What is the Impact of Drug Cost on Revenue?

Houston Methodist Health System | 1,247-Bed Hospital System

Impact Highlights

$522K

Recouped by reimbursement coordinators in three years

3

Full-time reimbursement coordinators hired based on improvements

Houston Methodist Health System, located in Texas, faced high drug costs that drained overall hospital revenue. Executives challenged the pharmacy and business office teams to mitigate the impact. Using Revenue Cycle Compass dashboard, Houston Methodist was able to go beyond traditional analytics to show what pharmacy costs could be reimbursed or covered by copay assistance, significantly offsetting initial drug cost.

Executive hospital leadership also created three new FTE reimbursement coordinator positions to identify the best payment solutions with patients pre-treatment, discuss out-of-coverage treatments with physicians, and work with the insurance predetermination process to navigate one-off cases. In just three years, Houston Methodist saved over $522K.

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Results

With the help of Revenue Cycle Compass, Houston Methodist gained $522,962 from recovery and assistance by reimbursement coordinators.

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