We’re thrilled to announce that the winners of HBI’s 2018 Revenue Cycle Study and Awards survey are:
- Children’s Hospital of Philadelphia
- Nebraska Medicine
- Springhill Medical Center
While all three have high-performing revenue cycles in common, they represent varied segments of the healthcare landscape. One is a nonprofit, pediatric health system in the East; another is a nonprofit, academic health system in the Midwest; and the third is a for-profit health system in the South. This diversity shows that while there is no single formula for success, commitments to process efficiency, forward-thinking initiatives, and the patient experience can form a solid foundation for revenue cycle operations.
Among other reasons for being selected, the winners all demonstrated top-decile performance in more than one studied metric. For example, CHOP stood out with top-decile point-of-service collections as a percentage of net revenue at 2.55% (the average among survey respondents was 1.08%). Nebraska Medicine’s cost to collect showed top-decile achievement at 1.06% (the average was 2.71%). Springhill’s CDI program showed top-decile significant return on investment, with DRG changes attributable to CDI at 2.50% of net revenue (the average was 0.96%).
For more information about this year’s winners and to learn how to participate in 2019’s survey, click here. HBI members will be able to access full survey results on the website in the coming weeks.
In addition to providing a pulse check on the financial performance of revenue cycles throughout the country, the survey process yielded a snapshot of the challenges at top of mind for executives. HBI analyzed keywords in essays that were submitted alongside financial performance.
Denials were the most common area of focus mentioned in those essays, followed quickly by reimbursement challenges and strategic improvements in patient access. Compared with the member research requests recently received by HBI’s Revenue Cycle Academy research team, this comes as no surprise.
Denial and appeal optimization has long remained the largest challenge for revenue cycle leaders, and HBI has responded to members’ needs by creating template appeal letters and scripting, optimizing our custom denial dashboard and analytics services, gathering together forward-thinking leaders as part of industry roundtables, and more.
Barriers to reimbursement extend beyond denials (e.g., identifying and resolving underpayments) and beyond payers (e.g., providing patient financing). Many HBI members are working to improve both denial and collection success by leveraging our in-person training workshops on how on each role affects others within the revenue cycle, point-of-service collections, and back-end account resolution.
Initiatives in patient access mentioned by survey respondents focused heavily on scheduling and pre-registration, indicating a renewed emphasis on ensuring patients can easily enter the revenue cycle. HBI is supporting members in this area by offering a new secret shopping service and analysis, which can reveal unknown pain points patients encounter during their first interactions with your organization.
Other common themes revealed within survey responses were site of service (with the ED and clinics being mentioned frequently) and patient status (i.e., inpatient, outpatient, or observation). This emphasis on where patients are receiving treatment and what level of care they’re provided suggests that hospital and professional revenue cycles are becoming more tightly interwoven as leaders seek to protect cash flow.
Also high on the list of common focuses were billing practices, analytics, technology (e.g., tools and software used by staff, customized rules and logic built by in-house IT), and process improvements (e.g., projects to enhance standardization and efficiency).
Automation was more frequently mentioned than AI, supporting our previous research that found true artificial intelligence has not yet found a firm foothold in the revenue cycle.
Another point of note is that quality monitoring was much more commonly mentioned than productivity, suggesting a shift in how staff performance is being assessed.
These insights will inform HBI’s future research, ensuring our teams provide your staff with top-of-mind information that will integrate seamlessly with your priorities.
If you would like to participate in HBI‘s next Revenue Cycle Awards, complete the form below to be notified!