Oswego Health

Gains Financial Transparency and Increases Efficiency With MEDITECH Expanse

Administrative worker typing on keyboard

Keeping a nonprofit healthcare system financially sustainable depends in large part on collaboration and information. At Oswego Health, a full-service community hospital, its leadership team has worked tirelessly to improve the organization’s bottom line for more than a decade. CFO Eric Campbell formed a multidisciplinary revenue cycle committee as part of that initiative. The committee promotes transparency by setting goals, reviewing metrics, and reacting to concerning trends.

Campbell and his team were eager to streamline their tedious, manual process of compiling reports that were quickly outdated. They saw an opportunity when the organization moved to MEDITECH Expanse; leveraging the platform’s redesigned Revenue Cycle solution, specifically the interactive Financial Status Desktop, enabled them to eliminate manual processes while improving transparency.

A single source of truth

Throughout Oswego, MEDITECH’s FSD is the single source of truth for all stakeholders; it supports the organization’s strong culture of transparency and accountability. From office staff to the CEO, everyone who uses this desktop is empowered to proactively monitor financial metrics, gauging real-time performance and informing decisions.

Campbell frequently works with his director of financial services to review receivables and cash flow, identify the root cause of issues, and drill into individual account details to support his findings.

“I use the Financial Status Desktop daily to look up cash receipts, adjustments, charges, and patient accounts,” said Campbell. “It’s been a wonderful development to have such easy access. I love it.”

Multidisciplinary performance measurement

Maintaining Oswego’s fiscal responsibility is a team effort. Campbell leads a longstanding, multidisciplinary committee who all play a role in ensuring smooth revenue cycle processes. This committee — which includes executives, quality officers, office managers, analysts, case managers, and the directors of ancillary and behavioral services — meets regularly to review dashboard metrics.

Committee members use the FSD’s daily and monthly status reports to review cash receipts, charges, days in revenue billed and unbilled, and other financial metrics. With this data, the committee is able to compare performance against goals and identify problematic trends, such as an increase in denials from a particular payer. Subgroups are then assigned to investigate solutions to the flagged issues. Using drill-down capabilities inherent in the FSD, they’re able to delve into granular details to identify the root cause.

Case management and utilization review staff also play a key role in Oswego’s revenue cycle efforts by ensuring adequate documentation, working with insurance companies to secure inpatient approvals.

Efficiency through automation

Using MEDITECH’s Revenue Cycle solution to automate processes, Oswego has gained transparency and efficiency, helping the financial services department to maintain consistent performance. Despite a 17% reduction in department size due to retirements, staff are completing the same tasks without being overburdened — a significant benefit at a time when recruiting has become more difficult.

Automated processes include:

  • Capturing emergency department charges through CPT codes embedded as a byproduct of documentation, ensuring ED bills are at the most appropriate level.

  • Enabling the fnancial services staff to view receivables and account details in the Patient Accounting Desktop for quick identification of payer issues and reduced aging.

  • Creating account checks to fix account issues before submitting them to a clearinghouse, which has led to a consistent 95% acceptance rate.

Because of these efficiencies, Oswego has kept A/R days low, even through its transition to Expanse: They currently average between 30-35 days in the hospital.

Community investment

Fiscal responsibility has enabled Oswego to dedicate $18 million annually to provide care to the uninsured, the underinsured, and the indigent as part of a community investment project. Campbell attributes this success to the organization’s solid revenue cycle.

“It starts at the top, from the CEO down,” said Campbell. “Through strong leadership and actionable, transparent data, we’ve been able to achieve our financial goals.”

Meeting monthly with representatives from areas throughout the organization, Campbell noted, has enabled Oswego to overcome obstacles that affect the bottom line through creative problem-solving. This committee brings that same know-how to its annual meetings, where they plan for the future. By bringing many disciplines to the table, Oswego has emphasized the importance of fiscal responsibility and enabled the healthcare system to make a real difference to everyone in the community.