Becker's Hospital Review

44 Executive Briefing How Identifying the Right Revenue Cycle Solutions Partner Can Save Hospitals Millions: A Case Study A s one of the area's only local- ly-owned, nonprofit health systems, Springfield, Mo.-based CoxHealth plays a major role in both the physical and economic health of southern Missouri. Along with five hospitals, a health plan, home health agency, home parenter- al services (home infusion therapy), CoxHealth Foundation and Cox Col- lege, the health system encompasses 84 clinics and nearly 1,000 beds across its 25-county service area. CoxHealth's 10,000 employees and more than 550 staff physicians account for a payroll of more than half a billion dollars — part of an economic impact on the region that exceeds $710 million. Along with its size and strength, CoxHealth is also known for excellence in care. All of the hospitals in the system are accredited by DNC-GL Healthcare for quality and patient safety. In fact, CoxHealth was the first hospital system in Missouri to receive this accreditation. In addition, the health system's flagship Springfield facility is the only one in the city to be named for four consecutive years to U.S. News & World Report's list of best regional hospitals, and received 28 number one rankings by CareChex for quality. In 2015, after new revenue cycle lead- ership came onboard at CoxHealth, the team perceived a need for additional resources to address a stubborn backlog of aging accounts. The looming imple- mentation of ICD-10, hospital officials realized, only reinforced the need to stockpile cash reserves before the new regulations took effect. "We recognized that we didn't have the internal bandwidth," says David Stong, System VP of Hospital Revenue for Cox- Health and CFO of Cox Medical Center Branson. "We lacked the staffing to give us as much ability as we needed to flex to cover all the various tasks." After making the decision to bring in an external partner, Mr. Strong talked to Da- vid Flexer, VP of Sales at Xtend Health- care. "We knew they had a phenomenal reputation in the market, even though we had never worked with them direct- ly," Mr. Strong says. Mr. Strong consulted several of Xtend's previous clients. Then, after consult- ing with his internal team, CoxHealth engaged Xtend for a major project. The assignment: for the entire health system, resolve and collect on all aged third-par- ty receivables that had surpassed the 90-day threshold (many of CoxHealth's receivables were older than 180 days). Spearheading the effort for Xtend was Will Eley, who managed the project onsite at CoxHealth's Springfield operation. He was supported by a dedicated team at Xtend's offices in the Nashville, Tenn. area. At any given time, Mr. Eley notes, between 18 and 24 Xtend personnel were working CoxHealth's inventory of accounts. Meanwhile, Mr. Eley worked daily to coordinate the company's efforts with CoxHealth's business office, patient access and compliance staff, to ensure a smooth flow of communication and to resolve any issues that arose. "With our volume of [aged] accounts, we had such a large task ahead of us that having a manager onsite was very important," says Paul Weaver, Director of Patient Financial Services at CoxHealth. "Having Will here got the project moving from the start, and he has done a fantas- tic job working with our staff. Because Xtend was here working closely with us, we got good buy-in from our team." It also helped immensely, CoxHealth ex- ecutives say, that Xtend was thoroughly familiar with the health system's Cerner Soarian health information services, which helped the Xtend team hit the ground running. By interfacing with Cox's billing information and then using Xtend's own proprietary interfaces with third-party payers, Nashville-based staff enabled Cox's revenue cycle team to see the current status, in real time, of all assigned accounts. Finding Root Causes Throughout the engagement, Xtend billing experts, viewing accounts re- motely, performed "root cause" analyses to ascertain why they were not being paid in a timely way, or, in some cases, denied. These analyses pointed toward a number of process improvements that Sponsored by: In 2015, after new revenue cycle leadership came onboard at CoxHealth, the team perceived a need for additional resources to address a stubborn backlog of aging accounts.

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