How an Illinois hospital overcame revenue cycle challenges by enhancing its EMR system

Implementing an efficient EMR is crucial for hospitals to maintain strong revenue cycle performance.

Unreliable digital health information can lead to clinical documentation errors and ultimately billing and collection problems downstream. An efficient EMR is also important to an organization's long-term financial picture.

With all of this in mind, Morris (Ill.) Hospital & Healthcare Centers had a decision to make regarding its EMR system. It could convert its Meditech system to a new version, Meditech 6.16 Expanse, or modernize its existing Meditech Client/Server version. The 89-bed hospital ultimately decided to go with the latter.

The problem

Alex Blumenshine, director of revenue cycle at Morris Hospital, said the existing Meditech Client/Server version was inadequate and included many old and inefficient processes. As he put it: It was "us working for the system instead of the system working for us."

As a result, the hospital faced various revenue cycle challenges, including more than $7 million in unposted cash receipts; increases in unbilled receivables due to coding and final abstracting delays; and lack of a formal claim denials management program, according to a case study. Net days in accounts receivables also doubled between April 2016 and September 2017. 

Mr. Blumenshine knew a conversion involved a lot of workload and cost, and officials wanted to make an informed decision about whether they should modernize the current system or convert to a new version. After interviewing several vendors, the hospital chose RevSpring, a Livonia, Mich.-based provider of consumer engagement, billing and payment solutions, to help analyze its options.

The fix  

In 2017, RevSpring assessed Morris Hospital's Meditech Client/Server to identify what features were being underutilized and where lack of technologies resulted in revenue cycle inefficiencies, according to the case study. After reviewing the assessment, interviewing staff members and meeting with hospital stakeholders, the hospital decided not to convert to the upgraded Meditech EMR. Instead, the hospital decided to take into account recommendations from RevSpring and invest in modernizing its existing EMR with help from the vendor.

Once that decision was made, Morris Hospital worked with RevSpring to create a project list and prioritized list items, said Mr. Blumenshine. The 18-month project plan began in March 2018 and included initiatives such as creating new processes for hospital billing and collection staff, rolling out a "two-pronged" claim denials management program and implementing a general ledger application.

Overall, the EMR modernization project was a success, according to Mr. Blumenshine. For example, Morris Hospital's month end accounts receivable totaled $58.5 million in February, down from a monthly average of $104.4 million in the third quarter of 2017. Additionally, the hospital's cashflow increased by nearly $17 million between 2017 and March 2019.

Mr. Blumenshine said the hospital does plan to take the leap and convert its EMR in April 2021. But for now, he said the EMR modernization project has been beneficial.

"It is always easy to look at going to a new product or switching products, but it is challenging to admit your system is flawed and to get in there and fix it," said Mr. Blumenshine. "If you can get in there and fix it, it's amazing how much more efficient and effective some of those systems can work. The right partner can help out any hospital."


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