1. ©2013 The Advisory Board Company advisory.com Riverside Health System, 800 Beds, Newport News, VA Root Cause Analysis Reveals Charge Lag, Drives Real Change Revenue Cycle Solutions Revenue Cycle Compass Case Study Late Charges a Persistent Challenge: Even after working to limit late charges, the seven hospital system recognized delayed posts dogged their Revenue Cycle. When compared with the Mid- Atlantic cohort, the Riverside team was in the lower quartile for the percent of charges posted within four days of discharge Root Cause Analysis Uncovers Underlying Problem: With the help of their Dedicated Advisor, Riverside ran an AR assessment in Revenue Cycle Compass. The investigation identified specific departments who struggled with late charges. A custom Time & Days to Post report identified key ancillary departments where charge nurses were having difficulty posting timely charges. Working Smarter, Not Harder: Through continued education and monthly report updates, staff were held accountable for charge lags. This drove improvement across the health system with a nine percent increase in Total Charges posted within four days of service and an overall decrease of 5 days in AR. Reporting Keeps Charge Posting Performance Efficient 5 Days Reduction in AR 9% Improvement of Charges Posted within Four Days of Discharge Riverside’s Patient Financial Services Team recognized they were underperforming when compared to peers across the mid-Atlantic region. They partnered with their Dedicated Advisor to run an AR Assessment in an attempt to the identify root cause of their ballooning AR. Through a custom Time & Days to Post report, the team identified late charges as an area of opportunity to improve cash acceleration. Riverside’s Project Management team utilized monthly Revenue Cycle Compass reports to identify key, high- offending departments. By isolating key impact areas, the group was able to invest wisely, not following a costly and time consuming organizational wide effort. By prioritizing individual departments, they customized their efforts and set specific goals. Pin-Pointing the Problem Source Maximizing Outcomes with Minimum Effort Impact Highlights

2. ©2013 The Advisory Board Companyadvisory.com 2445 M Street NW, Washington DC 20037 I P 202.266.5600 I F 202.266.5700 I advisory.com Spotlight on Late Charge Improvement After identifying the offending departments, the analyst team focused on additional education and process changes to improve efficiency. They worked with users individually to address concerns and improve awareness of the broader impact the staff was having on the hospital. They were able to see rapid gains in time to post charges and a reduction in total AR Days. The analyst team built lasting results by providing charge nurses Compass reports showing their performance versus the cohort average. This way they could see their peers performance and make changes accordingly. Riverside provided education for staff and monthly reports to help establish accountability in their departments. Process workflows were analyzed to identify opportunities to streamline charge posting procedure and resulted in a 5 day drop in AR as well as a 9% improvement in charges captured within 4 days of service. Strategy implementation Fostering Accountability Member Quote: “Time & Days to Post report allowed us to identify areas of opportunity and potential process workflow issues. By utilizing Compass, we were able to move from “Bottom Quartile” to “Top Quartile” in the cohort in only six months”. -Matt Midgett, Project Manager Data Visibility Allows for Best Practice Implementation 1)Mid Atlantic Cohort consists of 10 hospitals located in Virginia, North Carolina, and Maryland. The success of this specific initiative is part of a broader organization-wide focus for Riverside. They have established a team dedicated to investigating revenue cycle problems and identifying root cause issues as well as evaluating processes. This team has utilized Revenue Cycle Compass spanning departments to target specific areas of high opportunity and efficiently prescribe process changes. This team has yielded high r esults and consistently delivered organizational improvements. A Team Dedicated to Success