Stable revenue cycle helps rural hospital avoid closure trend, expand services
Leaders at Clara Barton Medical Center partner with Oracle Health to target growth and expansion using revenue cycle functionality.
“We want to be an organization that continually moves forward using this product in a way that’s superior for hospitals our size. We plan to do this for years to come.”
Rural health systems across the US face unique struggles as they fight for survival. Facilities are closing, leaving vulnerable patients without convenient access to necessary care. When the COVID-19 pandemic hit, health systems faced even more strain. By December 2020, 17 rural hospitals nationwide closed, totaling 176 rural closures since 2005.
While eight rural Kansas hospitals shuttered from 2010-2020, one medical center in a town of 2,500 residents expanded its services and facilities. Leaders at Clara Barton Medical Center in Hoisington, Kansas, recognized the role of revenue cycle stability in the critical access hospital’s continued vitality.
In 2016, medical center leaders implemented Oracle Health’s electronic health record (EHR) and Cerner Revenue Cycle Management.
“Converting to a new EHR was not something I wanted to do on my own,” says Jim Blackwell, CEO. “Finding a strategic partner, someone who believed in us, became the priority. A platform that served the physician clinics as efficiently as the hospital setting was key for us to celebrate our fiscal independence.”
After implementing the revenue cycle solution, the health system found itself on stable footing.
“Once we went live in August 2016, we were dropping outpatient claims shortly thereafter,” says Mary Bennett, director of patient accounts.
In the past four years since implementation, Clara Barton’s monthly A/R balance and days steadily improved, with A/R days falling from 48 to 39.1
“The revenue cycle tool offers a lot of power that allows the billing person to be more efficient,” says Bennett. “They can look at the claims, charges, registration, the EHR, and the diagnosis code. They have all these tools at their fingertips. From a high-level view, I can look at each biller’s worklist to see who’s most efficient at their claim processing.”
The strong revenue cycle also helped leaders expand services and facilities, including a new clinic in nearby Great Bend, Kansas.
“While we are a small organization, we have a strong regional referral network,” says Blackwell. “Our growth over the years has positioned us for another brick-and-mortar expansion that will help accommodate our patients' needs for years to come, both in our Hoisington community, as well as our neighboring town of Great Bend.”
The organization also built a new imaging suite in Hoisington to permanently house MRI services that previously occupied a mobile truck. Clara Barton Medical Center is also purchasing a robotic surgical system, something Blackwell believes is an anomaly for critical access hospitals.
“For me to be able to make the bond, the principal, and interest payments, we need an EHR that’s helping me turn cash so I can make that obligation,” Blackwell says. “If you don’t have an EHR that helps you fiscally, you’re finished.”
COVID-19 hit rural health systems hard. With elective operations canceled, routine appointments postponed, and the rush to purchase personal protective equipment, health system leaders worried about their bottom lines and whether they could continue providing care.
While Clara Barton Medical Center leaders felt the impact, they feel they handled the financial crisis better than others.
“I did not sweat as much as some of these other facilities,” says Blackwell. “We built a very efficient and successful revenue cycle. We’ve been able to stockpile reserves and weather different storms.”
Blackwell’s team hopes that work will be easier, thanks to continued support from their Oracle Health counterparts.
“During the pandemic, Cerner was amazing to watch,” says Rebecca Moore, project manager. “They did things that directly and indirectly affected our revenue cycle, and they completely anticipated our needs as a client—needs we didn’t even know we had.”
With strong support, Blackwell believes Clara Barton will continue to break the trend of many other rural hospitals and see more growth and expansion.
1 Comparing from November 30, 2016, to November 30, 2020.