Howard County Medical Center

Uses Expanse Revenue Cycle to Reduce Self-Pay Debt by 42% Through Community Engagement

Howard County Medical Center is committed to community outreach as a means to expand access to care across its rural, underserved population. The success of this outreach rests on maintaining its own fiscal sustainability when many Critical Access Hospitals are at risk of closing and carry the burden of uncompensated care.

But where other CAHs struggle, Howard County continues to thrive — an achievement CFO Morgan Meyer attributes to financial transparency and community engagement. The medical center recognized that, to succeed in this environment, it needed to have the same mindset as its patients and make every dollar count. 

Implementing MEDITECH Expanse in 2019 set the stage for even greater transparency and efficiency; by providing a single EHR and Central Business Office across care settings, staff could monitor each patient’s financial situation. It also enabled Howard County to establish a new position called a financial navigator, responsible for helping patients find ways to afford the care they need close to home.

Greater transparency through centralized monitoring

Howard County’s revenue cycle staff can now use their CBO to review patient accounts across care settings and automatically post payments. Patients make only one call to get all of their billing questions answered, which has increased satisfaction.

In addition, Howard County’s management team is able to analyze their financial health across settings using their new Financial Status Desktop. They rely on this interactive reporting tool to view real-time trends in daily reports. Meyer no longer has to wait until the end of the month to measure results, allowing her to make mid-month adjustments to reduce spending and maximize reimbursement. She also turns to the FSD to manage cost reporting for Medicare.

“At first I was skeptical that I would see what I needed to see,” said Meyer. “But MEDITECH was right. You can drill down to see anything you want with the FSD.”

Improving care access and affordability

A single EHR and CBO also enabled Howard County to tackle patient financial insecurity, a major obstacle to care. To support these patients, the medical center decided to establish a financial navigator position  – a move the community appreciates.

Financial navigators use Expanse Revenue Cycle’s Patient Accounting Desktop to review patients’ financial responsibilities across the continuum and align them with the internal and external resources needed to supplement their out-of-pocket expenses. Services may include securing co-pay assistance, locating cancer drug rebates, and finding lower-cost medications, as well as reaching out to expecting mothers about payment plans.

But financial navigators go beyond providing services directly related to medical expenses. They identify social determinants of health and provide patients with food donations, gas cards, transportation to and from appointments, and other assistance that could impact wellness. Patients develop a trusting relationship with their financial navigators, who complement Howard County’s chronic care management program. Together, these teams have contributed to healthier outcomes and a better patient experience.

“It’s not just about Howard County, it’s about the patients,” said Meyer.

Path to financial success

According to the AHA, most rural hospitals average A/R days over 50. MEDITECH’s Revenue Cycle solution has helped Howard County keep A/R days between 35-45; they’re currently at 39. Even its transition to Expanse progressed smoothly, without the typical A/R days spike CFOs expect when implementing a new EHR. Meyer attributes her organization’s success to rigorously building and testing the processing of claims prior to go-LIVE.

Leveraging financial navigators also helped the medical center reduce its self-pay bad debt by 42%, from $853,000 in 2019 to $490,000 in 2021.

But Howard County won’t stop there. The organization continues to strengthen its financial position by improving the patient experience, such as adding check-in kiosks to capture more accurate insurance information.