Achieving a New Standard in Primary Care for Low-Income Populations: Case Study 3: Revenue Maximization Program at the Brownsville Center

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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 Summary

Case 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.

Pre-RevMaxPost-RevMax
Weekly cash receipts: $66,434Weekly cash receipts: $97,174 􀃇 46%
Reimbursement per visit: $78Reimbursement 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

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Publication Details

Publication Date: August 1, 2004
Authors: Pamela Gordon, Matthew Chin
Citation:

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

Related Topics
Health Care Delivery

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