Supplemental information for benchmarking: case studies and top 10 lists

1. Advanced Revenue Cycle
Concepts: Benchmarking
Part II
Case Studies and Top 10 Lists
July 2012

2. Case Study: Health System in the Southwest
Benchmarking in Practice
• Started system-wide benchmarking in 2004
• Wanted to create streamlined and consistent reporting for revenue cycle information
• Used various methods and systems in each hospital for calculating and reporting revenue cycle
information
• Decided to develop one standard scorecard that each facility would use to report revenue cycle metrics
Challenges Action Taken Benefits
• Deciding what data and • Six major areas were selected to • Sense of camaraderie and healthy
benchmarks would depict the be monitored, including revenue competition among the facilities
health of the revenue cycle across outcomes, registration, and pre- • The scorecard has evolved from
all hospitals service coordination, HIM, case being an excellent executive report
management, contracting and to an excellent education tool
• Apples-to-apples comparison of revenue recovery, and patient
data account services • Net revenue increase of 24% over
• The necessary data had to be the past 6 years
• Targets were established for all of
readily available the goals in the six areas and • Increase in cash collections of ~
• Deciding what targets to use monthly reporting started; at year 13% and a decrease in A/R days
based on HFMA, HARA, and other end, a revenue integrity meeting is from 78 days to 42 days
sources held, and facilities receive awards
and recognition
• Gaining buy-in from staff about
the changes being implemented
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3. Case Study: Large Physician Clinic
Benchmarking in Practice
• An HIM director at a large physician clinic had 21 transcriptionists
• Each averaged about 140 lines per hour using conventional word processing software
and cassette tapes
• The transcription unit supports 80 physicians at a cost of 15 cents per line
Challenges Action Taken Benefits
• Needed to increase productivity • HIM director determined that in similar • Productivity continues to
settings, 1 transcriptionist supports 4
while maintaining quality physicians, and researched transcription best increase with an expected
practices on the AHIMA and American average of 275 lines per
• Transcription processes were Association for Medical Transcription
transcriptionist
not state-of-the-art in the websites and in AHIMA’s Communities of
Practice
organization • Cost per line is expected to
• Talked to peers on local HIM association decrease to approximately 12
• Little knowledge of benchmarks board and posted a discussion thread on the
Ambulatory Care Community of Practice; cents per line
or appropriate targets attended a national convention, visited
vendors, attended lectures on best practices
and transcription technology, and identified
goals for lines/hour and cost per line
• Identified 10 transcription departments of
similar size and scope and interviewed the
HIM director or transcription manager at
each; decided to pursue new
software, templates, and a digital dictation
system; planned for an incentive program
and explored allowing transcriptionists to
work from home
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4. Top 10 Things to Do
1. Keep your benchmark meetings short and concise – set up
subgroups that will meet separately to identify issues and develop
action plans
2. Schedule annual reflection/goal-setting days
3. Communicate to all relevant employees the reasons you are
tracking benchmarks
4. Include the right people
5. “Arm wrestle” your CEO or CFO into letting you attend the national
MAP event
6. Question the numbers repeatedly
7. Pictorialize your goals
8. Ensure that you have access to the right data on a timely basis
9. Reward success
10. Stay the course and bring chocolate to meetings
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5. Top 10 Things Not To Do
1. Get stuck in a rut
2. Set goals that are too large
3. Bring reams and reams of paper to meetings
4. Try and do it all yourself
5. Assume that someone else in the organization is doing it
6. Analyze benchmarks in a silo
7. Let technology stifle your goals
8. Push the information out to your team
9. Use benchmark meetings as a way to point out flaws in
coworkers and the organization
10. Just kidding – there are only 9
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