Today’s healthcare financial leaders operate within a dynamic, volatile marketplace and are ultimately responsible for maintaining or improving organizational profitability. Of course, the only challenge greater than setting a strategy that navigates all of this change is actually delivering on it.
I recently met with a client who not only has a strategy, but is making huge strides in delivering on it. It starts with taking on what many health systems have considered, but few have successfully accomplished: integrating hospital and ambulatory revenue cycle activities with complete integration of all processes on a single IT platform.
The need to implement an integrated revenue cycle is paramount. In a recent article in HFM Magazine, a publication by the Healthcare Financial Management Association, writers Ben Colton and Andrew Davis state, “Hospitals and health systems can obtain many benefits from tighter alignment with physicians, including a higher continuity of care, a stabilized referral base and readiness for new payment models…. A hospital or health system can experience three primary benefits from developing an integrated revenue cycle: a reduced cost to collect, performance consistency and coordinated strategic goals.”
This is where Amy Andrade, Senior Director of Revenue Cycle at Children’s Mercy Kansas City comes in. She recently discussed with me an important piece of her organization’s goal to be a worldwide leader in delivering optimal health outcomes via innovation and an integrated system of care: providing comprehensive family centered healthcare. Working closely with its parent and patient advisory councils, Children’s Mercy learned that patients and their families suffer significant anxiety regarding the financial aspects of receiving care. Not only must parents watch their child go through treatment, but they also must manage the confusing maelstrom of bills and statements from different providers, clinics and facilities.
Children’s Mercy quickly discovered that making a change as simple as providing a single statement to families could have a profound impact on the overall patient experience. And GE was there to help.
“GE Healthcare pushed us out of our comfort zone and challenged us to think differently,” Amy said. “We had to step back and look at our processes and reinvent them in order to get to the desired outcome. With our old system, we had internal manual processes that differed from hospitals to clinics to physician offices. Now we actually use a single, enterprise, revenue cycle- management solution across all care settings, which have driven us to better align our processes and deliver a better patient experience.”
Children’s Mercy has learned a few things along the way that can help other organizations considering an integrated revenue cycle:
- Collaborate with clinicians – Many health systems are so mission-oriented that staff doesn’t always see the downstream financial impact of decisions. By engaging the clinical teams early in the project, both teams were able to better understand the relationship between the clinical and financial aspects of delivering world-class care.
- Engage all relevant teams early and give them a voice – Change is hard. Change forced upon you is even harder. By engaging all teams early in the process, Amy gave participants a voice into the project and accelerated success.
- Measure, measure, measure – Carefully measure the performance of the integrated revenue cycle performance against industry standard Key Performance Indictors (KPIs). This is the key to identifying problem areas – across both the ambulatory and hospital settings – and making adjustments to improve performance.
By developing a single patient statement and implementing an integrated revenue cycle solution, Children’s Mercy is, indeed, delivering on its promise to deliver better outcomes.
About Children’s Mercy Kansas City
Children’s Mercy, located in Kansas City, Mo., is one of the nation’s top pediatric medical centers. The 354-bed, not-for-profit hospital provides care for children from birth through the age of 21, and has been ranked by U.S. News & World Report as one of “America’s Best Children’s Hospitals.” For the third time in a row, Children’s Mercy has achieved Magnet nursing designation, awarded to fewer than seven percent of all hospitals nationally, for excellence in quality care. Its faculty of 600 pediatricians and researchers across more than 40 subspecialties are actively involved in clinical care, pediatric research, and educating the next generation of pediatric subspecialists. For more than a century, Children’s Mercy has provided the highest level of medical care to every child who passes through its doors, made possible through generous community support. For more information about Children’s Mercy and its research, visit childrensmercy.org.
 Ben Colton, Andrew Davis; Integrating the Revenue Cycle for Improved Health System Performance. HFM Magazine, January 2015.