Sample Client Set
Representative Case Studies
Edward Hospital and Health Services
Edward Hospital and Health Services is a full-service, not-for-profit health system located in the western suburbs of Chicago. When leadership elected to implement a next-generation EHR system, they recognized the possibility of negative financial impacts across the revenue cycle. Edward Hospital and Health Services enlisted the services of MCS to complete a comprehensive risk mitigation engagement focusing on a prelive audit of the hospital billing system, conversion testing management (parallel claims testing and charge trigger testing), and financial risk mitigation (revenue capture/charge reconciliation, discharge not final bill and prebill management). The engagement resulted in the identification of technical build issues and a strategy to fix them pre-live, an overall claims acceptance rate of 98% in the pre-live environment, and a 99% pass rate on charges tested and validated; all of which enabled Edward to achieve 101% of baseline revenue within sixty days of go-live.
Parkview Health, Northeastern Indiana’s largest health system, had made a significant capital investment when they made the decision to implement Epic, a state-of-the-art, next-generation EHR system. The health system’s leadership recognized that in order to achieve a return on their investment, they would need the implementation to go seamlessly. MCS was engaged for a comprehensive, revenue cycle risk mitigation and revenue management project. The engagement resulted in the resolution of over 140 issues identified through the prelive build audit prior to go-live, 100% passage of all common claims scenarios, testing and validation of over 9,000 unique charge codes prior to go-live, a return to 100% of baseline revenue within thirty days of go-live, and a best-practice candidate for bill metric of five days within sixty days of go-live.
University of Michigan Health System
The University of Michigan Health System, located in Ann Arbor, MI completed a migration to the Epic platform in February of 2012. Soon after the migration was complete, the health system began experiencing a period of decreasing patient revenues, increasing accounts receivable, and diminishing cash flow. The University of Michigan Health System enlisted MCS to complete a thorough revenue cycle assessment, which identified key areas of risk, such as self-pay collections, call abandonment rates, underpayment recovery, denial management, and charge capture. Further, in early December of 2012, the system’s candidate for bill metric had spiked above twenty AR days. University of Michigan Health System turned to MCS to perform a post-conversion optimization, with specific focus on the areas identified by the MCS revenue cycle assessment. Highlights of the MCS engagement include a 71% reduction in candidate for bill days and a 68% reduction in call abandonment rates.
John Muir Health
John Muir Health (JMH), located in northern California, began undergoing changes in their reimbursement landscape, had made plans for an upcoming system-wide Health Information System (HIS) implementation project, and faced effects from recent industry and legislative trends. Experiencing a decline in net patient revenue for the organization, including decreasing payer reimbursement and an increasing portion of uninsured/underinsured within the patient population, JMH partnered with MCS for a comprehensive revenue cycle redesign engagement. The engagement lead to enhanced accountability throughout the revenue cycle through interim management and a focus on organizational design and governance structure. John Muir Health was able to realize a 98% increase in self-pay yield, 9% increase in third-party liability yield, a $200K net benefit in government eligibility, and over a 20% increase in point of service cash collections.