See how other organizations benefited from our expert services, resulting in reduced costs, increased revenue, and increased staff performance.

Strategy: Understand Denials, Increase Point-of-Service Collections, and Reduce Costs

Background: Rural non-profit hospital.

Objectives

  • Provide key findings and opportunity assessment regarding operational improvements and strategic sustainability alternatives.
  • Evaluate current state performance of revenue cycle functional areas (front, middle, and back) based on available data, key performance indicators, staffing, and workflows.
  • Assess current organizational structure to determine if it supports and promotes efficiency and growth

Approach

  • 10+ staff interviews and focus groups with key stakeholders
  • 35+ job shadowing observations
  • 100+ sample accounts reviewed during root cause analysis
  • 40+ source documents reviewed for effectiveness
  • Analyzed data assets (ATB, POS Collections, 835s, Denials, Write-offs, and KPIs)

Results

  • Identified $2.36M in potential growth year over year
  • Formation of pre-access unit will mitigate the denials originating from registration and eligibility which makes up 44.3% of total denials as well as eliminate unnecessary double work the organization was unaware of.
  • Educate and train staff on point-of-services collections to drive organization and increase collections by $515K.
  • Streamline manual follow-up processes to prevent 21% of open account receivable to be aged by 120+ days.
  • Develop denials management information so c-suite staff are aware of the current state, managers can implement initiatives, and frontline staff are aware of what causes denials.

Organization’s Ongoing Opportunity

  • Identified opportunity to increase the organization’s net patient revenue by 3.9%

Strategy: Reduced Costs, Increased Revenue, and Improved the Patient Experience

Background: Large health system in the Midwest. Net revenue of $3.5B. 20 hospitals and 62 outpatient locations.

The Problem

An ineffective patient payment collection cycle and segmentation strategy led to lower than expected revenue and higher operating costs

The Solution

Used an evidence-based assessment methodology, integrated with analytics, to find and validate where inefficiencies were occurring in the payment cycle

The Results

We reduced annual operating costs (-$2.5M) and increased annual Cash Flow (+$4M) by redesigning the patient payment collection cycle and re-aligning their segmentation strategy

Strategy: Improved Workflow, Enhanced Technology, Motivated Employees, and Increased Net Revenue

Background: Large academic medical center on the East Coast. Net revenue of $1B. 9,400 employees.

The Problem

Ineffective workflow and technology led to lower than expected point of service collections, employee satisfaction, and turnover

The Solution

Conducted an operational assessment, linked with data analytics and logic, that analyzed upfront collection patterns, workflow and technology, to identify root causes and opportunities

The Results

We increased upfront collections by +$3M via enhancing technology, restructuring the workflow, and motivating employees

Strategy: Reduced Idle Time, Increased Staff and Operational Performance

Background: Large health system in the Midwest. Net revenue of $3.5B. 20 hospitals and 62 outpatient locations.

The Problem

Operational inefficiencies and a less than optimal staffing model, in Patient Access, led to a high employee turnover, staffing challenges, and an increase in operating expense

The Solution

Applied an evidence-based analysis, supported by staffing analytics and algorithms, to uncover inefficiencies pertaining to the staffing model structure and non-valuable idle time tasks 

The Results

We increased productivity (+14.5%) and reduced operating expenses (-$3M) by restructuring the staffing model and integrated shared service functions to reduce employee idle time