Creating dashboards from the data provides a highly visual snapshot of where members excel and the areas that are most in need of transformation, which is helpful in conveying information quickly to senior leaders and engaging frontline staff, Kaspar said.
Initially, TPC members focused performance-improvement efforts on reducing unbilled accounts.
“Several of our members had just completed an EHR or revenue cycle management conversion or were in the middle of one, and struggles with unbilled accounts were the most pressing issue they faced,” Waldrop said. Today, areas of focus include cash acceleration, vendor management, denials management, clinical documentation and overall self-pay collections (e.g., point-of-
service, early out and bad debt).
During revenue cycle council meetings, representatives review overall trends in performance as well as trends by organization. They also seek guidance from leading organizations, whether within TPC or those recognized by HFMA’s MAP initiative as demonstrating high levels of aptitude in RCM.
For example, during TPC’s 2019 “Fall Classic,” an annual planning retreat for member organizations, the revenue cycle council used data from the HFMA MAP dashboard to examine trends in point-of-service and determine where improvement was needed. Members then collaboratively developed strategies to supercharge the patient financial experience for 2020, revising patient statements, building the infrastructure for a better experience, including patient estimators and electronic portals, and exploring strategies for increased transparency.
“Initiatives such as these would not be as clearly defined without the aggregated data provided through the MAP App,” Waldrop said.
The steady cadence of virtual and face-to-face communication builds a strong camaraderie that extends idea sharing beyond meetings.
“The intangible value of this approach is that I know my colleagues at other hospitals by name, I know what EHR they are on, and I can reach out and ask, ‘How is your performance better than ours in this area? What are you doing differently?’” Kaspar said. “I can also reach out to colleagues who are on the same EHR as we are and ask, ‘How did you pull this metric? How did you put this information together?’
“We’re continually seeking to learn from one another and help each other,” Kaspar said. “The value that the collaboration provides us elevates us all.”
5 lessons learned in data-enabled improvement
What can other hospital and health system leaders learn from TPC’s efforts to use data to promote collaborative steps toward revenue cycle success? TPC leaders share five lessons learned.
1. Invest in a robust platform for data collection and analysis. A Black Book survey found 76% of healthcare organizations plan to dedicate at least 10% of their 2020 technology budgets to predictive RCM analytics. “Data is critical when undertaking performance improvement initiatives,” Waldrop said. “If you can’t get data or you don’t have the right data, it can lead you down the wrong path. Good data and benchmarking points you in the right direction and helps you identify revenue cycle targets that make you more efficient and productive.”
2. Make sure you are measuring apples to apples. “Our members are fiercely independent, but they also want the benefits of being in a system by sharing information,” Waldrop said. “As we’ve taken steps to ensure we’re measuring revenue cycle data the same way and speaking the same language, we’ve been able to look to our high-performing members in various areas to ask, ‘How do you do it?’ This supports a level of collaboration around operational best practices that make the whole system better.”
3. Get into the weeds. Look for opportunities to go beyond the data to uncover the leadership tactics, processes or technologies that set an organization’s performance apart. “One of our members brought the fun back into revenue cycle by rewarding employees when they met their goals, such as around point-of-service collections, and it made a significant difference in their performance,” Kaspar said. “I think sometimes we forget to have fun in our work. Their example demonstrates the power of reenergizing your team.” At TPC, members also are expanding their collaboration by creating subcommittees around specific MAP Keys, such as denial write-offs as a percentage of net patient service revenue and days in total discharged not submitted to payer. “I’m really looking forward to digging into the details,” she said.
4. Involve clinicians in your efforts. “We’ve added clinicians to our denial committee team, including a physician adviser and representatives from admissions, case management and nursing, and that has made a tremendous difference,” Kelly said.
5. Focus on transparency. “If you don’t know where you are, you don’t know where you’re going,” Kelly said. “It’s good to be able to identify trends and see who is performing well in specific areas and who is not and to support each other in making improvements. Within TPC, my organization struggled with point-of-service collections, initially. Now, with the input we’ve incorporated from other members, our numbers have really increased, and organizations are coming to us for help. It’s gratifying to be in a position to offer guidance.”