How Academic Health Systems Can Increase the Value of Their Revenue Cycle Journey to Post-Pandemic Recovery

by | Oct 7, 2021

The Delta variant of COVID-19 that is currently spiking across the country reminds us that this pandemic is far from over. There is no way to know how long this variant will stick around or if there is another waiting in the wings. The bottom line is that the financial hardships brought about by the pandemic are likely to worsen before they get better. 

For large academic health systems with multiple facilities and affiliations, the challenges at hand—and ahead—are many. The good news is that these systems don’t have to go it alone; most have revenue cycle vendors that can help pick up the heavy lift. Sometimes, however, that heavy-lift comes at a heavy cost. According to Healthfuse research, the majority of health systems are unsure whether they’re receiving a positive return on their vendor investments. One reason is the lack of transparency and the supportive data with which to truly measure vendor performance.

What can large academic health systems do to protect themselves and ensure optimal performance by their vendors? West Virginia University Medicine (WVUM) has found an answer. 

WVU Health System is the state’s largest health system, encompassing 16 hospitals, including the West Virginia University School of Medicine; the affiliated schools of the WVU Health Sciences Center; four community hospitals; three critical access hospitals; and a children’s hospital, all anchored by a 690-bed academic medical center that offers tertiary and quaternary care. 

WVU Health System had more than a dozen long-term vendor partnerships across its vast health system but believed it was receiving little return on investment from those relationships. An initial assessment discovered vendor over-invoicing and most outsourced accounts were not being worked per best practice standards. The health system also identified bolt-on technologies that needed to be sourced and replaced.

WVU Health System engaged Healthfuse to build its Vendor Management Office (VMO) to serve as a centralized resource to oversee vendor performance and enforce accountability. The VMO worked with each vendor to update processes, WVU Health System utilization, and expectations. Reporting was established to monitor account-level activity, collection performance, and patient experience.

With Healthfuse, West Virginia University Health System achieves $27M in collections improvement and cost savings in 3 years.

With Healthfuse, West Virginia University Health System achieved improved transparency that created confidence and trust in the vendor relationships. Together, they designed a new vendor strategy to include automated processes, enhanced vendor work queues, and streamlined vendor communication.

To date, Healthfuse has delivered:

  • $16.2M in cash-factor improvement after 3 years
  • $250K in recoveries from invoice disputes
  • 30% reduction in self-pay collection costs
  • 270% increase in self-pay liquidation
  • 10X increase in outsourcer performance
  • 2X (doubled) net liquidation and cash recoveries for select vendors 

“Since engaging Healthfuse, we know exactly how our vendors are performing and how they can improve over time. We’ve increased outsourcer performance by more than 30% since we started.” Leah Klinke, Assistant Vice President of Hospital Revenue Cycle, West Virginia University Health System

The path forward

A successful journey to financial recovery requires optimally performing vendors with the most advantageous contract terms. Unfortunately, most revenue cycle leaders don’t have the market insight necessary to know whether their vendor contracts are reasonable or not. Fortunately, Healthfuse does. With insight into more than 3,000 vendors and hospitals, Healthfuse has the insight needed to benchmark and analyze the most effective partner contracts for each health system’s specific needs.

Read our latest eBook to learn more about how WVU Health System and other large academic health systems have been able to improve vendor performance, reduce costs, and maximize reimbursements.