The Client Challenge
Following a mid-sized health system’s significant investment in upgrading its electronic health record system, revenue cycle challenges and performance issues materialized. Growing numbers of initial denials, claim adjustments, and write-offs presented substantial opportunity to increase cash and net revenue through transforming its revenue cycle operations. The health system knew that a comprehensive approach rooted in cultural transformation was required to realize financial benefits and achieve sustainable, industry-leading performance.
Baseline Performance Indicators:
- Gross A/R days in high 60s
- Avoidable write-offs at 3x best practice (6%)
- Initial denial rate >15%
- Unbilled days >18
- Aged A/R over 90 days >50%
Navigating to Next: The Solution
The Chartis Group and the health system’s leadership agreed that every major revenue cycle key performance indicator needed improvement to generate the $20 million to $25 million of benefit identified in an initial assessment. Adopting a ground-up strategy, the team also developed a purposeful governance structure to model and communicate the cultural change needed for success.
The team restructured critical revenue cycle functions to streamline workflows, eliminate redundancies, and reduce delays and breakdowns. Chartis provided extensive training and development forefront-line staff and supervisors to utilize standardized processes, tools, and reporting mechanisms. To drive the initiative’s critically important change management and communication, Chartis helped create a ”common language” to serve as the source of truth. Implementation of a new meeting framework across the revenue cycle, a comprehensive reporting package, and enhanced staff accountability measures and controls employed with an “at the shoulder approach” enabled ongoing measurement—driving significant performance improvement and sustainable results.