August 1, 2004
Pamela Gordon, Matthew Chin
Achieving a New Standard in Primary Care for Low-Income Populations: Case Study 3: Revenue Maximization Program at the Brownsville Center, Pamela Gordon, M.A., and Matthew Chin, M.P.A., The Commonwealth Fund, August 2004
This related report summarizes four case studies of hospital quality, ACHIEVING A NEW STANDARD IN PRIMARY CARE FOR LOW-INCOME POPULATIONS: CASE STUDIES OF REDESIGN AND CHANGE THROUGH A LEARNING COLLABORATIVE
Executive SummaryCase Study 3: Revenue Maximization Program at the Brownsville Multi-Service Family Health Center
This case study chronicles the Brownsville Multi-Service Family Healthy Center's (BMS's) effort to collect revenues efficiently throughout the entire collection process. BMS serves a low-income community living predominantly in public housing. BMS's challenge was how to sustain revenue while meeting the overwhelming needs of its clients.
BMS was acutely aware of its pressing need to increase revenue, but its numerous attempts to fix the problem internally had failed. BMS turned to PCDC for help, and implemented PCDC's Revenue Maximization (RevMax) Learning Collaborative.
BMS used the learning collaborative model over a six-month period to streamline its entire collection process, which produced dramatic results in several financial indicators. As a result of the changes, average weekly cash receipts increased by 46 percent. Reimbursement per visit rose 55 percent, from $78 to $121.
|Weekly cash receipts: $66,434||Weekly cash receipts: $97,174 46%|
|Reimbursement per visit: $78||Reimbursement per visit: $121 55%|
|Total revenue increase: $345,000 51%|
This case study also documents how the work of the collaborative improved employee morale and encouraged high performance throughout the organization. These changes delivered another significant result: the adult medical care unit increased patient visit volume by 5 percent after several years of decline.
BMS improved its bottom revenue line by following the five strategic collaborative principles and, in addition, 10 RevMax specific change principles.
Ten RevMax principles:
- Do it right the first time
- Collect money due at the point of service
- Eliminate lag times between service and billing
- Manage claim rejections
- Redesign bad processes
- Encourage teamwork
- Leverage technology
- Share the data
- Establish good internal control systems
- Maintain appropriate staffing