How one hospital transformed self-pay collections and boosted efficiency

IU Health Goshen | 123-bed hospital

In 2013, being a self-pay collector at IU Health Goshen, in Goshen, Ind., was an uphill battle.

The hospital's two self-pay collectors, "were just working accounts oldest first as they could get to them," according to patient financial services director Chris Wert. "And, naturally, you're not going to get a hold of patients, and you're going to have patients who say they'll make a payment and then they don't. We were spinning our wheels."

To increase collections, and make collectors' lives easier and their jobs more rewarding, Wert needed a way to easily stratify self-pay accounts to follow up with the patients likely to pay and write off those that wouldn't.

IU Health Goshen began installing Self Pay Compass, an analytics platform and workflow tool designed exactly for this purpose, in the spring of 2013. That spring and early summer, Wert worked with the Advisory Board to input and analyze eight years of historical data on self-pay accounts and to revise processes and policies.

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A whole new approach to self-pay collections

By August, the hospital's self-pay processes had been transformed.

Instead of treating each account equally, Wert used Self Pay Compass to filter accounts by propensity to pay and credit score, so collectors could focus on the highest-yield opportunities.

"We eliminated touching a lot of accounts based on the data that we had in Self Pay Compass, so that we could focus our collectors' time and attention on the patients who have the ability to pay, who do typically pay, or who typically pay over a period of time, rather than spending our time trying to track down patients just because they have a balance with us," Wert said.

At the same time, Wert and her team created a system to better manage write-offs on accounts that were likely to be less fruitful. The cornerstone of this effort was introducing a presumptive financial assistance policy.

The new policy, which diverted accounts that met certain criteria automatically from bad debt to charity care, further reduced collectors' unproductive time while simultaneously increasing the hospital's community benefit.

A more rewarding job for collectors—and increased cash flow

These changes together substantially impacted the hospital’s financial performance. By July 2014, one year after the effort began, the hospital had written off close to $1.7 million in presumptive charity, a sum that likely otherwise would have gone to bad debt.

Prioritizing collectors’ work lists, and entirely removing approximately 350 presumptive charity accounts per month, also paid big dividends in cash flow. During the same time period, Wert's team reduced self-pay AR days from 170 to 121, including a reduction of aged accounts receivable over 120 days by almost $1.9 million.

Goshen savings

Today Wert and her team can't imagine going back to 2013. According to Wert, the collectors "absolutely love" Self Pay Compass. "We still send accounts to bad debt, but those were not accounts that would have paid or should have paid."

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There’s more to this story

In just five years, we’ve helped IU Health Goshen achieve far-reaching revenue cycle transformation, a 12% margin, and a strong foundation to continue to serve the community. Learn more about how we did it.

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