Revenue Cycle

Success Stories

Denial Managements Improvement Effort Produces $14.99M Reduction in Denials

At MultiCare Health System, the processes for denial management were not as effective as they could be, negatively impacting net patient revenue and financial performance through millions of dollars in adjustments. While only two-thirds of denials are recoverable, nearly 90 percent are preventable. MultiCare looked at improving denial management as an opportunity to improve appropriate revenue capture for services provided. Through targeted improvement efforts that included standardized workflows and increased data visibility, the health system is improving the root cause of denials.
Results:

$14.99M reduction in denials and avoidable write-offs.

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How One Hospital Took the Pain Out of Getting Paid

A hospital’s core mission is to provide the best care possible. To continue to do so, however, hospitals must be paid promptly. Discharged not final billed (DNFB) cases—where bills remain incomplete due to coding or documentation gaps—represent an ongoing challenge for hospitals around the country.
Thibodaux Regional Medical Center, like other hospitals, faces a myriad of new government regulations that have made hospital bill collection efforts more onerous. Its leaders recognized their inadequate manual DNFB process left hospital staff overburdened and put at risk the necessary cash flow to best serve patients.
The hospital automated and streamlined this process to relieve the burden on physicians, provide an integrated view of data, optimize visibility and workflow, and reduce the need to “downcode” reimbursements due to missing documentation. The hospital leveraged analytics to provide actionable feedback to continuously improve the process.
Thibodaux has already achieved significant improvements to cash flow and operational efficiency:

44.4 percent improvement in delinquency rate
8.2 days reduction in A/R days
70.5 percent decrease in the number of billhold accounts outstanding
50 percent decrease in physician portion of DNFB dollars
97 percent improvement in operational efficiency

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How Hospital Financial Transparency Drives Operational and Bottom Line Improvements

In an era of steadily declining operating margins, hospitals are seeking ways to increase their profitability. Learn how one hospital system integrated financial and operational data in near real-time, giving their leaders visibility into how their decisions are impacting the bottom line. Leadership is now making more informed decisions and they are addressing problems as they arise. Budgets are consistently being managed close to target and variances for each cost center are readily explained with drill-down capabilities into the general ledger. A significant manual effort associated with over 1,000 cost center spreadsheets has been eliminated and the organization has saved $12 million in labor savings.

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$74M in Healthcare Operational Improvements: How Texas Children’s Hospital Is Delivering on Its Vision

Federal and state funding reductions, along with increased competition, are the latest profitability challenges facing healthcare organizations. Texas Children’s recently faced this challenge head-on when projections indicated they would fall $50 million short of what was needed to build capital reserves and to maintain their bond rating. To improve financial performance and prepare for the future, the leadership team launched a system-wide performance improvement project called “Delivering on the Vision” (DOTV). DOTV would involve increasing accessibility for patients as well as driving healthcare operation savings. Texas Children’s goal, of increasing operating margins over 18 months by achieving $60 million in savings, has been surpassed — realizing $74 million in cost savings to date.

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Revenue Cycle Management: Analytic Driven Insights and Efficiencies

To run efficiently and use the money they earn to improve the health of a community, healthcare institutions must manage their revenue cycle well. Crystal Run Healthcare, one of the fastest growing multi-specialty group practices in the country, anda physician-led accountable care organization (ACO), is committed to ensuring that the dollars it earns serve its patient population and are not wasted on inefficient processes. To that end, Crystal Run recognized that to minimize manual reporting and make quick, well-informed decisions related to revenue cycle management, they needed to employ analytics. With the implementation of an advanced analytics application, on top of their EDW platform, this ACO now accesses data up to 99% more quickly, has reduced staff time to identify variance root causes by 97%, and is actively identifying financial management improvement opportunities.

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Healthcare Revenue Cycle: How to Improve Data Timeliness and Reduce Manual Work

With cash flows declining, margins tightening and bad debt increasing, it’s more important than ever for healthcare organizations to maintain their bottom line. Efficient, effective revenue cycle management that ensures timely payment is one key to an organization’s financial health. Learn how this healthcare system: a) improved their data timeliness, b) realized an estimated $380K in annual operational savings, and c) reduced manual work.

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How to Increase Professional Billing Charge Capture with Healthcare Analytics

The demand on hospital coders continues to rise – and even more so with the ICD-10 rollout. At the same time, health systems want to make sure professional billing charge captures are accurate. Learn how North Memorial Health System leveraged their hospital enterprise data warehouse – and the Health Catalyst Professional Billing Module – to: a) increase the number of provider notes with sufficient clinical data for billing, b) increase their monthly net income and c) improve their hospital coding staff productivity by 25%.

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