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Healthcare Revenue Cycle:
How to Improve Data Timeliness
and Reduce Manual Work
A Customer Success Story
© 2014 Health Catalyst
www.healthcatalyst.com
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
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
© 2014 Health Catalyst
www.healthcatalyst.com
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Solving The Money Problem
With 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.
© 2014 Health Catalyst
www.healthcatalyst.com
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
One Hospital System’s Success
The 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.
4
© 2014 Health Catalyst
www.healthcatalyst.com
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Manual Reporting and Data Integrity
The 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.
5
© 2014 Health Catalyst
www.healthcatalyst.com
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Manual Reporting and Data Integrity
The 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.
6
© 2014 Health Catalyst
www.healthcatalyst.com
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Manual Reporting and Data Integrity
The 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.
7
© 2014 Health Catalyst
www.healthcatalyst.com
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Solution: EDW with Advanced Analytics
To have a more coordinated,
efficient revenue cycle manage-
ment effort maximizing revenue
generation, the revenue cycle
team needed to:
8
Visualize the data in as near
real-time as possible
Eliminate manual report creation,
extraction and distribution efforts
Ensure data quality and data
modeling integrity
© 2014 Health Catalyst
www.healthcatalyst.com
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Solution: EDW with Advanced Analytics
The 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.
9
© 2014 Health Catalyst
www.healthcatalyst.com
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Solution: EDW with Advanced Analytics
The 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.
10
© 2014 Health Catalyst
www.healthcatalyst.com
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
The Revenue Cycle Explorer
Revenue Cycle Explorer executive dashboard provides a
high-level view of key performance indicators (KPIs).
11
Revenue Cycle Explorer Executive Dashboard
© 2014 Health Catalyst
www.healthcatalyst.com
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
The Revenue Cycle Explorer
The denials management dashboard arranges denials into
actionable categories to help identify root causes.
12
Revenue Cycle Explorer Denials Management Dashboard
© 2014 Health Catalyst
www.healthcatalyst.com
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Results
13
Improved Revenue Cycle Management
Since 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 Annually
By 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 modeling
The 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.
© 2014 Health Catalyst
www.healthcatalyst.com
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
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.
14
© 2014 Health Catalyst
www.healthcatalyst.com
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
More about this topic
Five 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
© 2014 Health Catalyst
www.healthcatalyst.com
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
For more information:
Download Healthcare: A Better Way.
The New Era of Opportunity
“This is a knowledge source for clinical and
operational leaders, as well as front-line
caregivers, who are involved in improving
processes, reducing harm, designing and
implementing new care delivery models, and
undertaking the difficult task of leading
meaningful change on behalf of the patients
they serve.”
– John Haughom, MD, Senior Advisor, Health Catalyst
© 2014 Health Catalyst
www.healthcatalyst.com
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
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.”
For more information, visit, www.healthcatalyst.com, and follow us
on Twitter, LinkedIn, and Facebook.
17

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

  • 1. Healthcare Revenue Cycle: How to Improve Data Timeliness and Reduce Manual Work A Customer Success Story
  • 2. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. 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
  • 3. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Solving The Money Problem With 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.
  • 4. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. One Hospital System’s Success The 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. 4
  • 5. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Manual Reporting and Data Integrity The 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. 5
  • 6. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Manual Reporting and Data Integrity The 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. 6
  • 7. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Manual Reporting and Data Integrity The 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. 7
  • 8. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Solution: EDW with Advanced Analytics To have a more coordinated, efficient revenue cycle manage- ment effort maximizing revenue generation, the revenue cycle team needed to: 8 Visualize the data in as near real-time as possible Eliminate manual report creation, extraction and distribution efforts Ensure data quality and data modeling integrity
  • 9. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Solution: EDW with Advanced Analytics The 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. 9
  • 10. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Solution: EDW with Advanced Analytics The 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. 10
  • 11. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. The Revenue Cycle Explorer Revenue Cycle Explorer executive dashboard provides a high-level view of key performance indicators (KPIs). 11 Revenue Cycle Explorer Executive Dashboard
  • 12. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. The Revenue Cycle Explorer The denials management dashboard arranges denials into actionable categories to help identify root causes. 12 Revenue Cycle Explorer Denials Management Dashboard
  • 13. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Results 13 Improved Revenue Cycle Management Since 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 Annually By 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 modeling The 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.
  • 14. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. 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. 14
  • 15. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. More about this topic Five 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
  • 16. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. For more information: Download Healthcare: A Better Way. The New Era of Opportunity “This is a knowledge source for clinical and operational leaders, as well as front-line caregivers, who are involved in improving processes, reducing harm, designing and implementing new care delivery models, and undertaking the difficult task of leading meaningful change on behalf of the patients they serve.” – John Haughom, MD, Senior Advisor, Health Catalyst
  • 17. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. 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.” For more information, visit, www.healthcatalyst.com, and follow us on Twitter, LinkedIn, and Facebook. 17