Case Analysis of Sutton Health Essay

This network identified that tralatitious stip block off touch on trunk had limitations that hindered the effective collecting of revenue. What with the recession, health dread organizations have seen an increase in the inability to collect debt from the self-pay, the uninsured and underinsured patients. This has caused a lot of struggle when it comes to the organizations to tackle the accomplishmental margins and the pro admits.I find there are a turn of events of reasons for the new increase in patients debts, the most gross are, poor leveling practices, lack of patient information and correct demographics. there is new cheek that is designed to set up more(prenominal) coordinated tutelage to said patients (Gleeson,2010). There are five geographic regions that reflects the health financial aid access to the customers of Northern California. Each of the five regions will have governance structure and it will oversee many of the Sutter affiliated medical facilities and withal the infirmarys. In its effort to increase point of receipts collections and improve the boilersuit revenue cycle Sutter health took steps to measure performance exploitation a handful of specific primary benchmarks, empowering PFS module to assume state for every individual account they handle, find all(prenominal)(prenominal) alteration is analyse utilise a rules engine to identify occupations in the lead patients leave the registration desk and ensure PFS cater receive appropriate comprehensive training to surpass under the new governance (Souza, McCarty, 2007).Obtaining the correct patient information plays a large part on non-collectable debt because patients are non able to be reached. These limitations were associated with limited access to accurate information by the account representatives, ineffective performance measures and fragmented centers of the service provision. The Sutter health program developed a system that was comprised of solutions th at were geared towards overcoming these limitations.The key problems and issues, is that the United States healthcare system is characterized by huge upkeep from collecting revenue from patients. This particular is brought about by a health care policy system which entails high allowable pay health plans and as well as higher co-payments plan. (Souza, McCarty, 2007). This situation has been made worse through the large proportion of the population not having healthcare coverage. The traditional health care system has had a sturdy time meeting their target revenue collection.This is due to several problems that link up along with the traditional payment system. Unlike when dealing with the payments through insurance claims but as well dealing with the up-front payments that are required by the hospital for payment of services in the first place the patient could even receive the service (Souza, Mccarty, 2007). So this operator that the patient services module (PFS) has to hav e murder and accurate information about above said client. This presented a problem for the traditional payment system where much of the customer payment system was carry outed in the back revoke.This system as well as required that the PFS staff ask for money from self-pay patients, but the PFS were not accustomed to this under the traditional system. The PFS staff found it hard to wait for the back end member to process customer information and to provide a breakdown of the patients payment details. So this became a tedious task for hospital accounting departments as well as for patients that had to wait a longer period before receiving services. The inefficiency of the traditional system not only resulted in low property services, but as well in low revenue collections.The system provides much(prenominal) a broad govern of health care services, which include acute, sub- acute, inhabitancy health, long term, outpatient care as well as physician lecture systems. These se rvices are provided through an integrated health care deliverance approach that gives the system the ability to deliver a full range of healthcare products and services. rks. Sutter likewise recognized that the traditional system did not provide a means for analyzing selected data nor did it generate required detailed typography on demand. This led to more cost as the hospital had to trust on programmers to generate such reports. The front desk staff also lacked sincere time information which hindered their ability to serve the client without consulting the back end staff.It also meant that the front desk staff could not monitor the patients progress (Souza, McCarty, 2007). some other challenge was that the PFS members were not empowered enough to be held accountable for each patients accounts they dealt with and it reduced the amount of accountability among the staff. These are some of the key challenges that the Sutter system were meant to address. The solutions that were em ployed by Sutter Health was an attempt to overcome the challenges stated above. Sutter Health implemented certain changes in the fore mentioned system that would make their operation more efficient.The strategies identified by the Sutter program entailed transferring most of the back end t inquire to the front desk providing accurate and complete information to managers and upfront staff providing more effective performance evaluation and integrating all data elements at heart the system (Souza, McCarty, 2007). Allowing front desk staff to handle much of the payment process was deemed to have an effect on the efficiency of the process. Various solutions were employed to ensure that this is achieved.One of these solutions entailed using benchmarks to measure performance by the Patient assistant Staff (PFS). Sutter identified a handful of primary benchmarks which included Unbilled A/R days, Gross A/R days, Major A/R days, Cash Collection,percentage of A/R over 90, 180, 360 days (Sou za, McCarty, 2007). This benchmark introduced shorter periods with which staff performances could be evaluated. This hold out was timely especially when onsidering that the industry has changed and things happen in terms of hours and days but not months. Another solution pertain empowering the PFS members to have full responsibility over the accounts they are dealing with. This move was meant to increase a sense of responsibility and accountability as each individual members will be responsible for his or her own account (Souza, McCarty, 2007). This also gave the PFS members more autonomy to act as they saw fit and this improved the speed and efficient of service delivery by these staff members.The program also provided the PFS members with tools, that enabled them to automate their accounts, sort out their accounting using various means and seen their performances based on the achievement of the target. PFS and other restrainer representatives were presented with individual dash boards that helped in the tracking of their progress in meeting targets. This also helped in enforcing the benchmarks set by this program. Sutters health program also introduced a front end collecting system as means of overcoming the mentioned problems.The pint of access collecting system introduced an opportunity for the health care facilities to reduce claims and denials. Though this system the patient records are analyzed before the patient leaves the registration desk. This enables the front desk staff to identify problems such as bad debt, patient or invalid patient type ahead of time enough and take the necessary corrective action. The Sutter health program also embarked on a comprehensive training program that was designed to countenance the existing PFS members and the registration staff. This gave staff the necessary competence to deal with the tools provided by this system.The training program also eliminated the need to hire formally improve staff to operate the syste m that would and more than the $10-$20 an hour compensable to current registration and PFS staff. For example, registration staff who were not used to asking patients for money were trained in effective communication skills. The training was also designed to introduce autonomy and effectiveness which acted as a bonus to the employee.