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How a multi-specialty clinic achieved the highest award in revenue cycle

The Healthcare Financial Management Association’s (HFMA) MAP Award for High Performance in Revenue Cycle recognizes organizations whose innovative and effective strategies have enabled them to achieve excellence in revenue cycle performance.

There are five award categories: Hospitals, Critical Access Hospitals, Hospital Systems, Integrated Delivery Systems and Physician Practices.

Winners excel in:

• Meeting industry standard revenue cycle benchmarks (MAP Keys)
• Implementing the patient-centered recommendations and best practices embodied in HFMA’s Healthcare Dollars & Sense™ initiatives
• Achieving outstanding patient satisfaction

Aggregated data from the six MAP Award winners for High Performance in Revenue Cycle – Physician Practice –  MAP Award 2020 Winner Statistical Data.

Award recipients are acknowledged as industry leaders and share proven strategies with HFMA members and other professionals.

Achieving the highest award in revenue cycle

I am excited to share that Graves-Gilbert Clinic (Bowling Green, KY), an Allscripts® Practice Management and Allscripts Touchworks® EHR client for more than a decade, has been awarded this high recognition under the category of Physician Practices.

Graves-Gilbert Clinic is a multi-specialty clinic founded in 1937. Since its inception, the clinic has grown to include approximately 200 providers representing 30 medical specialties. Its mission is to provide sensitive, compassionate care to patients with respect to the total well-being of the individual.

I had the opportunity to chat with Graves-Gilbert Clinic’s Chief Financial Officer Steve Sinclair to discuss his journey. These were the two key takeaways for achieving successful revenue cycle:

1. Take time to stop and evaluate your revenue cycle operations

Steve mentioned the importance of reviewing every process in the revenue cycle to identify opportunities. This is commonly a very challenging initiative, as executives are constantly bogged down managing the day-to-day activities of the practice, but one that needs to be embraced if the organization is to move from bad to good or from good to great.

He recommends not trying “eat the elephant” all at once–for instance, not trying to change all processes or address all challenges all at once, but instead to take smaller bites (opportunities) that can be thoroughly implemented. He also highlights the importance of changing the culture of the team to always be on the look-out for opportunities. The leadership team should embrace the sentiment of “we can do better” every time a denial is received. The idea is to become the best denial avoiders, versus the best appeal submitters. His feedback alluded to the fact that if, in a perfect world, the root causes of all denials were affectively addressed, organizations would not need to have staff in their billing departments doing follow-up work.

2. Seek expertise outside of the organization

Steve attributed much of the organization’s success to its engagement with a third party that specializes in revenue cycle. Instead of having a director of revenue cycle in-house, Steve highlights the value of having someone else outside of the organization review all of its processes, check the pulse of its key performance indicators and identify opportunities for improvement.

The in-house resource would most likely be motivated to highlight strengths or the way the organization manages its revenue cycle processes, rather than highlight weakness and how it can shake up current practices to achieve higher results.

Winning the HFMA’s MAP Award is not easy, but it is not impossible

Outcomes such as 18 Net Days in AR, 10.8% of AR over 90 days, 1.2 days charge lag and 2.1% denial rate definitely raise the bar for all of us. But with the right combination of skillful resources, optimized processes and state-of-the art technology, this is achievable.

I leave you with Steve’s paraphrased insightful comment about goals: Strive to be an innovator, strive for the highest recognition, make the appropriate changes along the way and the rest will be history.

Congratulations Graves-Gilbert Clinic for such an achievement of excellence!