Greg Douglass, serves as Director and Revenue Cycle Strategic Partner for Ochsner Health System.
On Friday Sepember 22, Mr. Douglass will speak at Becker's Hospital Review 3rd Annual Health IT + Revenue Cycle Conference. As part of an ongoing series, Becker's is talking to healthcare leaders who plan to speak at the conference, which will take place September 21 through September 23 in Chicago.
To learn more about the conference and Mr. Douglass's sessions, click here.
Question: Please share the state of revenue cycle management at your organization. What is your payer mix? What about your revenue cycle is working well, what needs improvement and what do you find yourself spending more time on?
Greg Douglass:
Ochsner is a single business office (SBO) Revenue Cycle that is performing well in a very strong growth phase of the organization. Our Revenue Cycle has enjoyed the benefits of a consistent, talented, and tenured leadership structure over the past several years. Our people, combined with operational enhancements driven by our integration with Epic have pushed our results to the next level. Our quest for improvements constantly center on strategies to mitigate unwanted or unnecessary write-offs for the organization. Ample resources are charged with uncovering root causes for claim denial and ultimately write-offs. These resources range from trained denials specialists that forensically investigate non-payment patterns to Revenue Cycle Strategic Business Partners that are deployed and embedded in clinical and hospital areas who assist in making corrections to root cause problems.
Q: How have alternative payment models affected your line of work? Can you share 3 specific steps, if any, has your organization taken to adapt to bundles and ACO payments?
GD: For the ACO, we have utilized internal resources to understand our financial and clinical performance, and develop action plans for improvement.
For bundled payment programs, we have brought new and outsourced analytic capabilities on line to help understand our financial and clinical performance.
Q: Percent-wise, roughly how much of your revenue cycle is automated? Do you plan to maintain that percent or increase in the next 1-2 years? What effects have you seen from automation, good or bad?
GD: We have various automation processes around all areas of our revenue cycle including access, billing, follow-up and others so it would be difficult to assign one percentage. However, one specific area where we have vastly increased our automation is in our pre-service and authorization division. We strive to only perform pre-service clearance on the cases that absolutely need the authorization or benefits verification review. Thus, we have increased our auto-authorization strategies. By enhancing the scrubbing capabilities of the Benefits Engine for each payer group we can identify and eliminate unnecessary human touches on accounts that do not need authorization. We have seen a tremendous reduction in FTE needs in this area and have been able to scale and stay lean through volume growth.
Q: What is one investment you've made in RCM that has surprised you in terms of ROI? How so?
GD: We invest heavily in leadership training. While the ROI hasn't actually surprised us, we have seen that it plays a vital role in overall improvement as well as leader retention. We utilize this training in combination with all our Revenue Cycle focus areas and have seen improvement in all of our key metrics. The "actively engaged" measure of our team members (as calculated by an independent third party) has continued to rise year over year and with that improved engagement comes a culture of continuous improvement. We firmly believe the degree to which we develop and train our rising leaders is a differentiator for us and plays a key role in our improvement as a Revenue Cycle.