ABSTRACT: Today numerous health systems find themselves managing complex medical groups, among which the most complex are the Service Lines. Physicians whose specialties are within the Service Lines (Cardiovascular, Orthopedics, Oncology or Women’s Services) find that their clinical work is performed in the hospital settings, yet their governance and decision-making processes often are made within the medical group structure. Frequently, this structure creates misalignment and competing interest, resulting in internal conflict for a health system. In this white paper, you will find the steps to overcome these struggles while gaining knowledge from first-hand experiences with a Cardiovascular medical group, which is outlined in a case study highlighting how RoundTable was able to combat these concerns and solidify solutions for a successful outcome. PROBLEM STATEMENT: Structure within complex medical groups is competing with that found in parent health systems. With specific specialty service lines needing its own governance and organizational processes, they are struggling with the development and [...]
Multi-hospital health systems are commonplace today. In fact, 69.7% of all U.S. hospitals are part of a system. Furthermore, 91.6% of all hospital discharges occurred in a multi-hospital system according to the AHRQ Compendium of US Health Systems-2017. Many of these systems stretch the U.S. -- some may be regional in nature crossing state lines while a smaller percentage dominate a single state. The complexity of a multi-hospital system is staggering. The countless medical groups of all subspecialties, the sheer number of leaders, the variety of delivery methods/ clinical protocols, and regional nuances, drive variation in cost and quality across the spectrum. In an effort to minimize the variety and delivery of the same standards in exceptional care, and to hold the similar cost structure; the most successful multi-hospital health systems have adopted a Service Line Management philosophy. Simply put, Service Line Management within a health system, organizes around clinical disease states for all hospitals, across all [...]
Finding all the pieces of a puzzle is sometimes difficult. One thing in healthcare that is clear-- coders are a big part of the Revenue Cycle puzzle. After attending the AAPC HealthCon 2018, two concepts are extremely evident: 1. Coders own a critical piece of the revenue cycle puzzle. 2. Coders need to expand their knowledge of revenue cycle operations by engaging in cross departmental discussions that have typically taken place in silos and should be viewed as a strategic resource to help SOLVE the puzzle! The What: What do they need to know? Coders’ expanded knowledge is now required to fully understand their role within the revenue cycle. Their job can no longer be that of just silent coding for hours, day in and day out. Rather, there needs to be an educational component of how they fit into the revenue cycle and how their role, which is sometimes overlooked, is an integral part of optimizing [...]
RoundTable Strategic Solutions Adds Members to the Team In a time when the global Healthcare IT market continues to grow each day, minute or even second, RoundTable Strategic Solutions is experiencing its own growth. As a local Baltimore based, nationally recognized full-service healthcare IT, operational change management and direct hire consulting firm, we understand the need to perform at the same rate and momentum as the rapidly growing industry. In order to keep up with the growth, expected to reach $280.25 billion by 2021 with 15.9 percent growth (based on Report by Research N Reports), RoundTable is building its team to meet the demand in the healthcare market. Just recently, RoundTable hired two industry experts to launch a Charlotte, NC office to accompany its Baltimore and Boston offices. Additionally, the firm added a Director of Marketing and Communications to the team. “Our growing team is thrilled to have Denise, Mike and Nicole join us,” said Scott Ketchen, [...]
RoundTable Strategic Solutions was recently engaged by an IDN to provide Cerner Revenue Cycle Advisory Services and to drive best practices for its Cerner Revenue Cycle Implementation. In two-short weeks, the RoundTable Executive Consultant drove the organization towards a 30% improvement in the Clean Claim Rate resulting in a 2M financial improvement. Organizational Challenge: PCP Claim Errors in Excess of 2M Two (2) Weeks Post Live RoundTable Approach: Using the Claim Error Analysis Report, RoundTable identified a trend/pattern in the top four (4) Claim Errors that were driving a large volume of claim edits and A/R within Cerner Revenue Manager. Given our revenue cycle operations AND Cerner Patient Accounting application expertise, RoundTable was able to implement a "Cerner Rule" that modified the interface and immediately reduced the Claim Errors. Impact & ROI: In two (2) weeks, the Clean Claim Rate Increased by 30% and resulted in a 2M Financial Improvement. We would welcome the opportunity to share [...]
Keep the “Patient” at the Center of the Discussions & Decisions. Develop Access and Scheduling Standards. Develop and/or Broaden Service Offerings. Appointment Scheduling for new and return patients. Appointment Reminder calls/texts. Portal message management. Referral Services. Template Management Schedgistration & Pre-Registration Services Optimize Performance of Existing Call Center Services Invest in additional agent FTE, training and QA resources and space. Standardize scheduling policies and procedures across practices. Incorporate clinical resources (RNs) into the contact center. Incorporate template oversight and access monitoring into the contact center. Service offerings can be broadened and hours of operation extended to offer clients more value and offer patients more convenience. Create new hire ‘boot camp’ that includes soft skills training. Develop competency-based testing for new hires and annual assessment of skills for all scheduling and registration staff. Develop a competency assessment tool to document agent’s skills vs. expectations and complete at least annually and after new skill sets added. Implement a robust [...]
Ability to remove non-essential POC functions from the office. Improves ability to focus on the “face to face” experience with the patient/customer. Decompresses local practice leadership. Ability to build leadership expertise in specific functions- call management, triage, training, other centralized functions. Improved Telephony platforms- On-hold messaging, call recording, customer surveys, performance data, etc. Scalable problem solving.
Implementing a robust Revenue Integrity program is essential to bridging the all too persistent gap between the full reimbursement to which an organization is entitled, and actual reimbursement realized within the traditional Revenue Cycle Management process. Many organizations are aware that they are affected by revenue leakage, but quantifying and eliminating revenue leakage can prove a daunting task. A successful Revenue Integrity Program will eliminate the traditional Revenue Cycle departmental silos that contribute to these challenges, aligning the Charge Description Master (CDM) and the rest of the Revenue Cycle process, and defining a holistic approach to charge capture which impacts all related departments. RTSS has guided a number of large and complex client organizations in mitigating risk to revenue through Revenue Integrity efforts, including providing Interim Leadership, gap assessment, CDM analysis and consolidation, auditing, facilitating operational engagement, and providing knowledge transfer and mentorship to client internal resources. Our methodology has identified several guiding principles which are key [...]
As you evaluate the Centralization of Call and Clinical Contact Center functions, RoundTable has provided 10 key things to consider! Balance Centralization with Personalization Do Not Centralize Broken Workflows Keep the “Patient” at the Center of the Discussions & Decisions This is an Investment in Clinical and Operational Infrastructure for the Future Readiness for “Continuous Improvement” Drive Towards a Return on Investment Decrease Registration / Eligibility Denials Increase Visit Volumes Evaluate Scheduling Guidelines to Maximize Capacity Schegistration will Drive Efficiency & Real-Time Eligibility Capabilities is Key Standardization of Scheduling Templates, Guidelines, and Appointment Types is Critical Prepare for Difficult Conversations and Over-Communicate with Front Line Teams Without Provider, Organizational Support and Cultural Readiness the Effort and Good-Intended Approach Will Fail.