SUMMARY
Organization: Emory Healthcare
Location: Atlanta, Georgia
Size: Six hospitals with more than 200 provider locations
Top-line Requirements: Prevent lost charges, decrease denial rates, alleviate under coding, and improve charge lag time
Emory Healthcare, the largest healthcare system in Georgia, is a multidisciplinary medical organization compiled of six hospitals and more than 200 provider locations.
Challenge
In 2002, Emory University’s hospitalist group employed 10 physicians at three locations and suffered from lost charges, high denial rates, undercoding, and 60 to 90-day charge lag. In order to solve these problems, Emory’s management implemented Ingenious Med for its physicians, billers, and administrators. Despite a nearly 3–1 physician to biller ratio, Emory lost charges and was unable to contest denied bills.
Solution
As of November 2005, Emory employed 60 hospitalists in 10 locations, and increased the number of charges captured, decreased denials, reduced charge lag to two days, and increased the physician to biller ratio to 10–1. Emory’s decision to purchase and implement Ingenious Med generated the following quantitative improvements over three years:
- Increased charges captured by 8 to 17 percent.
- Improved collection/realization rates by 3 to 5 percent.
- Decreased denial rates by 4 to 7 percent.
- Decreased the denied charge write-off rate by 12 to 17 percent.
In addition to providing substantial revenue benefits, Ingenious Med also enabled Emory to optimize its staffing support for physicians. Ingenious Med provided the following staffing improvements:
- Simplified and less expensive training — 0.1 full-time equivalent (FTE) dedicated and expert users at each facility.
- Streamlined auditing — 0.3 FTE for all sites.
- Better reimbursement team structure — 6 FTEs for close to $10MM in net revenue.
While Ingenious Med improved Emory’s profitability and operations, it also improved Emory’s quality of care by enabling rounding hospitalists to focus more on patient care.
Practicing hospitalists created Ingenious Med, and the program enhances physicians’ workflow in the following ways:
- Real-time communications possible between staff and physicians.
- Access to archived patients from any facility improves customer service experience.
- Primary care physician satisfaction improvement through faxed discharge summaries.
- Maintenance of user access is locally controlled.
- Real-time analysis of productivity saves administrative time and decreases burden.
Results
Ingenious Med generated between $30,000 and $60,000 per physician for the Emory Hospital Medicine Unit (EHMU). Given Ingenious Med ASP.net interface and scalability throughout growing practices, the substantial return on investment has helped EHMU become one of the most profitable departments in the Emory University hospital system.