Strategies for a High-Performance Revenue Cycle

As part of its performance monitoring, CHRISTUS St. John Hospital relies on nontraditional revenue cycle measures. These measures were developed with the help of an outside consulting firm that facilitated the redesign of its revenue cycle process. The following are just a few of these nontraditional measures.

120 net-to-cash percentage without self pay. At month end, staff look back to accounts discharged four months previously and determine whether they were paid. In June 2008, for example, staff measured inpatients and outpatients discharged in February 2008 and found that 91 percent of the accounts were closed.

120 net-to-cash percentage with self pay. This metric is the same as the previous one, but includes self pay and, thus, it always has a lower percentage.

Quality/length of time to liquidate (without self pay). This metric looks at efficiency in receiving payment. For example, of the 91 percent collected in the aforementioned metric, it considers the percentage collected during the first 30 days, 31 to 60 days, 61 to 90 days, and 91 to 120 days. Staff bonus plans are built around this metric.

Time of service collection potential. This one measures the actual collection at point of service and compares it with the amount owed, 30 days out, after payment from insurance. CHRISTUS St. John had been collecting 45 percent in May 2008, but was collecting 52 percent as of July 2009.

Publication Date: Thursday, November 05, 2009