The system began managing the hospital's daily operations in February 2023.
El Centro Regional Medical Center, an affiliate of UC San Diego Health, began efforts to stabilize its finances in February 2023. As part of the stabilization, UC San Diego began overseeing the hospital’s daily operations, as well as clinical and financial management.
A little over a year later, the facility is seeing results. The third quarter saw net operating income increase to $7.2 million, as well as a year-over-year gain of $16.9 million.
These gains can be attributed to improvements in the hospital’s contract management process, which have enabled it to negotiate favorable contract terms and efforts to ensure timely reimbursements for care.
“I am extremely proud of the results we have achieved and amazing progress we have made in a short period of time,” David Momberg, the hospital’s CFO, said in a statement. “Including turning around our net operating loss into profitability in a single year, achieving our first profitable quarter in over three years in Q3, as well as numerous gains on the operational front.”
Similarly, Selma Family Medicine Center in Alabama struggled to maintain financial stability when issues with staffing and limited resources began to negatively affect the facility. Looking to the revenue cycle, the facility’s administrative director, Jeff Denney, decided to invest in a new practice management system to increase efficiency with their billing processes.
By outsourcing, Selma Family Medicine saw a reduction in overall denials and days in accounts receivable, as well as a 39% increase in gross collections.
OSF Health also leaned into technology to strengthen the system’s revenue cycle—specifically the automated features of its EHR. Getting payers to utilize the EHR’s payer payment platform and automate prior authorizations enables staff to focus on more complex tasks.
“We have weekly underpayment reports and if we suspect that a payer has their rates loaded wrong, we’ll reach out to them,” Cathy Beebe, OSF director of ministry managed care, previously told HealthLeaders.
Whenever there are changes to Medicaid reimbursement rates, the system works with each payer’s Medicaid configuration teams to ensure make sure that rates loaded correctly.
Jasmyne Ray is the revenue cycle editor at HealthLeaders.
KEY TAKEAWAYS
The hospital's net operating income increased to $7.2 million in Q3 2024.
Improving its contract management process have aided its efforts to ensure timely reimbursements.