a-plus RCM reporting
15 practice group
- Payer contract negotiations
- Pay-for-performance initiatives
- Obstetrics episode reporting
- Transparency across the orgnanization
- Performance visibility across the organization
- Practice growth
- Better pay-for-performance results
- Billable care gaps closed
In 2014, OB/GYN Affiliates was still dealing in paper records, outsourcing billing, and using third-party reporting tools. The result was fewer opportunities to grow or enhance profitability and provider satisfaction. But after transitioning to athenaOne, they’ve expanded to 15 divisions thanks to higher revenue and greater visibility across the organization.
Reporting transparency, ease lead to profitability
Third-party reporting tools were nowhere as seamless “nor as robust” as what President Chris Hrubesky says can now be generated easily through athenaOne. And, OB/GYN Affiliates is performing far better financially than they expected. “On all of the acronym programs like MIPS and all of that, we would have been nowhere without athena, which has made it incredibly easy for us to qualify over the past five years,” he said. “Like on the Medicare side, we didn’t think we were going to get any money, but we ended up getting quite a bit.” Hrubesky added that having access to data also has assisted his group with more to leverage when it comes to negotiating profitable performance-based contracts.
For Director of Revenue Cycle Operations Liz Foelske, previously outsourced billing meant less transparency into claims. “I’m (now) able to look at several user-friendly reports on a regular basis that really help our revenue cycle.” Among those metrics are the zero-pay reports that identify forgotten modifiers. “We’re able to easily go into a claim and see all of the correspondence, look closely at the numbers — that wasn’t something we were able to do before,” she said. “I really wouldn’t know that our outsourced billing company was looking at it that closely.”
Foelske also has greater visibility into each location, thanks to reports about the number of patients with a credit card on file. Once patients consent to having this information stored, providers can automatically run a charge. The practice reduces the amount of time it takes for self-pay patients’ bills to clear accounts receivable. “I can leverage those numbers and go to the providers to say, ‘Hey, you saw 500 patients last month, but only got a credit card on file for 200. Look at the impact to your A/R,’” she explained. “It’s great to be able to leverage all the data from all divisions and say, ‘This is how you’re performing compared to your fellow physicians.’”
A solution that satisfies
Having the same cloud-based solution across all 15 locations makes it easier to streamline other data that enhances patient care. An obstetrics episode report that identifies patients who haven’t been seen within expected timeframes serves multiple purposes — patients are contacted to close potential care gaps, which in turn increases billable services.
Using athenaOne has helped bring on new providers and grow the business, said Hrubesky. “We’re able to show that to any groups that are interested in joining us that we’ve got good contracts, and we get paid. The proof is in the pudding—the physicians and the staff are happy and talking about results empirically and qualitatively.”
The proof is in the pudding — the physicians and the staff are happy and talking about results empirically and qualitatively.
* These results reflect the experience of one particular organization and are not necessarily what every athenahealth customer should expect.