leading the charge


SCP Health

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    ~400 healthcare facilities

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    ~7,500 providers

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    8 million patients

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    30 U.S. states

Challenges

  • Lack of automation meant higher number of staff
  • High volume of paper claims

Solutions

  • athenaIDX
  • athenaEDI
  • athenaIDX Hosting

Results

  • Updates to automate processes streamlined workforce
  • Volume of paper claims reduced
  • Gold Productivity Award for achievements in revenue cycle management

SCP Health provides clinical leadership and practice management solutions for emergency medicine, urgent care, hospital-based medicine, and intensive care across the United States. Since Chief Revenue Officer Keith Cantrell began eight years ago, the organization has doubled in size without increasing staffing or replacing employees who left by leveraging technology and other leading practices. His traditional benchmarking ratios made him think he could streamline and automate processes to improve efficiencies, and costs. Cantrell and his leadership team credit athenahealth – including athenaIDX™, athenaEDI™, and athenaIDX hosting — as an integral partner to making those enhancements.

A “transformative journey” with the right partner

Cantrell’s three pillars of a successful business model are always “people, process, and technology,” he says. Contributing to all of these is a partnership with the athenahealth team, which has been with SCP on what Cantrell calls a “transformative journey” years in the making. athenahealth’s business and technical talent has flexed alongside SCP’s transition from a smaller, regional emergency medicine staffing company when Cantrell started, to an organization that doubled in size from 2016 to 2019 through two large acquisitions. “Through it all, we’ve developed really strategic relationships with members of the athena team,” said Teresa Proctor, director of revenue cycle systems, who’s worked with athenahealth in various capacities for more than 20 years.

Among the most impactful initiatives that Cantrell, Proctor, and vice president of revenue cycle systems Laura Steinkraus Machen have worked on together with athenahealth was a migration to a hosted datacenter at a critical time to support exponential growth. That hosting partnership “gave the entire organization the confidence that SCP could handle doubling in size and the volume of accounts that go through the system,” said Proctor.

SCP was then able to expand its platform, working toward the goal of streamlining with a Linux server migration that Steinkraus Machen calls “life-changing” in terms of operational efficiency. Their migration of 25 servers from Milwaukee to Texas – which required collaborating with 30-plus vendors and updating and validating more than 1,000 AES, EDI and ETM processes, scripts, and routines – went so smoothly that revenue was not impacted, nor was data or days in accounts receivable. Steinkraus Machen says it was “really seamless to our end-users and non-eventful.”

But what was notable then, and for the future, is the continued teamwork between SCP and athenahealth. “Hosting is a full journey — it wasn’t one event. We’ve had different migrations and projects with athena’s hosting team and our relationship is not only a daily thing in how they maintain, update and do monthly maintenance, but several projects over the years have kept us current and moving in the right direction,” Steinkraus Machen explained, citing plans to transition to InterSystems IRIS for Health™ before upgrading the organization’s version of the athenaIDX application used. “Our relationship with the athenahealth hosting team is vital to our organization,” she said.

Clipping the paper means cutting the work

Another important milestone for the SCP team was an initiative with athenaEDI that decreased paper claims from nearly 35,000 to approximately 11,000 monthly. Optimizing and outsourcing paper claims increased the EDI claims rate from 95 to 99 percent and yielded a reduction in the number of resources and effort required to work claims, contributing to SCP’s top-place Gold Productivity Award placement, a designation for achievements in revenue cycle management.

Decreasing paper claims was an important business priority before the pandemic but proved pivotal to operational success when the organization had to transition its entire revenue staff to a homebased model in just 21 days in March 2020. “You wouldn’t want to be printing all of these claims from home,” said Steinkraus Machen. Cantrell added that SCP is “95 percent virtual running a revenue cycle from across the globe in people’s kitchens and homes.”

Exchanging manual processes for zero-touch automation

The year 2020 was notable for other reasons as well. SCP Health’s continued growth yielded a few disjointed processes across the organization – including 104 remit exchanges that needed remediation. Each exchange required individual handling by SCP end users specializing in payment reconciliation, posting processing, and posting reconciliation. Additionally, each unique configuration required significant manual effort due to limited and inconsistent logic.

While successfully navigating the challenges of the pandemic in tandem, a 2020 athenaEDI optimization project consolidated, standardized, and optimized exchanges to eliminate manual review and follow-up. Reducing down to just 25 remit exchanges, SCP now benefits from efficient and robust invoice matching. FSC transfers, payment take-backs and repayments post easily, says Steinkraus Machen. The automation resulted in a higher percent of remit posting – from 85 percent to 97 percent – and decreased manual posting by more than a third of overall volume of transactions monthly.

“When you have over 100 exchanges, and you changed one, you subsequently had to change the remaining 99 to keep your system and environment updated,” said Proctor. “Automating can be lifechanging, as more transactions are posted with automation. That’s zero-touch – and zero touch is the future.”

SCP also saw its enrollment rates for Electronic Remittance Advice (ERA) and Electronic Funds Transfer (EFT) increase from 70 percent to 85 percent. The optimization yielded 75 percent fewer application configuration components and 75 percent fewer daily end-user processes. The impact on the organization is both qualitative and quantitative, as the trio says SCP has reduced the system maintenance.

Proctor says the project is just one of several SCP has partnered with athenahealth for that has enhanced the foundations of the system. “We can do that with less people because the system is much more effective and more efficient.” she said.

Ambitious priorities pave the path forward

Successes and growth have positioned SCP on a path from a best-practices organization to what Cantrell describes as a leadingpractice organization. But he and his team still have an ambitious set of goals. As part of the core athenaIDX application, SCP is piloting computer-assisted coding, with a target of moving to 100 percent computer-assisted coding. SCP is also revamping its payer contract module to assist with underpayment appeals. A new provider credentialing platform that interfaces with athenaEDI should also allow for a reduction in manual processes. Rather than liken the infrastructure and support SCP receives to a backbone, Cantrell compares athenaIDX with a different metaphor. “So much of our world interfaces with athenaIDX. athena is the heart of our world.”

By the numbers:

Decreased paper claims from nearly 35,000 to approximately 11,000 monthly. Reduced remit exchanges by 75 percent. Remit posting increase from 85 percent to 97 percent. Enrollment rates for ERA and EFTs increased from 70 to 85 percent.

So much of our world interfaces with athenaIDX. athena is the heart of our world.

— Keith Cantrell, SCP Health Chief Revenue Officer