SUCCESS STORY | Strategic Alliance for Financial Efficiency
Intalere Strategic Alliance for Financial Efficiency (SAFE) Member Craneware Brings Dramatic Financial Turnaround to Critical Access Hospital
Adams County Regional Medical Center is a 25-bed Critical Access Hospital (CAH) recognized as a leading provider of quality healthcare services in the southern Ohio region. Serving a small, rural community has unique challenges. Unlike larger hospitals, CAHs operate on “bare bones” budgets in rural economies where many residents work for themselves part-time or even seasonally, making them less likely to have private healthcare benefits. In addition, the financial viability of CAHs is threatened by reductions in healthcare budgets at both state and federal levels.
Faced with these challenges, along with rising costs and declining reimbursement, Adams County Regional Medical Center had to improve financially and operationally in order to continue serving their community. In their region, more people paid cash for healthcare services than is typical. And for Medicare patients, they are reimbursed on a cost basis. Anticipating the potential impact of further reimbursement cuts from all payors, they began seeking solutions to support staff in improving financial performance, operational efficiency and compliance.
To achieve financial improvement, Adams County needed visibility into their processes to ensure they were receiving all earned reimbursement through proper pricing, charging and coding. Immediate access to current regulatory changes and competitive pricing data was a top priority.
An Intalere member since 1987, Adams County leadership discussed their financial improvement concerns with their Intalere representative during one of their regular meetings, which are held to continually assess and respond to members’ needs. He suggested Adams County evaluate Craneware’s solutions and services. Craneware is a partner in the Intalere Strategic Alliance for Financial Efficiency (SAFE), a unique partnership of market-leading companies, spearheaded by Intalere, providing best-in-class revenue cycle and financial performance improvement solutions that support healthcare facilities of all sizes.
As the leading provider of automated revenue integrity solutions, Craneware was the logical choice to help turn things around. Reliable software, support and results set Craneware apart. Adams’ representatives also liked the personable and professional approach Craneware undertook, listening to the facility’s objectives and demonstrating step by step how Adams could realistically overcome their challenges.
Automating Chargemaster Management – Worth Millions
Adams was losing millions each year due to inefficient manual chargemaster processes, with revenue leakage being a huge concern and compliance becoming an increasing priority. Adams County chose Craneware’s Chargemaster Toolkit-CAH, designed specifically for Critical Access Hospitals, to establish and maintain a complete and accurate chargemaster. Packaged with a CAH version of Craneware’s Online Reference Toolkit, the software also provides instant access to financial and regulatory coding resources.
Adams’ leadership was impressed that the software identified $1.3 million in potential financial performance improvements and they found that providing staff with online access to current coding and charging information all in one place was invaluable. Adams realized both financial gains and significant operational improvement with the Chargemaster Toolkit giving them visibility to quickly update data with more accuracy up front rather than spending extra time on the back end. What had previously been a labor-intensive process was now more streamlined, efficient and cost effective. The software also provided the tools required to establish effective and defensible pricing.
Focus on Charge Capture
To improve visibility into their revenue cycle and save significant rework by improving charge capture accuracy for compliant claims, Adams County implemented Craneware’s Bill Analyzer solution. Bill Analyzer identifies potentially missed charge items and prioritizes these issues to help address root causes and prevent recurrence. The software has identified millions in financial performance improvement opportunities and significantly reduced errors for Adams County. With clear, accurate and current data, they were able to move effectively toward solutions. Adams County also established a multidisciplinary team to support proper charge capture.
To guide documentation improvement, the team uses Bill Analyzer reports which provide the clarity and visibility needed to identify and correct root causes of recurring errors. The team held monthly meetings with clinical department managers to discuss revenue trends and opportunities. They found collaboration between clinical and financial departments was key to the charge capture improvement process, with clinicians being committed to their role in making sure the facility was properly reimbursed.
Implementation Support Leads to Optimal Use of the Software, Quick Return on Investment
Achieving financial success involves the right combination of technology, new business processes and support services. Craneware Professional Services worked with Adams County staff to assure optimal use of the software and a quick return on investment. Beginning with a needs assessment, the Professional Services team engaged staff to create a customized action plan to move Adams County toward sustainable financial improvement. Professional Services walked Adams County staff through the process and showed them how to use the software most efficiently in their own environment.
The assistance armed Adams County with an actionable plan and ongoing support for accomplishing financial goals. Professional Services provided an accelerated time advantage. Within six months, the software paid for itself many times over, and with Craneware’s help, Adams County made a dramatic financial turnaround in time to help save the hospital.