ALAMEDA HEALTH SYSTEM HB STABILIZATION HB KEY METRICS Status As of - - PowerPoint PPT Presentation

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ALAMEDA HEALTH SYSTEM HB STABILIZATION HB KEY METRICS Status As of - - PowerPoint PPT Presentation

ALAMEDA HEALTH SYSTEM HB STABILIZATION HB KEY METRICS Status As of 1/31 As of 1/24 Bottom Median Metric 13wk Top 73.1 Days $623.8M 74.6 Days $633.2M 75.1 Days 70.8 Days 63.1 Days Epic AR Days s 99.5% -$4.9M 99.2% -$8.4M 99%


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SLIDE 1
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SLIDE 2
  • Current Epic AR Days is 73.1 Days, down from 75.1
  • Soarian AR Days were 78 on 06/30/2019. Best performance was 71 days on 12/31/2018

Metric 13wk Top

Epic AR Days

s

73.1 Days $623.8M 74.6 Days $633.2M 63.1 Days

Charging Variance

s

99.5%

  • $4.9M

99.2%

  • $8.4M

104%

Payment Variance

q

  • 5.4 Weeks
  • $58.5M
  • 5.9 Weeks
  • $63.2M
  • 0.4 Weeks

Epic Pmt Avg

q

65.6% $7.1M 49.1% $5.3M 102.4%

Epic CFB Days

q

22.2 Days $191M 21.6 Days $184.8M 5.6 Days

Coding Days

r

1.1 Days $9.5M 1 Days $8.8M 1 Days

Claim Edit Days

q

7.3 Days $62.9M 7.5 Days $64.1M 1.2 Days

Open Denial Days

s

2 Days $17.3M 1.4 Days $12M 1.1 Days

Bottom Median Top

ALAMEDA HEALTH SYSTEM HB STABILIZATION

HB KEY METRICS

As of 1/31 Bottom Median Status As of 1/24

75.1 Days 70.8 Days 99% 99% 100.8% 1.9 Days

  • 2.4 Weeks
  • 1.5 Weeks

2.5 Days 2.1 Days 2.2 Days 91.3% 95.2% 8.5 Days 7.6 Days 2.5 Days 1.8 Days

p = Better than top 25% s = Below median

Status Key:

r = Better than median q = In the bottom

Threshold for the 35th percentile for the metric at week 18 Median value for the metric at week 18 Threshold for the 75th percentile for the metric at week 18

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SLIDE 3

Baseline AR = 75.7 Days 1.3 4.8 10.0 12.1 13.8 18.9 19.3 18.3 20.8 24.1 22.7 20.9 20.7 20.3 20.9 20.6 21.8 22.4 0.0 0.9 2.9 6.5 9.6 13.4 16.4 20.2 23.1 20.7 23.3 24.3 27.4 26.6 31.8 35.6 37.6 33.9 0.0 0.0 0.0 0.0 0.1 0.1 0.6 0.6 0.7 2.1 2.4 2.6 3.1 4.0 2.4 2.0 1.4 2.0

  • 10

10 20 30 40 50 60 70 80

AR Days

HB AR Breakdown

Other Days Outsourced Days Credits Days Self Pay Days Open Denial Days Outstanding Days CFB Days Min Hold Days In House Days

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SLIDE 4

Baseline Pmts = $10.8M 2 4 6 8 10 12 14 16 18

Financial Activity (in M)

Financial Activity

Total Payments Expected Payments

n

Epic Payments

n

Epic Adjustments

n

Legacy Payments

n

Legacy Adjustments

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SLIDE 5

Epic CFB Days

5 10 15 20 25 30

AR Days

Top Median Bottom Alameda Health System

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SLIDE 6
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SLIDE 7

Baseline AR = $52.8M 0.1 0.6 1.1 1.8 2.4 2.8 3.4 4.1 4.7 5.3 5.5 2.8 3.1 3.1 3.2 3.2 3.2 3.2 0.4 2.1 4.7 7.6 8.9 12.2 14.3 18.1 21.2 24.3 25.2 31.9 34.3 31.4 38.7 40.8 40.1 40.8 0.0 0.0 0.0 0.0 0.6 0.4 0.6 0.8 0.5 0.7 0.9 1.1 1.2 1.3 1.7 1.7 2.9 3.3

  • 10

10 20 30 40 50 60

AR Dollars (in M)

AR Breakdown

Undistributed Outstanding Statement Pending Statement Open Denial Outstanding Claims No Claim Status Claim Edit Claims Pending

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SLIDE 8

Baseline Pmts = $1.2M 0.0 0.2 0.4 0.6 0.8 1.0 1.2 1.4

Financial Activity (in M)

Financial Activity

Total Payments Expected Payments

n

Epic Payments

n

Epic Adjustments

n

Legacy Payments

n

Legacy Adjustments

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SLIDE 9

Epic CFB Days

5 10 15 20 25 30

AR Days

Top Median Bottom Alameda Health System

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SLIDE 10
  • On-Site, Cross-functional Teams (IT, EPIC, Contractor) matched

with Revenue Cycle leaders and their team.

  • Increase Elbow Support for Revenue Cycle
  • Additional onsite support from Epic
  • Additional Leadership support for targeted training,

support and improve overall performance

  • ARCR biweekly “Hit List” huddles to review and address high

level issues drive down CFB

  • Weekly Command Center Activities – Focused

IT/Operations/Epic teams to drive down high level issues

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SLIDE 11
  • Manual ED Charge Review currently for all Level 4/5s
  • Improve documentation
  • Goal is to automate and perform regular audits
  • Working with ED and IT Teams to automate process
  • (Levels 1-3 have been automated for several months. Some Level

0’s have come through as a result of entry errors)

  • Unposted Surgical/Procedural Charges
  • Developing more efficient process to load new supplies/hardware

into Epic on a regular basis

  • Working with various Clinical Teams to speed up process
  • Paper Attachments to Claims
  • Automating Electronic claims attachment functionality
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SLIDE 12
  • ABN Process (a compliance concern)
  • Work with Clinical Leaders, IT and Revenue Cycle to put in place
  • Will scientifically reduce write offs for our MediCare Claims
  • Contract Review
  • Ongoing workgroup to review contract discrepancies and payment variances
  • Additional System Automation
  • Now that we are stabilizing our new system we are turning on additional

automation to replace many manual processes

  • Care Management
  • Increase concurrent review and improve documentation timing
  • CDM Review
  • Improving our CDM updating process and pricing