Colorado health system transforms patient collection process

A combination of health IT and process re-engineering enabled Centura Health, the largest healthcare provider in Colorado, to increase its monthly patient collections from $469,000 in July 2008 to $1.6 million by March 2010.

While a health system can’t get out of the red without something like an estimation tool, a process needs to be in place to implement that tool, said Leslie Richard, Centura's corporate director of revenue cycle management.

Richard and John Woody, CIO of Financial Healthcare Systems, discussed how health systems can turn the paradigm shift of transparency and consumerism in the healthcare industry to an opportunity to transform the provider-patient relationship and educate patients about their services.

In order to increase patient collections, Centura developed a vision that included selecting a business partner that could provide a defensible estimate, determining patient portions for scheduled services, communicating with patients about their financial responsibility and collecting patient portions at or before the time of service, Richard said.

The 12-hospital health system defined its goals and established goals by patient type. CFOs at all facilities were asked to be champions of change and provide support across all departments.

To achieve these goals, Centura developed and provided staff training. The health system also implemented Financial Healthcare Systems’ Clearquote price estimator tool and added enhancements and reporting capabilities to its IT system.

While increasing upfront collection was an objective, focusing on quality and workflow improvement were critical components to the health system’s success, Richard said.

Six factors contributed to Centura's dramatic increase in collections:

• Understanding how to collect at point of service (POS);
• Understanding why they should collect at POS;
• Knowing what to collect;
• Implementing policies and procedures that enable successful collection at POS;
• Implementing monitoring tools for daily reporting and methods;
• Establishing specific locations for patient check-in.

By educating patients, providers can transform the typical post-service adversarial experience to a pre-service advocacy experience that can transform and enhance the patient-provider experience, Woody said.

Centura “celebrated success” for getting hospital buy-in, Richard noted. Some of the hospitals even implemented a bonus program if monthly collection goals were achieved.