Illinois hospital improves revenue cycle performance by taking a unique approach to Cerner software implementation

CGH Medical Center in Sterling, Ill., decided to take what it sees as a unique approach to implement new revenue cycle software.

The hospital had used Cerner scheduling, registration and clinicals and was looking for an integrated product with new technology and features for billing. In 2015, after multiple reference calls and visiting with other hospitals, CGH decided to switch from Allegra, its 1997 interfaced patient accounting system, to Cerner Patient Accounting for hospital and hospital-based professional fee billing.

"We wanted to go to Cerner if possible if the product worked, and after we did those reference calls and site visits, we felt like the product was at a place that was good," said Kenny Koerner, the hospital's director of revenue cycle.

CGH's visits also led the hospital to do an optimization phase with a third party, S&P Consultants. That optimization phase took place in February, March and April 2017, before the hospital kicked off the project with Cerner on May 1, 2017. 

"We wanted somebody to keep us honest and to kind of tell us what we didn't know about building and designing and implementing," Mr. Koerner said. "So we decided well in advance of the contract that we were going to use a third party in addition to Cerner to put it in. We did [the] optimization phase to try to kick off [the] project at a good point."

After the project kicked off, CGH found out Cerner was planning to delay the project due to unavailable resources, according to Zach Johnson, S&P's chief strategy officer. At that point, S&P took over leadership of the implementation.

Throughout the project, the hospital didn't miss any project deadlines or the key date for integration testing, which resulted in a smooth go-live on the scheduled date of May 1, 2018. 

The lesson Mr. Koerner learned from the experience to pass on to other hospitals: Pursue a partnership with projects like these.

"Partner with someone with a good framework in place to keep you on track with your project," he said. "In my eyes, I've seen a lot of the different consulting firms, and they have good people. The difference I saw with our [third-party] company is the framework they use. We pushed many items in a 12-month Cerner implementation schedule up [because of that]."

Mr. Koerner particularly noted S&P's InTegrity framework and "8-4-2-1" approach — where the hospital is notified of needed contributions eight weeks before the go-live, then at four weeks, two weeks and one week.

He said those notifications, as well as the optimization phase, helped ensure the hospital had the needed resources for the project at the right time.

Mr. Johnson agreed.

"Getting things started with phase zero before [project] kickoff was key to the preparedness of CGH," he told Becker's Hospital Review via email. "When the resource issues were identified, S&P was able to step in and take over the project with no disruption to the timeline or scope of deliverables.  After assuming responsibility for the implementation the S&P InTegrity framework allowed CGH to be proactive in their planning and gain insights from a highly experienced and objective third party."

The result was improved revenue cycle performance. About two months after the go-live, the hospital is seeing a clean claim rate to third-party payers of 97 percent, discharged not final billed is in line with numbers from before the go-live, accounts receivable metrics are positive and overall key performance indicators to determine success are "all on point," according to S&P.  Mr. Koerner said the hospital specifically began to see reimbursement in the form of electronic remittance and was able to post those automatically within 14 days following the go-live.

Overall, he believes the hospital's approach is unique in that CGH partnered with S&P to optimize and manage the project. Cerner agreed the approach of using third parties is unique, but still advocated for use of its services.

"It is rare for us to see clients use third parties for implementation in lieu of our services," the EHR vendor said in a statement to Becker's. "We bring 30 years of best practices across thousands of implementations at sites of all sizes, with dozens of clients going live successfully on our revenue cycle solutions each year. Our solutions are best implemented by the people who designed and work with them daily. Clients have a direct link to the software engineers who built the solutions, and other services such as regulatory advising and learning services, device experts, data migration and post-activation support teams."



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