In today’s challenging environment, healthcare leaders must seek opportunities to boost revenue through improved financial performance and reimbursement. Some common strategies include reducing the number of outstanding bill hold accounts, reducing A/R days, and managing discharged not final billed (DNFB) cases. This article tackles, the following topics: Common reasons accounts remain unbilled. Identifying opportunities for improvement. Using data analytics and process improvement to achieve financial goals. Creating lasting improvements.

1. How to Increase Cash Flow
Using Data and Analytics

2. © 2018 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
The Top Five 2019 Healthcare Trends
This presentation is a summary of the webinar presentation, “Using
Analytics to Increase Cash Flow,” by Greg Stock, MPA, President and
CEO at Thibodaux Regional Medical Center, and Mikki Fazzio, RHIT,
CCS, Director, HIM and Clinical Documentation Improvement, at
Thibodaux Regional Medical Center.
Greg Stock, MPA
CEO
Thibodaux Regional Medical Center
Mikki Fazzio, RHIT, CCS
Director, HIM and Clinical
Documentation Improvement
Thibodaux Regional Medical Center

3. © 2018 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
In business, cash is king, and that’s true for
healthcare organizations too.
Financial challenges are the number one issue
facing hospitals today, according to a 2018
survey of hospital CEOs by the American
College of Healthcare Executives (ACHE).
Among the financial challenges facing hospitals
today are declining reimbursement, rising
costs, changes in payer mix, declining inpatient
volume, documentation and coding issues,
increased payer denials, more regulatory
requirements, and bad debt, to name a few.
Cash is King!

4. © 2018 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
To maintain healthy margins, hospital leaders must seek
opportunities to boost revenue through improved
financial performance and reimbursement.
Some common strategies include the following:
Improving documentation and coding accuracy.
Reducing the number of outstanding bill hold accounts.
Reducing accounts receivable (A/R) days.
Managing discharged not final billed (DNFB) cases.
Common Strategies to Improve
Financial Performance
>
>
>
>

5. © 2018 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
While many of these strategies have been
around for a long time, many C-suites and
department leaders are unfamiliar with
managing DNFB cases, where bills remain
incomplete due to gaps in coding or documents.
According to a 2019 poll of “Using Analytics to
Increase Cash Flow” webinar attendees, 41
percent said they were “unfamiliar” with their
facility’s DNFB process and an additional 19
percent said they were “somewhat familiar.”
Only 16 percent of attendees categorized
themselves as “very familiar” with the
DNFB process at their facility.
Managing the DNFB Process

6. © 2018 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Effective management of the DNFB process
is one way hospitals can improve their
financial performance and cash flow.
However, without a robust data analytics
program to support these efforts, meeting
goals around DNFB improvement remains
elusive for many hospitals.
Managing the DNFB Process

7. © 2018 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
According to Health Leaders Media, accounts may be
unbilled for a variety of reasons:
The account requires coding that is not yet complete.
The account is coded but awaiting charges.
The account is coded but lacks a corresponding charge,
often identified during claim-editing.
The account is coded but gets rejected during claim-
editing because of an invalid revenue code, inaccurate
payer designator, or other missing element.
Managing the DNFB Process
>
>
>
>

8. © 2018 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Whether these accounts are waiting for a
medical coder or physician documentation,
they can account for millions of dollars just
waiting to be processed.
The implementation of ICD-10 in 2015
means an additional level of specificity
and documentation is required, further
compounding the problem for healthcare
organizations that don’t get and keep
their DNFB process in check.
Managing the DNFB Process

9. © 2018 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
As hospital bottom-lines shrink, leadership
may respond with belt-tightening tactics
such as cutting staff or operating costs,
which can appear effective initially.
However, these cuts often lead to declining
employee morale and can negatively
impact the patient experience.
Hospitals need to identify a sustainable
approach by analyzing opportunities most
likely to deliver the ROI they need, and
then focus on those identified areas for
improvement.
Identifying Opportunities for Improvement

10. © 2018 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Without robust analytics to support these
improvement efforts, targeted goals or
benchmarks may not be realized unless
healthcare organizations commit to built-in
accountability and visibility to ensure
sustained improvements.
A focus on improving coding and document-
ation processes, such as DNFB, can have
big pay offs for healthcare organizations by
alleviating cash flow problems and improving
efficiency and accuracy in what is frequently
a time-consuming manual process.
Identifying Opportunities for Improvement

11. © 2018 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Manual, inefficient processes can result
in overburdened medical coders and
physicians, contributing to burnout.
And, if organizations don’t have an
analytics platform in place, they may
lack the data needed to carry out
these processes.
The data may be disorganized, or the
process of reviewing the data may be
overwhelming due to the lack of
functionality.
Identifying Opportunities for Improvement

12. © 2018 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
The right analytics platform can also help
automate these time-consuming processes,
by organizing, sorting, and filtering data.
This allows the billing department to be
proactive by putting processes in place to
avoid delays in payment and spend less
time organizing the data and more time
putting the data to use.
Once in place, the analytics platform can
help identify the greatest areas of
opportunity for further improvements.
Identifying Opportunities for Improvement

13. © 2018 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
The first step for many healthcare
organizations embarking on a process
improvement journey is investing in an
open, scalable platform for analytics.
While the impetus for process
improvement is often financial concerns,
making an investment in analytics may
seem counterintuitive.
This is a necessary step in finding and
targeting the greatest opportunities for
improvements.
Using Data Analytics and
Process Improvement to Achieve Goals

14. © 2018 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
In the example of the DNFB process improvement, this might include the
following steps:
Invest in analytics.
Fine-tune and verify analytic data.
Communicate consistently with physicians and
key departments.
Educate key departments on data and analytics
and give access when appropriate.
Revamp time-consuming processes.
Revise department structure and create new roles.
Maintain and augment results through continuous
improvement.
Using Data Analytics and
Process Improvement to Achieve Goals
>
>
>
>
>
>
>

15. © 2018 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
In the case of Thibodaux Regional Medical
Center, these steps resulted in a $2.4 million
increased cash flow, according to the results
published in Health Leaders Media.
The organization was able to achieve these
results because its analytics platform offered
fast and easy access to the information needed.
The medical center was also able to improve
physician documentation, reduce A/R days,
and improve workflow.
Using Data Analytics and
Process Improvement to Achieve Goals

16. © 2018 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Inaccurate analytic data has little value and
can cause resistance to change.
When embarking on the process improve-
ment journey, it’s important for healthcare
organizations to invest both the time and
money that’s needed to provide access
and clarity of data to drive change.
Consistently sharing data with physicians
can help promote engagement and keep
them involved and committed to the process.
Additionally, having a robust analytics
platform, efficient processes, and account-
ability translates to sustained success.
Creating Lasting Change

17. © 2018 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
With declining cash flows, increasing regulatory
and reporting requirements, and tightening
margins, healthcare organizations need to be
mindful of their bottom lines and their cash flows.
Improved reimbursement, efficient, automated
processes, and proactive action are all needed
for hospitals to stay afloat in today’s demanding
environment.
The right data analytics platform can help
organizations identify opportunities, provide
timely access to the right data, and monitor
trends to maintain and expand their progress.
Creating Lasting Change

18. © 2018 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
For more information:
“This book is a fantastic piece of work”
– Robert Lindeman MD, FAAP, Chief Physician Quality Officer

19. © 2018 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
More about this topic
Link to original article for a more in-depth discussion.
How to Increase Cash Flow Using Data and Analytics
Healthcare Data Management: Three Principles of Using Data to Its Full Potential
Sean Whitaker
Why Clinical Quality Should Drive Healthcare Business Strategy
Health Catalyst Editors
Linking Clinical and Financial Data: The Key to Real Quality and Cost Outcomes
Bobbi Brown, MBA, Senior VP
Transforming Healthcare Analytics: Five Critical Steps
Ann Tinker, MSN, RN, Professional Services, Senior VP; Dan Hopkins, Professional Services, VP
Prioritizing Healthcare Projects to Optimize ROI
Dorian DiNardo, Senior VP of Analytics; Aaron Neiderhiser, Product Management, Sr. Director

20. © 2018 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Other Clinical Quality Improvement Resources
Click to read additional information at www.healthcatalyst.com
Greg Stock is the CEO at Thibodaux Regional Medical Center. He brings with him valuable
professional experiences and important instincts relative to succeeding in today’s often
volatile health care industry. His collaborative management style, strong physician relations
skills, an easy, outgoing manner, sense of humor and ability to challenge his staff to perform
at their very best, enables him to continue achieving and earning the loyalty and respect of
others who also are committed to excellence. Greg earned a Bachelor of Arts degree in 1978 and a
Master of Health Care Administration/Public Administration degree from Brigham Young University
in 1980.
Greg Stock, MPA

21. © 2018 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Other Clinical Quality Improvement Resources
Click to read additional information at www.healthcatalyst.com
Health Catalyst is a mission-driven data warehousing, analytics and outcomes-improvement company
that helps healthcare organizations of all sizes improve clinical, financial, and operational outcomes
needed to improve 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 65 million patients for organizations ranging from the largest US health system to forward-thinking
physician practices.
Health Catalyst was recently named as the leader in the enterprise healthcare BI market in
improvement by KLAS, and has received numerous best-place-to work awards including Modern
Healthcare in 2013, 2014, and 2015, as well as other recognitions such as “Best Place to work for
Millenials, and a “Best Perks for Women.”