Thanks to everyone who applied for the 2017 Revenue Cycle Award! These winners were chosen based on a combination of their overall revenue cycle performance reported for the most recent fiscal year, best practices they rated as having in place, and essays detailing some of their most important initiatives undertaken in the last year.
Rice Memorial Hospital is an 81-bed Level III trauma center located 100 miles west of the Twin Cities metro area in Willmar, Minnesota. Rice Memorial Hospital was selected as a Revenue Cycle Award winner this year due to a combination of current performance, improvement shown, and practices employed. In the past year, the hospital has yielded a 12% increase in net patient revenue (not attributable to payer contract changes), decreased net A/R 13.5% from 59 to 51 days—and survey results showing it dip to as low as 45.7 days—as well as a 70% reduction in medical necessity write-offs, and a 51% increase in clean claim rate. Rice Memorial Hospital reported a final denial rate of 0.23% of net patient revenue, which leaders attributed to a recently created and easy-to-understand denials dashboard that has allowed separate revenue cycle departments to understand and be held accountable for prevention opportunities.
St. Luke’s Hospital in Chesterfield, Missouri, includes one hospital with 493 beds along with 26 outpatient locations around the greater St. Louis area. St. Luke’s Hospital is a three-time consecutive winner of the Revenue Cycle Award, and continues to show top performance in many of the core and newly added categories. This organization was the number one performer in coding accuracy (99%), total dollar impact of CDI-driven DRG changes (2.24% of net revenue, compared to the average 0.74%), cost-to-collect (2.05%, compared to top quartile performance of 2.64%), bad debt as a % of net revenue (0.8%, compared to top quartile performance of 2.25%), and the percentage of net revenue arranged on a payment plan (0.98%, compared to top quartile performance of 0.42%). Leaders noted its interest-free payment plan option has been a significant patient satisfier, with 78% of those patients resolving their balances within 24 months. The organization was also one of two top performers in collecting after-insurance patient balances (6.17% of net revenue), and in point-of-service collections (1.74% of net revenue, which nearly doubled performance at the top quartile).
Furthermore, St. Luke’s Hospital reduced ED and nursing late charges 77% by cross-training coders, combining urgent care and ED coding into a single function, and reporting accounts at-risk for late charges on a daily and weekly basis. The organization’s call center resolves 99.8% of patient calls without escalation to a supervisor. And finally, centralized registration staff improved their productivity from 22 registrations per day to 37, increased accuracy rates from 68% to 96%, and reduced registration wait times by 60%.
Sharp HealthCare is a fully integrated with four acute care hospitals, 31 outpatient clinics, three affiliated medical groups, and more, serving San Diego, California. Sharp displayed top quartile performance in many categories, with point-of-service collections making up 0.83% of net revenue, and coding accuracy at 95%. The organization represented the number one performer in credit balances (0.51% of accounts receivable) and staff turnover—4.8% for front-end staff, 4.4% for back-end staff, and only 2.0% for coding/HIM. The organization had second-best performance in bad debt (0.94% of net revenue), cost-to-collect (2.46%), and denials (0.39% of net revenue).
Success in these areas may be attributed to number of practices, including a Revenue Integrity Steering Committee (RISC) that reviews aging account trends by payer; a formal process whereby utilization management presents potentially uncoverable denials to the CFO; the ability of payers to access their medical records and presumptively authorize services (strategies still in formalization); facility-specific payer relations meetings that gather mid-level and frontline team members; and an increased focus on claim automation. In fact, Sharp’s clean claim rate has seen a 7% boost this year. In addition, the organization has implemented a Revenue Cycle Training & Education department, as well as a gamification strategy where staff earn points and pass levels through a personally developed avatar based on their performance.
Congratulations to these three very deserving organizations, which faced strong competition from providers of various demographics. We are proud to call all of this year’s award applicants HBI members!
If you are interested in participating in the 2018 Revenue Cycle Awards Survey, complete the form below!