Golden Valley Memorial Healthcare

Improves RVU Transparency With MEDITECH

The end result is a new dashboard that saves the health information management staff approximately 140 hours per month.

Staff satisfaction is critical to recruiting and retaining healthcare professionals, especially for rural organizations. For physicians compensated using a productivity formula based on relative value units, a lack of transparency between administrators and physicians (whether intentional or not) can be a source of constant frustration.

Golden Valley Memorial Healthcare employs a dedicated HIM team to ensure RVUs are accurate. However, inefficient processes for tracking, validating, and subsequently sharing RVU data with physicians eventually led to upwards of 150 hours of manual validation — as well as burnout of its HIM staff.

“You can’t miss payroll,” explained Tara Dull, HIM director. “Brooke — our accountant — and I used to work fast and furious to process professional charges. We were sometimes up until midnight. It was not sustainable.”

Because of GVMH’s unique contracts with providers, many of their charges span across acute and ambulatory care settings. To get a complete picture of their particular workflows, HIM staff were spending time printing and manually reviewing schedules and incomplete record reports, to gauge which providers were missing RVUs. Something had to change.

Building a new dashboard

GVMH was already using MEDITECH’s Business and Clinical Analytics solution to automate reporting in other areas of the organization. Since the health system’s own staff were tied up with its Expanse migration and other priority projects, GVMH turned to MEDITECH to supplement its resources. MEDITECH helped the organization to merge disparate RVU data sources and visualize the results in a meaningful way.

“Our CIO knew there had to be a way to accomplish everything we needed with BCA. He valued my time and felt that seeking MEDITECH’s help in designing a personalized RVU dashboard would be the best way for me to get some of that time back,” said Dull.

“He pushed for CFO and CEO approval and once we agreed to a scope of work, the process moved pretty quickly. Turns out that BCA is more powerful than what I ever thought it could be.”

MEDITECH assigned Jonathan Bashford, a SQL data engineer, to walk through GVMH’s workflow, identify its needs, and design a new dashboard. Dull and Bashford talked multiple times per week, walking through examples and business logic while zeroing in on those services that had potential for missed revenue and charges.

They started with the ambulatory encounters, which represented the largest piece of the financial pie. They then progressed to services in the acute setting performed by members of the ambulatory physician groups, which involved the forwarding of charges between settings.

“We went through multiple iterations,” said Dull. “Jonathan kept uncovering additional benefits and new ways of seeing the data. He was very familiar with MEDITECH’s side of the house and put everything in layman’s terms for me.”

The completed dashboard gave GVMH a list of patients by contributing provider and associated charges. For those patients associated with a provider who did not list identified charges, staff could easily identify the reasons why. For example, a mid-level provider who treated the patient may have received the RVU credit instead, unsigned reports could be preventing coders from issuing charges, or coding staff may simply need to be notified that the patient account requires coding.

Getting time back

GVMH’s new dashboard dramatically reduced the time needed to process RVUs — from 150 hours down to less than eight. Staff can quickly determine which provider RVUs were applied to, incorporate edits, and even identify incomplete records without having to look elsewhere. Everything is cleanly organized, and HIM is also able to drag and manipulate certain templates to view data in different ways.

“The RVU dashboard paid immediate dividends in hours saved,” said Dull. “Our CFO loves that we are available for other projects that she previously didn’t have hours budgeted for.”

The HIM staff aren’t the only ones benefiting. Physicians used to scrutinize their RVUs, contacting the HIM staff to inquire about specific missed charges. Now the number of calls has dropped dramatically, with some months requiring no follow-up at all.

Physicians receive monthly RVU reports. A face sheet, designed by MEDITECH, outlines charges produced by month under a provider’s name — including total quantity per CPT code, work RVU value, and what RVUs were charged. Detailed reports are given upon request and providers also have the option to review dashboards themselves, though most prefer paper reports.

“We’ve gotten great feedback from providers,” said Dull. “They like the additional detail we can pull out of BCA, and it’s created a lot of awareness across the organization. People are even asking if we can pull other details.”

GVMH is now looking to MEDITECH for help with other organizational improvements, such as implementing provider scorecards and Joint Commission dashboards.

“It’s nice to have an idea and actually have that exact concept delivered without shortcomings and workarounds,” said Dull. “We were able to get exactly what we wanted without having to compromise. Without years of experience, it would be difficult to get a solution as good as what we received from MEDITECH’s Professional Services.”