Issue link: https://beckershealthcare.uberflip.com/i/1169964
21 CFO / FINANCE the positive and negative impact their processes had on our own operations. ree major areas were: turnaround time for claims adjudication and percent paid the first time; rejections that eventually were overturned based on appeals and pure tenacity; and authorization requirements outside of CMS rules that typically set a prece- dent. Within one year of this program, we real- ized a reduction in rejections through avoidance ranging from 21 percent to 50 percent depending on the area of concentration which included in- fusions, physical therapy, cancer care and other outpatient services. Our payers are aware that we are collaborative and relentless. is is facilitating a paradigm shi for many of them based on pro- moting integrity and trust. Q: Federal officials have been working to address price transparency. What is your take on the best price transparen- cy approach to reduce costs and meet patients' expectations? DG: For more than a decade or so, we have listed our charges for the most frequently used services so that patients could query those. But in 2015, we launched a self-service portal where patients can put in their own insurance information and get out-of-pocket estimates. It helps patients un- derstand what their out-of-pocket cost is because charges are not helping patients understand what their risk-sharing is. e portal is very easy to use. We give estimates in English and Spanish, and patients can connect with one of our rep- resentatives anytime they want. ey can do it through email or phone, but we're working on setting up chat right now, as well. at's been a great experience for our patients and for us be- cause they're much more advised. I believe that price transparency is about being open with the patient, making sure they under- stand what their personal liabilities are, having the information available to them and then also having somebody help explain and navigate them through why their out-of-pocket cost is what it is. We also really work with our patients in helping them determine how to make choices. Q: If you could pass along one piece of advice to another hospital revenue cy- cle leader, what would that be? DG: Stay ahead of what's going on while man- aging the day-to-day tasks. You can't do one without the other. Vision and sustainability re- quire integration – not sequential steps. With the revenue cycle, you have to be tenacious, you have to be passionate and you have to be unyielding with vision so you're always ahead of the game. You can't be hesitant to be a pioneer, and you have to persevere. Sometimes it's very difficult when you're in the revenue cycle to get people to understand — and to help promote — the idea that efficiencies to optimize cash collections be- gin with everyone in the healthcare system. If awareness is not fostered with the patient prior to service and expectations are not managed by both the healthcare system and patient prior to service, optimized cash collections cannot be re- alized. Providing education for providers, clinical teams, management and support staff ensures consistent and clear information throughout the health system and for the patient. It's also criti- cal to provide easy, accessible tools on the hos- pital website so all employees who have patient contact can quickly address questions regarding estimates, financial coordination/assistance, bill- ing and other financial issues. e response may be as simple as providing contact information or a link to the healthcare system website. Ending thought: Collaborate with everyone to strategize, develop, execute and provide the patient with an overall positive patient experience. When a patient says "thank you" during collections or financial assistance, that's success. n Partners HealthCare nearly doubles operating income in Q3 By Ayla Ellison B oston-based Partners HealthCare saw its revenue and operating income rise in the third quarter of fiscal year 2019, according to unaudited financial documents. Partners' operating revenues totaled $3.6 billion in the third quarter of its fiscal year, which ended June 30. That's com- pared to the same period of 2018, when Partners reported operating revenues of $3.3 billion. Net patient service revenue and research revenue increased year over year, and the health system reported $47 million in royalty income. After factoring in a 5.2 percent increase in operating ex- penses, Partners ended the third quarter of fiscal 2019 with operating income of $180.3 million. That's nearly double the operating income of $91 million the system reported a year earlier. "We experienced strong financial performance this quarter," Partners Treasurer and CFO Peter K. Markell said in an earn- ings release. "This quarter was particularly strong as a result of a significant one-time royalty payment, continued success through our strategic Partners 2.0 initiative and improved performance in our clinical and research sectors." Partners reported a 5 percent operating margin for the third quarter of fiscal 2019, up from a 2.7 percent operating mar- gin in the same period of the year prior. n Advocate Aurora Health's net income more than doubles in Q2 By Ayla Ellison O utpatient volume growth helped push Advocate Aurora Health's revenue higher in the second quarter of 2019, according to unaudited financial documents released Aug. 22. Advocate Aurora Health, which was formed in April 2018 and has dual headquarters in Downers Grove, Ill., and Milwaukee, reported revenue of $3.2 billion in the sec- ond quarter of 2019, up from $3 billion in the same pe- riod a year earlier. Patient service revenue climbed 8.8 percent year over year partially due to increased outpa- tient volume. The health system said capitation revenue dropped 9.9 percent year over year due to the conver- sion of a full-risk arrangement to fee-for-service. After factoring in a 4.7 percent year-over-year increase in expenses, Advocate Aurora posted operating income of $132.3 million in the second quarter of 2019. That's up from $107.2 million in the same period a year earlier. The 28-hospital system reported nonoperating income of $286 million in the second quarter of this year, which includes investment income of $194.4 million. Advo- cate Aurora ended the second quarter of 2019 with net income of $418.4 million, up from $158.7 million a year earlier. n