Innovation

Getting a better understanding of financial performance

Receiving health care services is unlike receiving amenities from any other industry, financially speaking. It’s complex. Laurie Hurwitz, senior vice president of the Revenue Cycle for OSF HealthCare explains it best.

“Suppose you get a manicure, and then tell the manicurist they need to bill someone else,” said Hurwitz. “They agree but aren’t sure how much to collect from you. As a result, they wait to send you a bill in six months after that other person pays their portion of the bill, and tells the manicurist how much you owe. It seems like a weird way to operate a business, but that’s what happens in health care every day.”

It’s a rather simplified explanation of how health care organizations function. But it gives you an idea of everything they must track in order to understand the financial and operational performance of their health systems. This is done through the revenue cycle.

Revenue cycle management is the process of capturing, managing and collecting patient service revenue, according to the Healthcare Financial Management Association. It encompasses every part of a patient’s interaction with a health care system from scheduling and registration to treatment and bill collection.

The Revenue Cycle division worked with Healthcare Analytics, a part of OSF Innovation, to get a better understanding of its revenue cycle’s effectiveness — all in one place.

Revenue cycle dashboard

The Revenue Cycle Dashboard provides an overview of how well the revenue cycle is functioning by region, financial class (general types of insurance) or plan code (specific types of insurance). This includes times when insurance companies deny payment for a certain service and when reimbursements are made without error.

The dashboard shows credit balances and collection percentages as well as bad debt, charity and other items. It also includes patient feedback that is used to improve their experience.

“The purpose of the dashboard is to take data elements from disparate systems and put them together all in one place,” said Bryan Kaiser, director of Analytics and Reporting for Healthcare Analytics. “This gives the Revenue Cycle division an easy and convenient way to track how the organization is doing financially.”

Metrics are trended over the last 13 complete months and include both hospital billing and professional billing. The revenue cycle is something patients don’t typically see or understand, but impacts every part of the clinical experience.

“Our goal is to reduce costs for patients. Being more efficient in the way care is delivered and paid for helps us do that,” said Hurwitz. “It also helps us provide the best financial experience for our patients.”

Hurwitz says the dashboard also allows her team to ensure everything within the revenue cycle is calculated in an industry-defined, standard way.

Simplifying the complex

Ultimately, the Revenue Cycle team is in charge of overseeing the various ways OSF collects the money used to provide quality care and maintain operations. Having clearer visibility into the data allows the organization to determine where things are going well, where they are not and areas for improvement.

“The Revenue Cycle Dashboard really just consolidates all of this data and makes it a little more manageable for leaders to deal with,” said Kaiser. “The Revenue Cycle team can also ensure the effective management of the revenue cycle and provide those making decisions in the organization with the best information.”

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