New York-Presbyterian/Columbia University Medical Center Increases Operational and Financial Performance of Cardiology Division

Huron partnered with NYP/Columbia to increase operational and financial performance in the Division of Cardiology. During the engagement, the division was able to launch initiatives accounting for more than $4 million in annual margin improvement while increasing provider and patient satisfaction.

Challenge

Leadership at NYP/Columbia sought to improve the financial stability of the Division of Cardiology by increasing practice efficiency and organizational effectiveness; optimizing the revenue cycle; and improving clinical documentation.

Approach

Huron partnered with NYP/Columbia to increase operational and financial performance in the Division of Cardiology. Working side-by-side with physician leaders, administrators and other key health system stakeholders, Huron developed and implemented consistent procedures and standards, addressed utilization and performance issues and significantly improved revenue collection in coordination with the division’s strategic plan.

During the engagement, the division was able to launch initiatives accounting for more than $4 million in annual margin improvement. The engagement also implemented numerous quality and access initiatives, increasing provider and patient satisfaction.

Increasing Practice Efficiency and Organizational Effectiveness. Huron worked with NYP/Columbia to develop a clinical and administrative staffing model. The Huron team also developed training materials and practice dashboards to improve operational performance and ensure sustainability. Organizational effectiveness was improved through development of decision matrices for division leadership.

Working collaboratively, Huron developed a plan to shift nurse practitioners from non-revenue generating providers to autonomous revenue generating providers practicing at the top of their license.

Optimizing the Revenue Cycle. Huron partnered with division leadership on revenue cycle process improvements to enhance transparency and accountability, increase cash and reduce administrative write-offs. The partnership included implementing local insurance verification/referral/authorization teams to ensure the financial security of each visit. Insurance verification and authorization secure metrics increased by 10 percent and 42 percent, respectively. Monthly steering committee meetings were utilized to assess and prevent denials and write-offs. A/R follow-up worklists and productivity standards allowed the division to reduce cardiology-owned follow-up work in process by 56 percent.

Improving Clinical Documentation Accuracy. Huron delivered customized training for providers through one-on-one education and feedback as well as group sessions based on provider documentation practices to increase the overall accuracy of documentation and billing. The education initiative covered approximately 100 providers. To ensure sustainable success, Huron provided follow-up reviews and tailored education based on the results. Huron’s work increased cardiology’s E&M coding accuracy rate from 36 percent to 83 percent, which resulted in increased revenue.

New York-Presbyterian/Columbia is internationally known for its cardiology program, which ranks among the top 10 programs in the country. The Division of Cardiology has more than 150 providers including physicians, nurse practitioners and physician assistants.

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