Improving Front-End Processes Boosts Collections and Reduces A/R
The history of Health First runs deep in Brevard County, Florida, dating back to 1937 when Brevard Hospital first opened in Melbourne with 27 beds. Now known as Holmes Regional Medical Center (HRMC), the hospital is Brevard’s largest, with 514 beds. Health First was formed in 1995 when HRMC and two other hospitals joined to create a truly integrated not-for-profit healthcare delivery system. In the ensuing years, Health First has added the county’s largest multi-specialty physician group, its own health plan, four fitness centers, multiple outpatient and wellness centers, a regional trauma center, an electronic intensive care unit, and a fourth hospital.
The Challenge: Struggling with Accuracy
Like other healthcare providers, Health First struggled with a variety of challenges that originated at the front-end of the revenue cycle, but were often not detected until billing issues arose. Upfront collections were lower than they should have been and, in many cases, registration and eligibility errors had to be manually corrected downstream by managers. This meant that employees handling front-line patient access could have been receiving inaccurate information. They could later hear from the patient financial team that the information they were capturing was not completely accurate or updated on a timely basis.
Patient Access and Registration staff were challenged by a changing healthcare environment, variable insurance coverage, and mandates to improve customer service—all while needing to register patients quickly and accurately.
The Health First Quality Assurance team needed a way to engage and empower the Patient Access team to easily capture accurate and timely data, engage patients, and improve point-of-service collections. To satisfy this laundry list of needs, Health First implemented a unique approach to front-end revenue cycle that emphasized employee accountability for registration accuracy, clean claims, and increased collections.
The Solution: Focusing on Front-end Processes
Using the combination of Clearance Patient Access Suite and Ahi QA, Health First generates scorecards that show Patient Access staff missing information, and how each staff member is performing compared to peers. It also creates opportunities for engagement because now employees can reach out to the QA team as their coaches for guidance in interpreting edits, and take any needed corrective measures.
The Results: A/R Down, Collections Up
With this renewed focus on front-end revenue cycle processes, Health First realized both tangible and organizational benefits including:
- Up-Front Collections Increased over 45%: Over the past four years, real-time visibility into registration data accuracy has contributed to Health First’s boost in point-of-service collections by more than 45%, and the health system continues to meet or exceed aggressive targets.
- A/R Days Reduced by 18%: The combination of more accurate registration information being fed downstream plus improved point-of-service collections has had an undeniable impact on the bottom line. In a 12-month period, A/R days improved from 44 to 41.
- Immediate Visibility into Potential Registration Errors: Real-time quality assurance flags errors for Health First registrars after the registration is complete, so they can verify and collect any additional information needed from the patient before that patient leaves. This helps correct registration errors and also helps reduce the need for additional FTEs to perform registration QA/Audit processes. By not focusing so much time on QA, staff is able to engage patients and improve up-front collections.
- Higher Employee Engagement: Ahi QA scorecards have contributed to increased rapport among employees and helped stimulate a more productive dialogue between Patient Access, QA and Patient Billing. This increased employee engagement is reflected in Health First’s improved Press-Ganey employee engagement scores.