One hospital and two health systems that documented $10.3 million in aggregate financial performance improvements were selected from hundreds of hospitals nationwide to receive the 2013 Revenue Cycle Solutions Award.
The awards, presented by the Advisory Board at this year's Revenue Cycle Solutions Summit, honored Houston Methodist, Kalispell Regional Medical Center, and Methodist Health System.
About the Winners
Houston Methodist, a five-hospital, 1,633-bed system in Houston, Texas, was facing increasing eligibility denials (refusal of reimbursement based on a patient's insurance coverage). The health system identified that discrete front- and back-end data posed a barrier to educating teams and implementing effective performance improvement processes. As a result, it pursued a data integration effort and a training program that improved front-end insurance coverage verification and ultimately decreased the potential for denied payments by $7.2 million over a 10-month period.
Kalispell Regional Medical Center
Kalispell Regional Medical Center (KRMC), a 163-bed hospital in Kalispell, Mont., observed that "self-pay" patients, who cover all their own costs, were taking longer to pay bills. To inflect this metric, KRMC redesigned its billing process, using analytics to help patients to better understand what they owed and training staff to help explain these obligations. With these initiatives, KRMC collected more than $1.2 million in eight months with no increase in writeoffs as a percent of total revenues.
Methodist Health System
Methodist Health System, a three-hospital, 787-bed system in Omaha, Neb., and Council Bluffs, Iowa, focused on patient access and point-of-service collections. This included standardizing scheduling, improving pre-certification management, automating medical-necessity checking, and increasing collections at the point of service by $1.87 million.
The three institutions are among more than 600 hospitals nationwide that are members of the Advisory Board's Revenue Cycle Solutions programs—customized solutions that combine research, consulting, training, and technologies that drive next-generation revenue cycle performance. The awards recognize institutions' leadership in initiatives to improve financial sustainability.
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