Case Study: Southeast Hospital

About the Client

Southeast Health, managed by Southeast HEALTH, and a member of the TPC network, is a not-for-profit community hospital serving over 600,000 people in 22 counties in Southeast Missouri and Southern Illinois. SoutheastHEALTH’s premier healthcare system extensive care network includes 50 care locations in 10 communities, and specialty care clinics with 30+ specialties.

The 18-month relationship with Healthfuse transcends-vendor it is a true collaboration. Healthfuse genuinely cares about improving the performance of our vendors, and they do so with careful monitoring and hands-on assistance. Healthfuse manages every service line, and we’ve seen a marked improvement. I consider them trusted advisors with an in-depth knowledge of revenue cycle best practices and keen business acumen. I would recommend them to anyone looking to improve their net revenue and business performance.

Bonita M. Gregory, Director of Revenue Cycle

Challenge

As the largest provider for community healthcare in the region, Southeast Health partnered with several community-based collections vendors, including early out self-pay, bad debt and A/R Follow-up to achieve their revenue cycle goals. Their new Director of Revenue believed they were not meeting the maximum return on those partnerships, especially with early out self-pay outsourcers. An initial audit conducted by Healthfuse revealed that current self-pay outsourcers were only working 40% of their assigned inventory, numerous patient accounts were found that never appropriately made it to bad debt vendors, invoicing errors, and a lack of accountability controls.

Solution

Southeast Health engaged Healthfuse to build and operate its Revenue Cycle Vendor Management Office (VMO), leveraging technology, advisory support, and industry domain to drive optimal bottom-line results.

Results

Healthfuse identified a recurring P&L opportunity for Southeast Health of $2.3 million with a three- year impact of nearly $7.2 million.

Recurring P&L opportunity of
$2.3M
Three-year impact of
$7.2M

To date, Healthfuse has delivered:

Collections Improvements

Collections Improvements of $3.1M

  • Discovered and corrected self-pay cash recovery issues and launched new patient
  • Implemented new eosp vendor with expertise in patient billing education payments portal

Cost Savings

Invoice Recoveries of $240K

  • Launched new invoice verification and certification processes to reconcile and certify on a daily basis
  • Created new reporting standards to differentiate between insurance and patient payments

Contract Savings of $1054K

  • Improved contract rates by carving out insurance payments from contingency rates