Case Study: Health First
TEXICAN LEADS HEALTH FIRST’S REVENUE CYCLE TRANSFORMATION, RESULTING IN $52 MILLION ADDITIONAL CASH IN 15 MONTHS.
About
Health First
The
Challenge
- Achieving financial goals set by senior leadership and based on national benchmarks
- Creating a culture of accountability for sustained performance improvement
- Implementing a quality assurance program to improve staff results
- Streamlining processes to improve efficiency and effectiveness
- Optimizing existing technology to maximize productivity
We recognized the need to partner with Texican, a trusted advisor, to lead comprehensive and sustainable revenue cy”cle improvements for Health First.
Background
Health First realized the value of a best in class revenue cycle performance initiative that would maximize cash on hand, improve net revenue and reduce operating expenses.
With a new Executive Team in place, Health First understood that outdated processes and under- utilized technology had created significant revenue cycle opportunities. Several of the Health First Executives had previously worked with revenue cycle firms and knew the impact that the right partner could provide to cash collections, net revenue, and requisite cultural change. As Health First reviewed proposals from several national RCM firms, the need for an organization that could provide more than
a one-time cash acceleration became a primary selection criteria. Health First wanted a partner that would drive sustainable improvements to net revenue, while promoting a cultural change within the organization.
Texican worked side by side with Health First
management and staff pro”
industry leading best practices
Texican projected a $40M cash improvement in the first year, which quadrupled the projected results of their competitors.
Texican’s compensation was tied directly to the results of the engagement.
Texican had a 20+ year track record of sustainable revenue cycle improvements.
The
Texican Commitment
Based on Texican’s experience in the healthcare revenue cycle and Health First’s needs, the project scope was determined to be:
• Assess and identify areas for improvement within
the revenue cycle
• Cash acceleration and net revenue improvement
of $40M
• Re-design processes and train revenue cycle staff
• Optimize and re-deploy existing technology
• Provide interim management
their corresponding solutions. Once approved, these issues were attacked by the appropriate team members consisting of Health First and Texican professionals. This process facilitated collaboration, mentorship, and ultimately
the change of behavior required to provide sustainable change.
The
Patient Access Solution
The
HIM Solution
The
PFS Solution
| INITIATIVE | ACTION TAKEN | ACCOMPLISHMENT/ BENEFIT | ||
|---|---|---|---|---|
| Utilize best-practice “Collection Logic” for follow-up activity | Implemented Texican’s Collection Enhancement Program, including management review processes | Increased management and staff education facilitating two-way communication | ||
| Redesign workflows to maximize collection efforts | Utilized Texican’s proprietary work queues Re-deployed Receivables Workstation to enhance cash through more effective follow-up Implemented Texican’s 15 minute review process |
Immediately increased cash flow Increased efficiencies resulting from exception based workflows Reduced errors and improved collaboration among revenue cycle departments |
||
| Analyze billing edits for deficiencies | Billing system edit overhauled | Reduced rejects and increased first-pass pay rates | ||
| Process redesign for billing and follow-up responsibilities | Aligned employee skills to meet their daily work expectations | Created more effective and efficient work efforts |
The
Technology Solution
Texican’s methodical analysis of Health First’s patient accounting system indicated that there were additional improvement opportunities to be realized through the integration of Texican’s workflow logic.
in inefficiencies due to redundant efforts and manual processes.
Texican transformed Health First’s revenue cycle team’s efforts and culture to work by exceptions rather than manually or systematically reviewing all accounts. The results included improved collection performance contributing to a 9.9 percent reduction in labor expense based on automation and process improvement.
The
Results
Texican exceeded all deliverables from their initial assessmen”t, including significant increases in cash and recurring net revenue.
About
TEXICAN, INC.
a sole focus on hospital receivables management and cash acceleration. Our senior consultants each have a minimum of 15 years of hands–on experience in all facets of revenue cycle operations. Historically, Texican has helped clients improve incremental cash collections by an average of 12 percent
per engagement, reduced bad debt expense
and improved operational efficiencies. In addition, we have worked with a variety of hospitals and health systems, including community hospitals, integrated health systems, university-based teaching facilities, and both for-profit and not-for-profit hospital organizations and large physician groups (contracted and employed).
As our corporate theme, “Achieving Results Through Adaptation,” suggests, we do not promote the abandonment of your current business model. At Texican, we pride ourselves not only on the
Contact
Information
Tony Reyna
Texican, Inc.
16530 VENTURA BLVD, SUITE 305 ENCINO, CA 91436