The Challenges:
System conversion; new claims systems at local payers; more self-payer receivables

Launching Rochester General’s new computer system – which is integrated with medical records – caused the organization to redo all work flows. The revenue cycle team worked really hard and made significant progress. As a result, Rochester’s numbers are looking much better.

The organization had a culture of continuous improvement for a long time. Most of the time, they compared themselves with themselves, and were happy if their numbers were moving in the right direction. They’ve looked for years for standard metrics to make apples-to-apples comparisons with like organizations, but until recently that data wasn’t available. Using HFMA’s MAP Keys, Rochester was able to see how they compared to the rest of the country, and to the high performers.

Things keep changing for Rochester. Their two largest payers are putting in new claims systems. High-deductible plans are increasing self-payer receivables. These factors are forcing them to look into every nook and cranny. What’s coming now – ICD-10, the Affordable Care Act, population management, health exchanges – causes their team to continue looking for good ideas to improve their process.

BIGGEST LESSON LEARNED: Rochester listens to their customers. They solicit feedback from their patients on how Rochester can improve their statements to make them more understandable. And Rochester discovered how important it is to listen to their physicians as well. 

The Payoff

  • Reduced DNFB from 12.8 days (2010) to 9.3 (2012)
  • Reduced Net Days in A/R from 32.9 (2010) to 24.2 (2012)
  • Won HFMA’s 2013 MAP Award for Performance Improvement in the Revenue Cycle

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