Providence Profile

The Challenge:
Decrease Aged A/R as a Percentage of Billed A/R

Our aged A/R (as a percentage of billed A/R 90 days or greater) was ticking upward. We decided to dig into why that was happening and set a goal of improving that number. We knew that addressing this would affect other key performance indicators. We had to improve point-of-service cash collections and reduce denials. To accomplish all of these improvements, we had to make some big changes.

The secret was empowering staff to make the changes and holding them accountable. We reorganized our business office and set up three self-directed, competitive work teams. We clearly defined expectations, documented the results, gave the staff the power to make decisions, and created incentives for improving performance.

We used the MAP Keys to measure progress and benchmark ourselves against our peers and industry leaders. Having the numbers from other facilities motivated us. If other hospitals similar to us could accomplish this, we could too.

So we set goals and drilled down from department, to team, to individuals. MAP App’s quarterly progress reports helped me keep everyone focused on the idea that these goals were attainable. It’s harder to enforce accountability if you can’t show that your expectations are valid. Plus, I could show our progress compared to other hospitals in the Southeast – or hospitals that are similar sizes – in real time. The figures demonstrated that we were really accomplishing something and helped us get the resources we needed, such as funds to invest in new technology.

We achieved a one-time improvement in cash flow by decreasing aged A/R, and we’ve had ongoing improvement in denials. Because we’re collecting on accounts sooner rather than later, the revenue cycle is more efficient and we’ve significantly decreased our cost-to-collect. We were pleased to earn HFMA’s MAP Award, which recognized all the hard work of our staff in achieving these results.

The Payoff

  • Reduced Aged A/R as a Percentage of Billed A/R (90 days or greater) from 28.6% (2010) to 14.5% (2012)
  • Attained top 20th percentile in Denial Write-Offs as a Percent of Net Revenue
  • Achieved a Medicare Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey score for “patient would recommend this hospital” of 85%
  • Winner of HFMA’s 2013 MAP Award for Performance Improvement in Revenue Cycle

What's Your Story?