Internal benchmarking data allow the patient access department at Ronald Reagan Medical Center in Los Angeles to improve continuously.

“It assists us in creating action plans with the greatest impact on outcomes,” says Drew D. Totten, principal administrative analyst for patient access services.

One of the most impressive examples is how the data identified collection trends by employee over time.

“Collections have doubled based off of best practices which stemmed from benchmark data,” Totten reports. “In the pre-registration department, revenue increased by 140%.” Important productivity gains were achieved. “We have several key staff members out on various types of leave status,” Totten says. Surprisingly, certain registration areas are seeing an increase in productivity, even with fewer employees.

“We identified opportunities for those employees to take on more responsibility and tasks,” Totten notes. “It’s not that they were overstaffed, but underutilized.”

Basic metrics, such as how long a typical case takes to clear, or how many cases can be worked per hour, came into play. “Based on that data, we set achievable goals for each employee daily,” Totten adds.

Another change involved employees who work cases from work queues. Previously, employees had no real ownership of the cases.

“Employees worked cases one day, and had different cases the next. Unresolved cases from the previous day were worked by someone else,” Totten explains. Staff spent much of their time reviewing the previous employees’ work to become familiar with the case. Most cases required repeat calls to the insurance company to obtain authorizations.

“When the employee is familiar with the case, they will remember it from day to day,” Totten offers. Employees can pick up where they left off by simply reading the last note in the patient’s records. In contrast, an employee unfamiliar with the case has to research the entire case, reviewing all previous notes to understand the next step.

“By having each employee work their caseload by date of service, we have seen a 25% increase in productivity,” Totten reports.

Employees are assigned a date of service, which they follow until the day prior to the patient’s appointment. There is no lengthy prep work needed, because the employee stays with the case until its completion.

“We now have ownership for each case,” Totten says. “Employees can be more productive and clear more cases than before.”


  • Drew D. Totten, Principal Administrative Analyst, Patient Access Services, Ronald Reagan Medical Center, Los Angeles. Phone: (310) 481-9759. Email: