Plumas District Hospital increases revenue with clinically driven revenue cycle
A clinically-driven revenue cycle brings measurable results, optimized resources, and enhanced clinician support.
United States | Healthcare Providers
“While COVID-19 has been a major focus, people have other medical needs they come in and address, and we still have to find a way to pay the caregivers and get them the tools they need.”
Cushioned against the Sierra Nevada mountain range and the edge of American Valley sits Quincy, California—the largest community in Plumas County and home of Plumas District Hospital (PDH), a 25-bed critical access hospital. After relying on an outdated paper-based system with manual processes, CFO Caleb Johnson and PDH leadership knew they needed to change their revenue cycle platform.
“The system we were using had a payroll smaller than ours,” says Johnson. “We constantly had to find ways to get claims out the door to get paid for services we provided to our patients.”
When PDH staff discussed looking for a new revenue cycle system, Revenue Cycle Manager Lacey McKenzie was quickly on board.
“I had previous experience with Cerner at Adventist Health System, and I was excited to see how we could implement it and create new processes,” says McKenzie.
After going live with Oracle Health in September 2019 and using the clinically driven revenue cycle with help from the CommunityWorks consulting team, PDH staff experienced newfound success.
Improvements included a 3.7% decrease in A/R days,[1] a 19.6% decrease in discharged not final billed (DNFB) days,[2] and a 22.5% increase in average daily revenue (ADR).[3]
“Just prior to COVID-19, we were enjoying the highest levels of revenue we’ve seen,” says Johnson.
Looking ahead, Plumas leaders viewed the relationship with Oracle Health as positive and evolving.
“While COVID-19 has been a major focus, people have other medical needs they come in and address, and we still have to find a way to pay the caregivers and get them the tools they need,” says Johnson. “Our purpose is to make sure we are appropriately compensated for the good work we do. We chose Cerner to help achieve that purpose.”
1 Comparing average of 55.93 days, 9 months pre-conversion (September 2018 to May 2019) to average of 53.91 days, 9 months post-conversion (September 2019 to May 2020).
2 Comparing average of 8.86 days, 9 months pre-conversion to Cerner (September 2018 to May 2019) to average of 4.73 days, 9 months post-conversion (September 2019 to May 2020); DNFB from the Plumas legacy system only included standard delay, bill suppression, and correction required, therefore we only compared those Oracle Health metrics to average the calculated positive variance between Plumas legacy and Oracle Health actuals. Acute and ambulatory DNFB (standard delay, bill suppression, and correction required) decreased 1.45 days or 19.6%, to average 7.4 days, from a baseline of 8.860 days.
3 Comparing average of $113,105.21, 9 months pre-conversion (September 2018 to May 2019) to average of $138,627.29, 9 months post-conversion (September 2019 to May 2020); excluding April 10-12 due to wide variance (incorrect quantity, which was corrected on April 13).