Improving Revenue Cycles at a West Coast Public Hospital?

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Mr. Johnson was the chief financial officer (CFO) of a 222-bed teaching hospital in southern California. Mr. Johnson recognized a lot of problems with the processes within the various revenue cycle departments he managed which impacted cash flow for the facility.  Mr. Johnson met with the hospital chief executive officer (CEO) to express his concerns and the fact that he felt his existing staff did not have the expertise to fix many of the problems they were facing.

Ms. Thomas, the hospital CEO, agreed with Mr. Johnson’s evaluations and concerns and the two prepared a package for the Board of Supervisors to submit a request for proposal to several revenue cycle improvement vendors.  This request was approved by the Board and sent to several vendors with known successful track records in this area.  During the next several weeks the responses were evaluated and a final vendor selected.

It was determined through a Revenue Cycle Performance Evaluation completed by the vendor prior to the kick-off of the engagement that the largest opportunity for improved cash would be to address the bottlenecks in the cash flow, the excessive days in accounts receivable, the backlogged accounts in denied claims and improved process through the entire revenue cycle at this public hospital.

When the engagement began, the net days in accounts receivable were 103 and the time from discharge to final bill was 33 days. The vendor was engaged for a four-year period to provide cash acceleration and revenue cycle improvement on a “pay for performance” [P4P] fee structure.  A historical review of the hospital’s financial data determined an average monthly collection amount (baseline) the hospital was achieving each month prior to the start of this engagement.  The P4P fee structure required the vendor to reach the baseline each month before the hospital was required to pay any profession fees for the services of the vendor.

KEY ISSUES:

What could the hospital do to realize immediate benefits with regard to:

– accelerated cash flow?

– reduced days in accounts receivables?

– streamlined revenue cycle processes?

– better trained existing staff?

– return on investment?

MORE: Rev Cycle Mgmnt

Conclusion

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Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com and http://www.springerpub.com/Search/marcinko

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A Survey to Understand the Modern Doctor-Patient Milieu

Doctors – Take Our Professional Contentment [“Happiness”] Survey

By Ann Miller RN MHA

[Executive-Director]

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Today, when patients communicate through instant messaging, Twitter, Facebook, and other Web 2.0 electronic mediums, they might feel that health providers are already more like the virtual “Doctor” than the all-too-human “Bones.”

The Contemporary Practice Milieu

Before long, according to one technology expert, 20% – 50% of all doctor-patient communication will be virtual. But we suggest you pause before rocketing ahead into this brave new future that advocates call Health 2.0—the application of social media tools to the health care environment.

Electronic technology in all of its forms has obviously had a profound impact on medicine. We focus here on just one of its most notable effects: the changing doctor-patient relationship. We believe Health 2.0 has the potential to deepen this relationship—or not. It depends on how you use it.

Our Guidance

There are an almost overwhelming number of social media tools for managing the doctor-patient relationship. How do you choose the right ones? We offer some guidance in this essay by focusing on three issues:

  • What matters most in the doctor-patient relationship?
  • What counts as a good relationship?
  • How should you use social media tools to build a relationship?

We have found that there is no one best way to use Health 2.0 technology. But, there is just one rule. As the novelist E.M. Forster said, “Only connect.”

The Survey

And so, we ask you to opine:

  • Has your doctor-patient relationship changed in recent years with the rise of the Internet search engines like “Dr. Google and Dr. Oogle” [for dentists] and the push to empower patients to take a greater role in their own care via HD-HCPs, private or direct payment models, etc?
  • Are patients more demanding of your time and attention than in the past? Do they understand the economic pressures that affect your practice? Do they care, or should they even care?
  • How do you handle noncompliant or uncooperative patients? What strategies work best or least? Is this issue underappreciated by the people pushing to base a greater portion of reimbursement on quality measures and outcomes?
  • How much time each week do you spend on paperwork, phone calls to payers, insurance companies, and other administrative tasks? How much has this increased in the last few years? Have you reached your breaking point, yet?

Assessment

Please give us your thoughts and opinions in the text box below.

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com and http://www.springerpub.com/Search/marcinko

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko 

Practice Management: http://www.springerpub.com/product/9780826105752

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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Silverman, Jennifer. “Impact of Virtual Visits on Doctor-Patient Relationship Unclear: an end to ‘true medicine’?” Ob.Gyn. News 38.21 (2003): 29.

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