Leveraging Revenue Cycle Benchmarks: Taking Performance to the Next Level Melinda Hancock, FHFMA, CPA Partner Healthcare, DHG Healthcare (moderator) Greg Meyers System Vice President, INTEGRIS Health Tracey McKnight, RN, MM Senior Director, Revenue Cycle Spectrum Health System
Primary Event Sponsors
Additional Event Sponsors
INTEGRIS State Wide Presence 7 Med-Surg Hospitals 2 Mental Health Hospitals Jim Thorpe Rehabilitation Hospital INTEGRIS Heart Hospital INTEGRIS Cancer Institute Proton Therapy Center 6 Centers of Excellence 120 physician clinic locations 65% of the state s population live with 30 minutes of an INTEGRIS facility
INTEGRIS Health Statistics 1,920 Licensed Beds 50,000 Inpatient Discharges 650,000 Outpatient Visits 775,000 Physician Office Visits $1.5 Billion in Net Revenue FY15 Operating Margin of 4.6% FY15 Net Days in AR 39.44 POS Collections - $18 million in FY15 Bad Debt and Charity 4.55 % FY15 Cost to Collect 2.32%
INTEGRIS Payer Mix Medicare 48.13% Medicaid 10.46% Managed Care 31.86% Commercial Insurance.72% Private Pay/Other 7.63%
Spectrum Health System Spectrum Health is a not for profit system of care dedicated to improving the health of families and individuals Mission and Vision To improve the health of communities we serve To be the national leader in healthcare by 2020 Key Focus Areas Heal the whole person Access within 48 hours Own the cost of care Named one of the Top 15 Health Systems in the nation by Truven in 2014 & 2015
Spectrum Health Integrated Care Hospital Group Medical Group Priority Health 12 Hospitals 3,100 Physicians & 183 Ambulatory & Advanced Practice Service Sites Providers Including Post Acute Services 1,100 Members in Fred and Lena Meijer the Medical Group Heart Center Helen DeVos Childrens Hospital Lemon Holton Cancer Pavilion 653,000 Priority Health Members Members in 48 States
Spectrum Health System Statistics 1,666 Licensed Beds 71,538 Inpatient Admissions 631,163 Outpatient Visits (includes ER, surgeries and clinic visits) 2,138,070 Physician Encounters $2.7 Billion in Net Revenue FY15 Operating Margin of 7.4% FY15 Net Days in AR 40.2 POS Collections 2.5 Million or 2.7% of total annual patient cash collected Bad Debt and Charity FY15 3.8% Cost to Collect 3.91% SHMG Net Days in AR - 28 Collection of Self Pay Cash - 32% Lag Days Overall 5 Days Payment Velocity 24 Days Bad Debt and Charity FY15 2.3% of net collections
Spectrum Health Payer Mix Medicare 26.4% Medicaid 14.2% Commercial/Other/ Managed Care 57.3% Self Pay 2.1%
In my organization revenue cycle benchmarking is: a) Very important and focused on peer comparisons b) Very important and focused on month-overmonth internal comparisons c) Somewhat important d) Not a priority e) Only important to my CFO
Critical Benchmarks
At the strategic level, if I could only monitor one benchmark, it would be: a) Denials as a % of total claims remitted b) Aged A/R > 90 days c) Net days in A/R d) Cash as a % of net patient service revenue
For revenue cycle process improvement, my organization supports: a) Formal Six Sigma methodology b) LEAN c) Internal methods/no formal methodology d) External consultants e) None of the above
Experience with LEAN
True or false: there are definite barriers to the adoption of LEAN in my organization a) True b) False
Group Curbside Consult Reducing Barriers
LEAN Projects on the Horizon
20 Questions
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