Cook Children's Optimizes Financial Performance Through EHR Conversion
Challenge
After spending years maintaining two legacy electronic health record (EHR) platforms, Cook Children’s Health Care System, a 370-bed pediatrics hospital located in Fort Worth, Texas, with $2.1 billion in annual gross revenue, decided to undergo an EHR conversion. One goal of the conversion was to provide a robust set of revenue cycle reporting capabilities, an integrated bill for both hospital and professional services, and enhanced clinical workflows. Cook Children’s had not undergone an information technology (IT) conversion of this scale but was aware of the challenges similar organizations had faced during their conversions.
Solution
Cook Children’s selected Epic Systems Resolute Revenue Cycle as part of its integrated EHR conversion, and partnered with Guidehouse Inc. to support the success of the implementation.
Through the partnership, the organizations developed a solution that included financial risk mitigation services both pre- and post-system go-live. Pre-live services encompassed IT advisory, training, and operational change management support required to leverage the new technology platform. Post-live support focused on stabilizing revenue to historical baseline or better levels and submitting error-free claims to payers.
Given the trusted partnership, Cook Children’s challenged Guidehouse to help the organization:
- Capture 100% of gross revenue (volume-adjusted) compared to baseline within 30 days
- Reduce unbilled accounts receivable (A/R) volumes to Epic top quartile benchmarks within 60 days
- Ensure at least 95% of claims successfully transmitted through the external scrubber daily
- Provide interim management services to fill short-term gaps in the organizational structure
Impact
Through data transparency, epic expertise, and an objective perspective, Cook Children's and Guidehouse achieved the following performance targets:
- Gross Revenue Capture
- >100% of hospital billing (HB) revenue vs. baseline within 30 days of Epic go-live
- >100% of physician billing (PB) revenue vs. baseline within 30 days of Epic go-live
- Unbilled A/R Throughput
- Reached 4.9 AR days in HB accounts in candidate for bill within 60 days of Epic go-live
- Maintained <2 AR days in PB accounts in claim edit work queues within 60 days of Epic go-live
- Claims Acceptance
- Achieved daily target of 95% HB claims accepted via scrubber within 60 days of Epic go-live
- Achieved daily target of 95% PB claims accepted via scrubber within 60 days of Epic go-live
