Collections up 30% with target goals

Staff members are able to view their progress

By simply posting collection scores on a scoreboard in patient access areas, upfront collection rose significantly at Maury Regional Medical Center in Columbia, TN.

"We implemented these boards about eight months ago, and our upfront collections are up over 30% compared to the previous year," reports Rodney Adams, director of preservice and patient access.

Each department has its own collection goals, and so do individual registrars. Goals are based on previous collection data, with a percentage increase over the previous year — typically a 10% improvement. If the emergency department collected $25,000 in April 2013, for example, the goal would be $27,500 for April 2014. (See related story, p. 65, on how to set collection goals.) "We share the daily collections numbers by department on a visual management board," says Adams. "This scoreboard contains daily metrics and goals by department, as well as whether yesterday’s goal was met."

Staff members are required to look at the board daily, as are the area supervisors. Managers and directors review the information weekly or bi-weekly, and senior leadership review progress every month. The board includes this information:

• Historical data: in most cases, a graph of the past 13 months.

• A supervisor’s analysis of why a particular goal was not met.

"Problems discovered include systems issues, such as edits not working appropriately in our registration QA system, or even issues within our physician office systems causing them to send us incorrect orders," says Adams.

• The previous day’s score.

Not meeting the collection goal results in coaching or additional training, and ultimately, it can be a cause for termination. "Exceeding the goal results in a better performance appraisal, which means a bigger raise," says Adams. "Also, it gives them bragging rights in their area."

Collections are more difficult

The biggest challenge for upfront collections has been the steady increase in patients’ out-of-pocket responsibility, says Shelita Russ, CHAM, director of patient access services for Ochsner Medical Center — Kenner (LA) and Ochsner Baptist Medical Center in New Orleans.

"With patients now responsible for larger upfront liability amounts, the conversations at the registration desk are becoming more difficult," she says.

Russ posts collection goals to make the staff aware of how they compare to their peers. She also pairs strong collectors with struggling ones.

"It strengthens morale throughout the entire team to know that not just one person is carrying the collection load, and that all members are doing their part," says Russ.

SOURCES

• Rodney Adams, MMHC, Director of PreService and Patient Access, Maury Regional Medical Center, Columbia, TN. Phone: (931) 490-7103. Fax: (931) 490-3910. Email: radams@
  mauryregional.com.
• Diane Ward, Assistant Director, Enterprise Patient Access Services, UK Healthcare, Lexington. Phone: (859) 323-2590. Fax: (859) 218-7526. Email: diane.ward@uky.edu.
• Shelita Russ, CHAM, Director, Patient Access Services, Ochsner Medical Center — Kenner (LA). Phone: (504) 894-2912. Email: sruss@ochsner.org.