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August 9, 2016 News No Comments

Culling Through Mountains of Data to Achieve Meaningful Change
By Jim Denny, CEO, Navicure


Research shows that organizations that leverage analytics are five times more likely to make faster decisions. Considering this fact, along with the mountains of data accumulated by the average healthcare organization, it’s no wonder healthcare leaders have named data analytics implementation a high priority.

Navicure’s May and June 2016 data analytics survey shows that 45 percent of the 622 survey respondents currently have an analytics solution, although 45 percent of respondents without an analytics solution are in the process of selecting or implementing one. If healthcare leaders using such solutions overwhelmingly recognize the value of data analytics, then why haven’t a larger percentage of their peers implemented a technology solution? The answer may lie in the sheer size of the opportunity afforded by analytics. The amount of data and numerous types of data can make it difficult to develop program parameters and get started. The following three steps can serve as a foundation, helping you get your analytics program off the ground quickly and efficiently:

1. Obtain organization-wide buy-in

Analytics is more than just a technology solution; it’s a data-driven approach to process improvement. With that in mind, two factors are especially important for any organization embracing analytics. First, leadership must believe in this data-driven approach. They must begin making decisions based on what the data tells them. Second, the analytics implementation should extend to staff, not just leadership. When mapping the various ways you’ll use analytics, make sure supervisors use data to pinpoint specific tasks and workflows that can be improved, and conduct training accordingly. In addition, staff should be included in the analytics strategy, using analytics to take action and correct their errors.

2. Identify your organization’s critical key performance indicators

An early-stages analytics program can benefit from starting small with the one or two KPIs deemed most critical to organizational success. By identifying KPIs that correlate to your current challenges, you can focus efforts on the areas that will yield maximum results. Some essential revenue cycle KPIs are:

  • Days in A/R
  • First pass rate
  • Denial rates
  • Rejection rates
  • Charge lag
  • Overall cash flow performance

More than 55 percent of survey respondents said their most important KPIs are days in A/R, and denial and rejection rates. Forty percent also rated denials as their top revenue cycle challenge, followed by patient payments and billing (37 percent). To that end, most organizations can make immediate revenue cycle management improvements by first targeting denial and rejection rates. However, if cash flow is your greatest concern, kick off your analytics program by measuring and monitoring charge lag and overall cash flow performance. Organizations should also start to include patient-specific payment KPIs as part of their active monitoring given the growing patient self-pay trend. It’s important for your organization to see the benefits of analytics, and starting with KPIs that can move the needle enables you to get quick wins.

3. Make actionable data an integral part of your strategy

Dashboards are important because they can give leadership and supervisors an easy-to-review snapshot of the above KPIs, but their effectiveness is limited without actionable data. For instance, if you’re targeting denial and rejection rates, the back office team working denials and rejections needs detailed analytics data that enables them to drill down all the way to the claim level. Only then can they begin to understand their error patterns, take action, and create change. At a more detailed level, features such as grouping and filtering can help this team even more. For instance, grouping by denial type enables a billing specialist to determine the cause and related financial impact of each category. Setting up these groups on the front end will allow her to clearly see which denials require certain types of action, thus enabling her to work more quickly while making fewer errors.

Getting the Most Out of Your Investment

The good news about analytics: It’s an investment with a high return, and it can give you both near-term and long-term results. In Navicure’s survey, nearly three quarters of respondents with analytics solutions had achieved cash flow improvement by reducing days in A/R. Fifty-six percent also increased revenue by identifying bottlenecks so they could get paid more quickly, and almost half had improved productivity by using analytics to pinpoint staff that needed training. In summary, those are black and white, irrefutable data-driven reasons to support the value of analytics in healthcare organizations.

Jim Denny is CEO of Atlanta-based Navicure.


JenniferMr. H, Lorre, Dr. Jayne, Dr. Gregg

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