Before Go-Live, Novant Health Ramps Up Collections Efforts to Build Cash 'Cushion'

Healthcare executives have been warned: Any electronic health record implementation will be accompanied with a productivity lag, at least for the short-term.

Executives at Winston-Salem, N.C.-based Novant Health, are heeding this warning proactively as they work to implement the Epic EHR across their entire system.

Prior to its first EHR go-live, at Novant Health Presbyterian Medical Center in Charlotte, NC., the health system outsourced legacy accounts receivable so that it could free up its existing billing and collections team for training on the new system, while building up a revenue "cushion" to help mitigate anticipated losses of productivity post-EHR implementation, explain April York and Craig Pergrem, senior directors of patient finance at the health system.

Executives were concerned coders and billers would initially lose some productivity on the new system, and were also aware physicians and other providers would likely experience the same loss — meaning the system would experience slower revenue for at least some period of time.

The outsourced team "pushed" collections efforts, seeking to bring in outstanding payments owed by both payers and patients.

"In an effort to get ahead of what you know is going to be slippage when you go live— you're always evaluating your strategy," says Ms. York. "We have two go-lives to know historically how long that shortage may last, so we establish targets based on anticipated shortfall to prepare and cushion ourselves for what we will experience 60-days post go-live."

The system is now in the midst of its third wave of implementations with it's largest go-live, scheduled for Aug. 2, says Ms. York.

One of the cash acceleration strategies being used is in partnership with its zero-percent interest payment plans for its patients, through a partnership with ClearBalance. This time, the system opted not to outsource additional accounts receivable and to proactively pursue patient receivables by using its existing staff to sign up patients with outstanding balances in the new payment plans or add new balances to already existing plans

Changing the focus from "you must pay this way" to providing more payment options proactively, has helped the system achieve a slight revenue lift in advance of its planned go-live from a patient collections perspective.

According to Ms. York, an additional million dollars has already been brought in by these efforts in the last two weeks.

Mr. Pergrem says giving patients more flexibility has been especially useful in North Carolina, where high-deductible health plans are very common. "North Carolina is in the top two or three states for high-deductible plans, so it's not unusual for us to see $10,000 deductibles," he says. Plus, giving the patient more options helps Novant better carry out its mission of "delighting the patient," he adds.

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