Robin Bradbury

About re|solution Founded in 1998 VHA Preferred Vendor Services include: -Cash Acceleration -Revenue Cycle Assessments -A/R Management Training -Interim Management and Staffing -Virtual Business Office -Payment Reviews -Self Pay Cleanup

Time and Energy

When performance is measured, performance improves. Revenue Cycle 101

Objective measures are always better than subjective measures. Revenue Cycle 102

Preview Performance Metrics Behavioral Competencies Interviewing and Selecting Performance Management

Patient Encounter Charge Ticket Order Entry Coding Edit Billing Transmission Follow up Payment Reporting HOSPITAL The Revenue Cycle

Performance Metrics HFM Toolbox – Key Revenue Cycle Metrics Sample Benchmark Indicator Analysis from re|solution Revenue Cycle KPI and Standards Take it down to the individual level Keep it simple Monitor, train and achieve

Days in Revenue Outstanding Cash Collections Cash as a % of Net Revenue Write-offs as a % of Revenue Aged AR Greater than 90 Days Days in Discharge to Final Bill Up-front Cash Collections Key Measures

Free Benchmark Study Sample Information: Facility Bed Size:122 Average Daily Census:38 Total Accounts Receivable:$8,000,000 Cash Receipts per Month$900,000 Gross Revenue per Month:$2,000,000 A/R Over 90 Days:$3,500,000 Monthly Cost of BO:$45,000 Write Offs per Month:$150,000 Number of Open Accounts:19,000 Number of FTE's in BO:12 Percent A/R in Self Pay:40%

Value Proposition Actual Example HospitalPeer GroupDifference Cash Opportunity AR Days Reduction824339$1,476,815 Days over 90 Reduction31.7%24.4% 7.3% $217,374 DNFB Reduction $652,439 Cost to Collect Reduction $ $ $ $33,356 Bad Debt Write off Reduction8.9%2.3% 6.6% $855,290 Charity Write off Reduction1.9%6.9% -5.0% NA

Front end, middle and back office resources Raise performance level awareness Align goals Creates healthy competition Cream will rise to the top Expectations and Performance Standards

Expectations

Estimate, Validate, and Advocate Estimate Charges, insurance coverage and patient portion Validate the information Advocate for the patient to deal with the obligation –Cash, Check or Credit Card –Payment plan –Medicaid Eligibility –Charity Care –Reschedule? Software is available to do this

People “Our people are our most important asset!” How does that manifest itself in your organization?

Improving Performance The best way to build a team is to hire the right people in the first place!

Conduct a job analysis Create a structured job-related interview Use past-event interview questions Use interview panels Control our biases and first impressions Use a rating guide Use consensus rating 7 Keys to Effective Selection

Paradigm Shift Since we all have existing staff – we need to be engaged in engaging them.

Options Fire everyone and start over Hire employees away from your competitors Browbeat the ones you have to get results Train and educate the employees you have Set expectations and measure results Shift the paradigm

Skills vs. Behavior Fired anybody recently? Why? Resume and skills questionnaires will determine skill set How do we get people to play in the sand box nicely?

Performance Evaluations Think of some of your last evaluations Positive and negative

Interviewing Keys To Success Define competencies you desire to promote Ask interviewees to give examples of when they exhibited these competencies Interviewing versus evaluation

Identify Key Competencies Sample Competencies and Performance Expectations: Patient Financial Services Representative

Gather Action Examples Key – they must be verifiable Have employees gather examples Use negative and positive examples Tie back to expectations

Discussion Matrix R+ R= R- A- A= A+

Impact of Process Before After 6 Months 12 months 18 months

Summary Set expectations Metrics and behavior Hire people who have demonstrated those expectations Review and coach to expectations Succeed

Questions?

how to measure and improve performance in the revenue cycle