Case Study: Cooper University Health Care

About the Client

Cooper University Health Care, located in Camden, New Jersey, has served the South Jersey region since 1887. Cooper includes South Jersey’s only Level I trauma center, a leading cancer center, the only Level II pediatric trauma center in the Delaware Valley, four urgent care centers, and more than 100 outpatient offices. Cooper employs more than 7,000 employees including 1,250 nurses and 630 physician in more than 70 specialties. Cooper University Health Care chose Healthfuse to help evaluate and optimize vendor recovery processes and compliance, and to yield maximum return on investment.

Over the years, we found that the number of vendors we had increased significantly and it was difficult and time consuming to manage them all. With Healthfuse, we were able to establish performance visibility and create a more efficient vendor strategy.

Charles Reitano, VP Revenue Cycle
Cooper University Health Care

Challenge

Cooper partners with multiple vendors for aged insurance collections and underpay recovery, with the average tenure of three years. Experiencing slight declines in collection rates, Cooper’s vice president of revenue cycle realized the need for a comprehensive evaluation of all vendors, as well as related internal processes.

Solution

Cooper engaged Healthfuse to conduct a regression and collection analysis to determine what types of accounts were being pursued and recovered. Using its automated rules-based auditing tool, Healthfuse discovered that many outsourced accounts were not being worked consistently. In the case of its insurance follow-up and underpay recovery vendors, only certain commercial payers were being pursued, leaving several payer accounts inadequately worked. This resulted in a redesign of the entire third-party collections processes, which included leveraging a primary and secondary collection effort.

Results

With Healthfuse, Cooper was able to implement a more strategic process for optimizing payer recoveries. They achieved a more comprehensive view of variances for all payers, including Medicare secondaries, Medicaid, worker’s compensation, and third-party liability payers, which were previously unworked. This insight enabled Cooper to ensure maximum return on its vendor investments.

To date, Healthfuse has delivered:

Collections Improvements

112%

  • Increase in vendor recoveries

36%

  • Improvement in A/R inventory reconciliation

Cost Savings

$1.8M

  • In average annual yield over 4 years

$310,000

  • In over-invoicing recovered from work comp vendor

53:1 ROI