Healthcare Revenue Cycle:How to Improve Data Timeliness and Reduce Manual Work

A Customer Success Story

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Revenue Cycle Manager

This application gives me instant insight into our revenue performance. I don’t have to pull together a number of reports to see how successful we are being at collecting timely payment. All the pertinent aspects of the revenue cycle are here in front of me on the dashboard.”

- Revenue Cycle Manager

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Solving The Money ProblemWith declining cash flows , tight margins and bad debt , it’s more important than ever for healthcare organizations to maintain their bottom line. Efficient, effective revenue cycle management ensures timely and accurate payment as a key to an organization’s financial health.

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One Hospital System’s SuccessThe organization tried to improve their processes—including upgrading its revenue cycle management system—with little success.This presentation explores how by simply adopting a healthcare analytics solution the health system was able to finally improve revenue cycle management and reduce rework.

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Manual Reporting and Data IntegrityThe health system had made a significant investment in a revenue cycle management solution, but only 15 percent of the revenue cycle team was actually using it. The team didn’t trust the system because it had too many data integrity and data modeling calculation issues.

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Manual Reporting and Data IntegrityThe system did not calculate denial rates accurately. Instead, the team pulled data from the business intelligence (BI) department.The number of reports the revenue cycle management team requested from the BI team was staggering.There was no centralized report tracking.

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Manual Reporting and Data IntegrityThe manual reporting process created a significant problem with data timeliness which is is critical to managing accounts receivables and denial rates.With report turnaround at times being as much as 30 days the window for insurance resolution had closed.Clearly the manual system was not working.

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Solution: EDW with Advanced AnalyticsTo have a more coordinated, efficient revenue cycle manage-ment effort maximizing revenue generation, the revenue cycle team needed to:

Visualize the data in as nearreal-time as possible

Eliminate manual report creation, extraction and distribution efforts

Ensure data quality and data modeling integrity

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Solution: EDW with Advanced AnalyticsThe health system turned to Health Catalyst’s Late-Binding Enterprise Data Warehouse™ (EDW) platform for a solution.The organization had already deployed the EDW to aggregate data from the electronic health record (EHR), financial systems and more, hoping to drive operational improvement initiatives.

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Solution: EDW with Advanced AnalyticsThe health system deployed the Health Catalyst Revenue Cycle Explorer financial application on top of the EDW.The application uses key revenue cycle management metrics residing in one place as a single source of truth.The healthcare organization can identify macros issues—versus reviewing claims in a piece-meal fashion.

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The Revenue Cycle ExplorerRevenue Cycle Explorer executive dashboard provides a high-level view of key performance indicators (KPIs).

Revenue Cycle Explorer Executive Dashboard

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The Revenue Cycle ExplorerThe denials management dashboard arranges denials into actionable categories to help identify root causes.

Revenue Cycle Explorer Denials Management Dashboard

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Results

Improved Revenue Cycle ManagementSince the data in Revenue Cycle Explorer is updated in near real-

time, the revenue cycle team can access the application at any time to get the most up-to-date information, enabling them to more effectively manage their revenue cycle.

Savings Estimated at $400K AnnuallyBy reducing manual data operations and dependence on manual one-off reports, the system eliminated its previous revenue cycle IT provider. They reduced the BI reporting queue by 30 percent allowing them to focus on strategic reporting.

Enriched data integrity and modelingThe revenue cycle team now trusts the accuracy of the data because it has been validated within the EDW. They no longer feel compelled to manually verify the calculations. The team is able to use the application to resolve root cause cycle performance issues.

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What Next?The organization has defined benchmarks for key healthcare revenue cycle measures such as claims denials, under-payment and accounts receivable aging. With these validated baselines, the team is ready to measure the improvement in the health system’s revenue cycle management going forward.

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More about this topicFive Ways for Improving Hospital Revenue Cycle Management Bobbi Brown, Vice President of Financial Engagement

5 KPIs that Require Revenue Cycle Managers’ Attention Devendra Saharia, CEO, AGS Health, Inc., HFMA

Revenue Cycle Explorer Download the product data sheet

How to Increase Professional Billing Charge Capture with Healthcare Analytics Case Study

Finding $5.7 Million with a Healthcare Data Warehouse John Wadsworth, Vice President of Client Technical Operations

Link to original article for a more in-depth discussion.

Healthcare Revenue Cycle: How to Improve Data Timeliness and Reduce Manual Work

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For more information:

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– John Haughom, MD, Senior Advisor, Health Catalyst

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ABOUT HEALTH CATALYST

Health Catalyst is a mission-driven data warehousing and analytics company that helps healthcare organizations of all sizes perform the clinical, financial, and operational reporting and analysis needed for population health and accountable care. Our proven enterprise data warehouse (EDW) and analytics platform helps improve quality, add efficiency and lower costs in support of more than 30 million patients for organizations ranging from the largest US health system to forward-thinking physician practices. Faster and more agile than data warehouses from other industries, the Health Catalyst Late-Binding™ EDW has been heralded by KLAS as a “newer and more effective way to approach EDW.”

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