim rejections
• Becoming more self-sufficient (and effective) with pre-bill analysis

“For me, it’s charge capture, all day long.”

Rhonda Lupardus, Chargemaster Reimbursement Manager, Midland Health

Making the Move to Vitalware

A demonstration of the Vitalware® by Health Catalyst® revenue integrity and chargemaster solutions made a convincing case for Midland to make a change. The comprehensive approach to data and unified workspaces for key processes were especially compelling. Midland was now enabled to pursue a more aggressive and focused approach to charge capture while staying with their same EMS provider, but with a new foundation for their mid-revenue cycle. VitalCDM, VitalKnowledge, VitalAnalysis, and the Vitalware team were there to help them meet their goals.

A Smooth Transition

The learning process is the first concern when transitioning from one set of revenue cycle tools to another. Will new users be able to pick it up quickly? Will veterans adapt to new views and methods?
Midland quickly discovered that Vitalware was very user-intuitive. It made sense for the end-users. The Midland team was able to view the software and know what they needed to do. “The solution is user-friendly, you can understand right away what you’re looking at — it doesn’t require its own Master’s degree,” added Rhonda Lupardus.

“Of all the implementations I’ve done, this was the smoothest yet.”

Rhonda Lupardus, Chargemaster Reimbursement Manager, Midland Health

In addition, whenever questions arose during the transition, Vitalware personnel were on call for immediate support. Just one phone call was all that was needed for answers, and in many cases, additional time-saving guidance.

The Midland team characterized early wins as “low hanging fruit.” But now the hunt is for more complex, multi-cause issues that require collaboration and corrections outside their department. As progress is made, the team expects the returns to continue to be substantial.

Customizing the Workspace

The ability to customize Vitalware’s products and tailor views to the needs of Midland’s teams and individual users has been a huge asset. With the customization afforded by the Vitalware tools, Midland Health can do things “their way” rather than adapting to the tool’s way. Moreover, the flexibility and depth of their new tools invites new options for “their way” to continue to evolve and improve.

“We were able to accomplish a lot very quickly, but now we’re learning even more about the capabilities, so we’re going back, and tweaking to get things exactly the way we want them…so it was good and it’s getting even better.”

Rhonda Lupardus, Chargemaster Reimbursement Manager, Midland Health

A Unified Med-Revenue Cycle Solution

One key to Midland’s sustained success is the comprehensiveness of Vitalware tools. Comprehensive, but according to Midland personnel, also unified on a single platform. VitalCDM (chargemaster), VitalKnowledge (regulatory information), and VitalAnalysis (charge capture) all work together in sync, and helps the Midland team do the same.

Another key to success is the solution’s ability to consume 100% of charge and claims data. Once fully consumed, the data is used to provide better workspaces and context-sensitive cues, as well as flexible workflows, to assure work gets completed by the right folks at the right time.

Better Edits — beyond the basic edits already in Midland’s clearinghouse. They now have the ability to look back at their build and make sure things are correct. For example, they caught, and fixed, a transposed HCPCS that took what they knew should be a catheter, and made it into a cardiac stent.

Improved Data Views — the Vitalware platform allowed Midland to add triggers and targets to their downloads, providing immediate visibility to a path of remediation — removing the hassle of going back to research the claim.

Pre-Bill Analysis — Midland tested Vitalware’s solution side by side with their clearinghouse and discovered they could gain significant efficiency by running the Vitalware pre-bill analysis beforehand. Obtaining the draft 837 from Cerner before it hits the scrubber allows for a comprehensive pre-bill analysis. Now Midland is getting ahead and cutting down on rebills and rework.

Scorecard Data Shows Success

Midland Health’s results using their Vitalware solution are in and highly favorable. Their mid-revenue cycle VitalAnalysis two-month scorecard demonstrates:

• Monthly Gross Identified:
  $1,565,772
• Monthly Net Identified:
  $308,268
• Cumulative Gross Identified:
  $2,935,407
• Cumulative Net Identified:
  $583,898

Outstanding Support

A proactive, responsive support team has played a key role in the experience and success for the Midland team. A regular weekly session is scheduled to touch base and share progress, and to answer any questions that have come up. But the Vitalware team is always on call and their demonstrated knowledge and experience ensures answers are obtained. “They’ve been able to hop on the phone right away and go to work with us on any issue,” Lupardus shared, “that availability, and timeliness, together makes a real difference. Combined with the ease of use of the tool, I find myself ramping up very quickly.”

“Whenever we’ve had challenges, the team has been there to support us…just one call and I can get the answers I’m after.”

Rhonda Lupardus, Chargemaster Reimbursement Manager, Midland Health

A Winning Partnership

The strong partnership between Midland Health and Vitalware has created a path to better mid-revenue cycle efficiency. Midland values innovation and embraces change to support the health and well-being of their growing community. And the improvements to this financial piece of their business have allowed Midland to pursue their established goals.

With Vitalware as a partner, Midland Health continues its commitment to making their community the healthiest in Texas.