Background and Challenge

Tegria partnered with a healthcare system in Pennsylvania to perform an in-depth Revenue Cycle assessment. The assessment focused on the hospital system’s contact center, front-end operations, and Patient Financial Services. This highly-ranked 500+ bed hospital system desired technical and operational improvements that would create and maintain a self-sustaining, peak-performing revenue cycle. In collaboration with their leadership, Tegria identified opportunities to increase revenue, ensure patient retention, strategically invest, and improve the overall patient experience.

Solution

Tegria deployed a cross-functional team of experts to assess the organization’s revenue cycle, from a technological and operational perspective. The technical investigation intended to identify opportunities to enhance automation, improve reporting capabilities, and modernize system functionality. The operational investigation identified long-term solutions, which included: aligning best practice staffing, implementing and enforcing accountability, and establishing a streamlined governance structure.

Opportunities

The table below highlights some of the high-level recommendations we made from our findings.

Results

Over the course of the assessment, we identified and documented more than 40 themes and findings along with 98 detailed recommendations and estimated benefits. A few high-level findings included:

• $29M in annual net revenue opportunity identified
• $17M in cash acceleration opportunity identified
• $1M in cost reduction opportunity identified
• 14 FTE bandwidth increase with recommended changes
• Created a formal strategic roadmap and governance structure
• $5M in denial improvement opportunity identified