Monitoring Improves Patient Access and Cuts Costs at Princeton Baptist Medical Center

 

Area of Excellence
Princeton Baptist Medical Center brought its registration, insurance verification, and service authorization rates to 90-plus percentiles over a period of two years. The 499-bed hospital, which is located in Birmingham, Ala., and is one of the four hospitals in Baptist Health System, increased the preregistration rate from 68 percent to 100 percent, improved the quality of registration information from 98.7 percent to 99.8 percent, and raised the service authorization rate, which at one time had been as low as 35 percent, up to 90 and 95 percent in 2009 and 2010.

How They Did It
Princeton Baptist set benchmark targets based on recognized best practice standards and regularly monitored key performance indicators to track progress. The organization also paid attention to positive unintended consequences, such as the opportunity to eliminate duplicate services, and achieved $186,000 in cost savings.

Key Steps
Step 1. Selecting goals that made sense for its organization by reviewing and consolidating benchmarks and best practices from HFMA, American Health Information Management Association (AHIMA), National Association of Healthcare Access Management (NAHAM), and the Joint Commission on Accreditation of Healthcare Organizations.

Step 2. Publishing dashboards more frequently and more transparently. Instead of monthly written dashboard reports, Princeton Baptist reported dashboards on a weekly basis by e-mail.

Step 3. Choosing to outsource preregistration to a company that supplied expertise the organization lacked, namely, trained clinicians who could discuss directly with payers the need to authorize services.

Step 4. Installing an automated quality assurance system that increased the accuracy of registration information.

Step 5. Recognizing offshoot benefits from technology. The system acquired for preregistration processing had additional capabilities, such as passing orders between physicians’ offices and the preregistration area. This system allowed Princeton Baptist to cancel a previous contract for handling physicians’ orders and cut costs.

Lessons Learned

• Use best practice standards to select performance goals
• Monitor performance goals frequently and regularly
• Search for outsourcing services that fill gaps in in-house expertise
• Don’t restrict monitoring to preset goals but look for ways to reduce duplication, enhance efficiency, and capture cost savings