Presbyterian Healthcare Services
Achieved remarkable revenue cycle performance improvements across the health plan and care delivery system
Measurable impact
Presbyterian Healthcare Services collaborated closely with MedeAnalytics to deploy the robust, comprehensive revenue cycle and business analytics necessary to achieve big goals across both their payer and provider sides. In total, this partnership achieved payback on their investment in just 9 months.
The story behind the numbers...
The Challenge
After making a series of strategic technology investments, Presbyterian found themselves in a disconnect. Each application and tool they had introduced had a unique, system-specific purpose, making them rich in siloed data but poor in actionable insights. As a health plan and a care delivery system, Presbyterian needed to unite technologies and optimize its revenue cycle management analytics and reporting across the organization to drive sustainable success.
- Integrated delivery system in New Mexico
- Nine hospitals and 32 clinics
- Annual patient encounters:
- 60,000 inpatient discharges
- 420,000 outpatient hospital visits
- 5M physician office visits
- Delivered care for 110+ years
- Financed care for 21+ years
The Solution
Presbyterian had put together a strong, data-focused team. But they did not have the capabilities necessary to provide efficient reporting and generate impactful insights, even after a significant investment in their Epic electronic health record (EHR).
Their Epic EHR did not enable drilldowns into claim level details or allow them to easily identify trends with the needed granularity. Effectively tracking revenue cycles across multiple care settings was nearly impossible, and they were unable to proactively identify gaps in accounts receivable (A/R) collections and denials likely to happen. These gaps and challenges led to their revenue cycle management being reactive, and they lacked visibility into gaps in RCM staff productivity, resulting in sub-optimal revenue cycle performance.
By partnering with MedeAnalytics, Presbyterian transformed their approach to data and decision-making by weaving powerful analytics into simple, daily workflows. This enabled the organization to:
Presbyterian is already working on plans to further their predictive and optimization analytics with MedeAnalytics innovative solutions.
“The benefits that we receive from integrating the MedeAnalytics solutions in conjunction with other tools that we have at Presbyterian have become critical to our processes.
We've improved efficiency, speed to insights, and staff efficiency. We've standardized reports across revenue cycle functions. We have embedded insights into operations and workflow. We have near real-time analysis and decision-making. When you add up the benefits, the value generated from these MedeAnalytics solutions totals to about $3.4 million—and this is just the beginning.”
Soyal Momin, SVP, Chief Analytics Officer, Presbyterian Healthcare Services
More about Presbyterian Healthcare Services:
Impact Summit 2022 session:
Enabling a Data and Insights Driven Analytics Transformation with Revenue Cycle Management (RCM) at Presbyterian Healthcare Services
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