Anderson Regional revenue cycle chief highlights dramatic turnaround

In 2013, Anderson Regional Health Medical Center began rebuilding its revenue cycle operations by bringing all operations in-house, hoping to improve efficiency and slash accounts receivable days.

"There was no standardized workflow," said Revenue Cycle Director Kevin Adams, speaking at the Revenue Cycle Solutions Summit at HIMSS17 in Orlando on Sunday. "There was poor employee morale and there was very little to no automation of the processes."

To fix the problems, Adams, who had been with the 300-bed Meridian, Mississippi system for 27 years, was promoted from his role overseeing the front end, to revenue cycle director responsible for all functions and about 120 employees.

Through a financial status desktop offered through their EHR platform, he and his team revamped revenue cycle. They created a system of transparency within the data of roughly 20 performance indicators.

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That data is available at midnight each night, to about 35 department leaders.

According to Adams, the daily reports made them far more nimble. At the same time, parameters built into the system catch claims before they're sent out and denied.

In accounts receivable, goals are set on a monthly basis and each staff member is accountable.

"The revenue cycle team struggled through adversity," Adams said in an interview prior to the event. "We feel more strategic and agile, employees have ownership in their individual roles, we have continuous monitoring of financial status. The desktop makes us aware of where we're trending. We have the right tools and training."

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Anderson succeeded in reducing the number of A/R days. In 2013, accounts receivable days were in excess of 95 days, and the system had credit balances of over 7,000 accounts, representing $7 million in credit balances.

A/R days are currently down to 47, and probably in the mid-thirties if factors such as self-pay are removed.

Credit balances are down to 725 accounts worth around $600,000.

The process has taken time, though. In 2014, the system revised most of their dictionaries within the billing system. They did maintenance and cleanup, and using process improvement Lean, improved their workflows. The efficiency was needed to bring up the bottom line from losses in 2014 and 2015.

The health system also cut 18 percent of their non-clinical staff, according to Adams.

By 2016, that turned around. Lost revenue was reduced by about 90 percent. Overall, the system saw a $14 million improvement, all due to the changes.

In 2016, Anderson received the Healthgrades Award for being in the top 2 percent in the nation for patient safety and experience.

Now, Anderson is shooting for a $2 million profit for fiscal 2017.

"To go from a $15 million loss in one year, and make that $14 million swing, now, another $2 million margin, that's something that's attainable for our organization," he said.

Twitter: @SusanJMorse