Children’s Hospital and Clinicals of Minnesota Targets Integrated Solution For Revenue cycle, Case Management and Clinical Documentation Improvement
Children’s Hospitals and Clinics of Minnesota (St. Paul and Minneapolis, MN) worked with Huron’s team on developing and delivering an integrated approach to improving financial performance and quality of care for patients. The organization realized significant financial gain totaling $24 million in recurring revenue and $7.7 million in one-time benefit with the implementation of new technology, streamlined case management and clinical documentation improvement.
Children’s Hospitals and Clinics of Minnesota sought to focus on revenue cycle operations, case management and clinical documentation to improve patient satisfaction, quality of care and financial performance and prepare for the impacts of reform.
Huron worked with Children’s to implement integrated solutions, strengthening operational processes for revenue cycle, case management and clinical documentation. Coordination of these operational functions was critical to the engagement’s success, which delivered a $24 million recurring annual benefit.
Optimizing the revenue cycle. Huron and Children’s drove net revenue improvement by implementing new processes, job aids and techniques system-wide. The engagement generated a recurring annual benefit of $15.3 million and a one-time $7.7 million improvement in cash collections. The engagement, which included both hospital and professional fees, implemented AEOS™ — Huron’s proprietary technology that provides a single, comprehensive IT platform and consistent workdriver, exception-based workflow and enhanced business intelligence. AEOS drove transparency in work in process (WIP), increased accountability and efficiency and reduced manual processes — from scheduling through claim resolution. AEOS technology served as an overlay to Cerner and Invision, providing visibility of account lifecycle, enabling staff to diagnose breakdowns and next steps to improve performance.
Streamlining case management. Huron refined Children’s case management structure by introducing best practices, maximizing efficiency and implementing new processes to ensure accuracy in patient status. Huron’s AEOS technology improved the case management concurrent denial processes, organizing workflow, providing real-time status tracking and creating visibility so that billing and collection staff could focus on areas needing collaboration with the case management department. This allowed Children’s team to understand the number of concurrent versus retrospective denials and to enhance payer management discussions. Huron also helped implement a physician advisor program to support both case management and clinical documentation functions. Overall, the case management solution improved net revenue by $6.6 million annually.
Improving clinical documentation. Huron focused on advancing the existing clinical documentation program by adding clinical experience, improving staff level education and involving physicians and staff in communications. Huron’s side-by-side approach helped Children’s strengthen job aids, tools and metrics to improve performance. As a result, Children’s boosted its clinical documentation performance by $2.3 million annually.
Children’s Hospitals and Clinics of Minnesota is an independent health system with two pediatric hospitals, 12 primary and specialty-care clinics and six rehabilitation sites. Children’s is regularly ranked by U.S. News & World Report as a top children’s hospital.