When Titus Regional Medical Center embarked on two significant Electronic Health Record (EHR) conversions within a 24-month period, they uncovered a critical opportunity to safeguard revenue integrity throughout the complex process. With guidance from Chris Torres, Sr. Director of Accounting & Finance, and the support of Sixth Sense Intelligence, Titus successfully navigated the challenges of EHR transitions, focusing on proactive revenue monitoring and data-driven decision-making. This case study details the obstacles encountered, the strategies implemented, and the tangible impact on revenue cycle management.
Download the full presentation below to get detailed insights into Titus Regional Medical Center’s EHR conversion, including key metrics, challenges, and strategies for preventing revenue leakage.
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Sixth Sense Intelligence and Titus Regional Medical Center
Les Rescorl, the CEO of Sixth Sense Intelligence, has revolutionized the healthcare landscape with a business intelligence platform designed to find hidden opportunities for enhanced efficiency, performance, and operating margins.
Chris Torres, Senior Director of Accounting & Finance at Titus Regional Medical Center, brought critical expertise to Titus Regional Medical Center’s EHR projects. Together with Sixth Sense Intelligence, Titus applied a structured approach to monitor and address revenue risks, ensuring a seamless transition to new systems while protecting the revenue cycle.
A Failed EHR Conversion and Unexpected Revenue Leakage
Titus’s journey began with an Epic Community Connect implementation in 2018, which coincided with a complex ERP replacement. Despite comprehensive planning, Titus encountered initial challenges, including inconsistent KPI tracking and significant revenue discrepancies across departments. Revenue cycle gaps became apparent shortly after go-live, with departments struggling to meet baseline revenue targets due to insufficient KPI tracking and lack of transparency.
Recovering with Expert Guidance from Sixth Sense Intelligence
With significant revenue leakage identified, Titus relied on Sixth Sense Intelligence for specialized support. Sixth Sense implemented automated KPI tracking and analytics tools to quickly uncover key leakage points, including charge coding issues and observation rate misclassifications. Within three months, Titus regained control over its revenue cycle, using data insights to forecast budgets and optimize their revenue cycle processes across departments.
Key Pain Points from the First Conversion:
- Revenue Shortfall: Within the first 10 weeks of analysis, the team identified over $1 million in revenue leakage, primarily from missed charges and increased observation rates.
- Operational Disruptions: Departments faced difficulties meeting revenue targets, hindered by limited KPI tracking and visibility across financial processes.
Applying Lessons for a Smoother Second EHR Conversion
In 2020, Titus faced another EHR transition, this time migrating to a more mature Epic instance following the acquisition of their original Epic Community Connect partner. Leveraging insights from their first experience, Titus made several key improvements:
- Enhanced Training Programs: Additional training sessions ensured all staff understood the updated workflows and system nuances.
- Automated Revenue Monitoring: Implementing automated tracking enabled continuous oversight of revenue indicators, minimizing risk during and after the transition.
- Streamlined Workflows: Established workflows and more realistic expectations contributed to a smoother transition process, with reduced revenue impact.
Revenue Leakage Sources and Prevention Strategies
Les Rescorl, CEO of Sixth Sense Intelligence, identified three main sources of revenue leakage during EHR conversions and offered strategic solutions:
1—Charge Master and Process Flow Issues
Titus addressed common issues related to charge codes by comparing billing data before and after conversion to flag discrepancies. Even minor inaccuracies in charge master entries, such as unit pricing or documentation triggers, can contribute significantly to revenue leakage.
2—Case Mix Index Monitoring
Case mix index declines can occur when DRG coding is disrupted, impacting reimbursement rates. Monitoring the case mix index by provider and payer helped Titus ensure that reimbursement rates remained stable, minimizing revenue dips.
3—Observation Rate Oversight
Misclassifications in observation rates can greatly impact Medicare reimbursements. With automated tracking, Titus monitored the observation rate and implemented corrective actions as needed to meet industry standards and prevent unnecessary revenue loss.
Titus Regional’s Proactive Approach to Safeguarding Revenue
Titus Regional Medical Center’s story illustrates the importance of preparation, vigilant monitoring, and external expertise in preventing revenue leakage during EHR transitions. With Sixth Sense Intelligence’s analytics platform, Titus now has a reliable foundation for KPI tracking, improved observation rate management, and ongoing revenue cycle integrity.
Is Your EHR Conversion Affecting Your Revenue?
EHR conversions can pose significant revenue risks, but Titus Regional Medical Center’s experience shows that these risks are manageable with the right strategy. Learn how a proactive, data-driven approach can safeguard your healthcare organization’s revenue during EHR transitions.
Download the full presentation below to get detailed insights into Titus Regional Medical Center’s EHR conversion, including key metrics, challenges, and strategies for preventing revenue leakage.
Download the presentation: Preventing Revenue Leakage when Changing EHRs
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