The Challenge: Meet
pressures to improve performance, increase our understanding of patient access
benchmarking, and set realistic goals
Presbyterian Healthcare Services started in 1908 as a
tuberculosis sanatorium and has grown into an integrated delivery system
throughout the state of New Mexico serving one in three residents. As the
largest private non-profit in New Mexico, we have 8 hospitals, employ nearly
800 providers, and exceed 1.3M visits annually.
Our current revenue cycle challenges include:
- Pressure to improve performance—specifically
reduce denial write-offs, increase self-pay collections, and reduce
uncompensated care
- Lack of patient access benchmarking—we have
several KPIs for this area but haven’t had a sense as to whether we were truly
operating in an acceptable range
- Realistic goal setting—we push to improve prior
performance but sometimes we set goals that are too high or two low compared to
industry averages
The decision to look at MAP App was to help meet the above
challenges. The specific factors leading to our decision to become a subscriber
include:
- Standardized KPI calculations—eliminated
variation and ensures that we are comparing apples-to-apples
- Identified improvement opportunities—and target
specific areas for improvement
- Benchmarking capabilities to "like"
organizations—we can subdivide our delivery system and benchmarking along those
subcategories
- Revenue cycle transparency—in distributing KPIs
to leaders across the organization, there is a higher level of understanding of
performance
One of the key features that we have deployed to our revenue
cycle leadership is the customized
dashboards. The dashboards allow us to see all MAP Keys or just those
related to a certain person’s job function. Or, we can span across all MAP Keys
related to patient access, revenue integrity, claims adjudication, and
management.
Our team really likes the opportunity reports as they allow
us to quantify opportunities into organizational opportunities. So, for
example, if we are able to improve denial write-offs by 0.3%, then that revenue
impact to the organization is more than $227,000. We are really looking into
using this feature more to drill down and understand where we can make
improvements that contribute to the bottom line.
We also like the ability that MAP App gives us to sub-divide
our health system. We have created separate views for facilities within the
system giving us the ability to find similar comparisons and benchmarks. In
doing this, we have an idea of how those facilitates should be performing
instead of what we have traditional done which is aggregate them into one big
bucket and then compare them against other organizations which may not end up
being that similar.