BUFFALO, NY – A holistic approach to consolidating patient access and accounting systems among its five hospitals has paid big dividends for Kaleida Health.
The integrated delivery system, based in Buffalo, N.Y., achieved positive results in improving its contact with patients, both before treatment was delivered and after, when the system sought to improve its efficiency and success in collecting payments.
As a result of its efforts, the system increased point-of-service collections, reduced aging accounts receivable and increased overall cash collections, said Barbara Losi, vice president of revenue cycle and service access operations.
While the implementation of a new software application played a key role, Kaleida’s experience suggests that a wide-ranging, coordinated approach can help providers achieve a better return on overall investment.
Executives at Kaleida, which processes 1 million claims annually, decided they needed to consolidate systems to increase efficiency and expand capabilities, Losi said. The system’s hospitals had different patient access and accounting systems.
In addition to focusing on one approach, officials wanted to replace mainframe systems, integrate with the master patient index and have a new system work with contract management, decision support and general ledger systems.
“We wanted to fully integrate with our other systems,” said Linda Koester, the project’s manager.
Kaleida’s efforts to improve its revenue cycle put a lot of focus on the front end, Losi said.
“We wanted to streamline the entire scheduling and interfacing process,” she said. “If someone was scheduling in one system, we didn’t want to repeat that in registration. If we have all the information in place, we can better estimate the patient’s out-of-pocket amounts.”
Kaleida also was looking to reduce the cycle time of collections by supporting the automation of tools and processes and improve the accuracy and completeness of patient information.
The health system selected Sunrise Patient Financials from the Atlanta-based Eclipsys Corp. Kaleida was able to fully involve multiple departments in the switchover to the new system and was able to drop bills within three days of going live in September 2006, Losi said.
“We had to delay the go-live in a couple instances, and when we decided we were ready, we were comfortable that it would do well right out of the box,” said Fran Meyer, the system’s vice president for information services and technology.
The quick start was undergirded with exhaustive testing with clearinghouses and payers, he said.
The integrated approach has enabled Kaleida to increase point-of-service collections to $5.4 million in 2007, compared with $4 million the previous year. Overall cash collections increased by 9 percent in 2007 compared with the previous year, a $70 million increase, Losi said.
Accounts receivable measures also have improved. 2007 saw a 32 percent decline in accounts receivable that were more than 90 days old.
Losi emphasized that a number of factors led to the improvements, including improved pre-registration workflows that involve eligibility and referral checking and pre-authorization for treatment. She also cited improved work-quality monitors on both the front end and back end, and said the system is working hard to manage and learn from claims denials.