While the process of managing a patient’s health can be complicated, so too is the process of managing that patient’s account. Healthcare revenue cycle management is a broad area that can be complex, especially for small and independent healthcare facilities with limited resources. However, by focusing on key metrics, TPC hospitals can compare themselves to other Members, identify areas for improvement, and measure progress objectively.
TPC & HFMA MAP Keys
Hospital and health system CEOs have named financial challenges as their number one concern every year from 2012 to 2014, according to the American College of Healthcare Executives. Within this area, reimbursement is their biggest issue, followed by the rising cost of collections services.
To help combat these issues, TPC Members collaborated to incorporate HFMA MAP Keys as their key performance indicator metrics across the membership. HFMA MAP Keys are industry-standard metrics using objective, consistent calculations to track an organization's revenue cycle for optimized performance. TPC implemented the program with nine Members and identified two keys of focus for 2017: denials and point of service collections. Having access to this data provided much needed transparency, allowing Members to improve efficiency at the facility level. By being able to benchmark across the membership, discuss best practices, and implement improvement programs, Members have seen a $5.3M decrease in denials opportunity and an $8.5M decrease in point of service collections opportunity. Both have been a testament to the power of having the right information in order to take the right corrective actions to improve performance.
Based on the initial success in denials and point of service collections, TPC Members have identified seven MAP Keys to standardize policy and identify process improvement opportunities in 2018, including:
- Point of service collections
- Service authorization rate
- Days discharged not final bill
- Clean claim rate
- Late charges as a percentage of total charges
- Aged accounts receivable percentages
- Denial rate
TPC and You
TPC provides the framework for independent, community-based hospitals to achieve system value through standardization, utilization, and pricing strategies that optimize operational, financial, and clinical performance. As part of TPC’s Revenue Cycle Program, hospitals have the ability to access key metrics and benchmark themselves to a peer network. By partnering with TPC in your revenue cycle, you can not only improve your processes, but decrease losses as well.
Stronger Together. Superior Results.
To learn more about TPC’s Revenue Cycle Programs and how our HFMA MAP Keys program can help your hospital’s revenue cycle, visit http://www.tpc1.com/revenue-cycle.