Case Study: ProHealth Care - Revenue Cycle
ProHealth Care is a 400-bed community-based healthcare system offering a full range of services. ProHealth Care has two main campuses, more than 175 primary care physicians and specialists, and 70 advanced practice providers at 15 clinics.
ProHealth Care had a proven history of high performance, but industry and market shifts were demanding a focus on delivering high-quality care while decreasing costs. While ProHealth Care’s revenue cycle was performing well, leadership lacked the transparency and tools to identify significant opportunities for improvement.
ProHealth Care engaged Huron for a comprehensive transformation engagement. The revenue cycle portion of the engagement delivered $19.3 million in annual recurring benefit against a $13.3 million target. The engagement also increased cashflow by $6.8 million through accounts receivable liquidation, exceeding a $4.4 million goal.
Establishing comprehensive revenue cycle reporting: Huron’s solutions provided financial outcome and operational reporting that improved clarity and transparency, and brought uniformity across hospital and physician groups. Huron and ProHealth Care worked together to deploy consistent reporting processes across distinct groups within the organization, focusing on staff management, operational efficiency and financial outcomes.
Due to increased transparency, collaboration increased across the revenue cycle. ProHealth Care continues to maintain revenue cycle performance benefits from the Huron engagement.
Educating patients on healthcare costs: The Huron team helped ProHealth Care implement processes and procedures to educate patients on their expected liability, and offered assistance with identifying additional coverage options. Revamped scripting, policies, and procedures improved communication with patients and resulted in a 20 percent increase in self-pay accounts collection ratio.
Reducing denials and driving efficiency: Huron worked with ProHealth Care leadership to drive process improvements and efficiency in many areas of the revenue cycle, such as automated staff workflows and the integration of payer system data into staff workflows and reporting. Huron focused on implementing consistent denials reporting across the hospital and physician groups. A cross-discipline denials meeting provided focus on root cause prevention. As a result, denials decreased 11 percent in a seven-month period.
Implementation of Huron’s workflows led to a 71 percent reduction in physician group timely filing/ appeal write offs, and a 55 percent reduction in overall physician group avoidable write offs.Download Now