Monthly point-of-service collections topped $1 million for the first time at Mercy Hospital Springfield. The department made a point of celebrating successes to motivate reluctant collectors.

  • Managers gave each employee a movie ticket and served root beer floats.
  • Each team member was given a personal goal.
  • Staff members enjoy meals together, with food and supplies donated or brought in by managers.


In January 2015, patient access employees at Mercy Hospital Springfield (MO) collected more than a million dollars in one month for the first time. This milestone didn’t go unnoticed by anyone in the department.

“Management celebrated the success of its team by serving root beer floats. Each coworker was presented with a card and a movie ticket to a local theater, provided with donated funds,” says financial analyst Vera Hart.

One of the biggest challenges is balancing increased point-of-service collections with providing compassionate care, according to Jeff Brossard, CHAM, director of patient access. “It is so very important to celebrate our successes,” Brossard emphasizes. “We all respond better to positive reinforcement than negative reinforcement.”

The million-dollar milestone was especially noteworthy because patient access only recently began collecting from patients routinely. Many were uncomfortable asking patients for money, in part due to the hospital’s nonprofit status.

At first, many patients challenged patient access employees by stating, “We have never been asked for money in the past,” or “Do I have to pay to be seen?” “Patient access had to learn to ask for payment without offending the patient or giving the impression that the patient had to pay or wouldn’t be seen,” says Hart.

The hospital has long been known in the community for willingness to meet the needs of those who are not able to pay. “Patient access representatives suddenly had to be more intentional with their request for money,” says Hart.

Goals slowly increased

Collection goals slowly were increased, to bring the hospital closer to the Healthcare Financial Management Association benchmark of 2% of net revenue.

“Often when working with individualized goals, it can be perceived as negative reinforcement,” says Brossard. “Any chance we get to celebrate our successes helps to change that perception to more of a positive reinforcement.”

Each team member was given a personal goal based on the total goal for patient access, the goal for their specific department, and their job within that department.

“Coworkers are praised and recognized for their hard work and high standards,” says Hart. “This helps maintain a high morale even through this tough time of change.”

Point-of-service collections increased from a monthly average of $241,824 in fiscal year 2011 to $310,653 in fiscal year 2012 and $594,574 in fiscal year 2013. “There has been a continued push to improve collections,” says Hart.

In fiscal year 2014, monthly collections averaged $802,000, which is a 332% increase over a three-year period. In the first seven months of fiscal year 2015, monthly collections were $106,000 higher on average.

Celebrating successes

Here are some ways the department continues to celebrate successes with point-of-service collections:

Successful collectors earn points in the hospital’s Going the Extra Mile (GEM) program.

Employees earn points for compliments given to them via comment cards, overheard comments, or recommendations from coworkers or supervisors. Based on the number of points received, the employee receives a plastic “gem” attached to a lapel pin to wear on their clothing or on a plastic badge.

“When employees move to the next level, they are given a certificate and a new ‘gem’ to wear,” says Hart. “Employees are recognized for their GEMs at our quarterly meeting.” These levels are used:

— 1 GEM: The employee receives a citrine gem and a plastic badge.

— 10 GEMs: The employee receives an amethyst gem and five “Mercy points,” which can be redeemed in the hospital gift shop. One Mercy point equals $1.

— 25 GEMs: The employee receives an aquamarine gem and 10 Mercy points.

— 50 GEMs: The employee receives an emerald gem and 25 Mercy points.

— 75 GEMs: The employee receives a ruby gem and 50 Mercy points.

— 100 GEMs: The employee receives a diamond gem, 100 Mercy points, and a special plaque signed by the patient access director and the vice president of finance.

“We periodically award coworkers with a GEM for top collector or most improved collections,” says Brossard.

The department enjoys meals together.

Some of the food and supplies come from donations or gift cards that are used to pay for a catered entrée.

“Our management team contacts supermarkets and specialty stores to see if they are willing to help with specific items,” says Hart. “The cost to the department has been near zero.”

Patient access managers and supervisors bring vegetables, salads, and desserts, and serve the meal in a large conference room. “This year, we opened this up for anyone to bring something,” says Hart. “The management hangs out to visit with coworkers.” The meals are scheduled during a time which covers all the day shifts, but the night shifts aren’t overlooked. “Management returns and sets up again in the evening for the overnight coworkers in the ER,” says Hart.