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CASE STUDY 3: REVENUE MAXIMIZATION PROGRAM AT THE BROWNSVILLE MULTI-SERVICE FAMILY HEALTH CENTER

CASE STUDY 3: REVENUE MAXIMIZATION PROGRAM AT THE BROWNSVILLE MULTI-SERVICE FAMILY HEALTH CENTER

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Published by pcdc1993
Revenue Maximization (RevMax) gives health facilities strategies and tools for
streamlining financial processes. The goal of the program is to transform revenue collection systems so that facilities efficiently collect all money to which they are entitled.

The transformation of financial systems takes place over the course of an intensive five-to eight month RevMax Learning Collaborative that is led by national experts. During this time, teams of participants from different health facilities learn to:

• Track the path of revenue collection in their facilities

• Identify breakdowns and loopholes in the collection process

• Design new procedures to make revenue collection more efficient

RevMax’s Collateral Benefits: Seamless Work Processes, Improved Morale RevMax helps participants design solutions for managing and expediting self-pay collections, lag times between dates of service and billing, and claims rejections. The program also stresses the importance of communication and teamwork.

Enhanced communication and strong teamwork help seamlessly integrate the work of the front desk with clinical and back-office operations. This seamless process helps RevMax participants generate and collect more money. Moreover, it results in a better working atmosphere, improved staff morale, and efficient work processes that improve the quality of patient care. These are welcome collateral benefits of the RevMax program that were particularly important for employees at BMS, who placed a high value on their
relationships with patients and wanted to increase revenue without sacrificing those relationships.
Revenue Maximization (RevMax) gives health facilities strategies and tools for
streamlining financial processes. The goal of the program is to transform revenue collection systems so that facilities efficiently collect all money to which they are entitled.

The transformation of financial systems takes place over the course of an intensive five-to eight month RevMax Learning Collaborative that is led by national experts. During this time, teams of participants from different health facilities learn to:

• Track the path of revenue collection in their facilities

• Identify breakdowns and loopholes in the collection process

• Design new procedures to make revenue collection more efficient

RevMax’s Collateral Benefits: Seamless Work Processes, Improved Morale RevMax helps participants design solutions for managing and expediting self-pay collections, lag times between dates of service and billing, and claims rejections. The program also stresses the importance of communication and teamwork.

Enhanced communication and strong teamwork help seamlessly integrate the work of the front desk with clinical and back-office operations. This seamless process helps RevMax participants generate and collect more money. Moreover, it results in a better working atmosphere, improved staff morale, and efficient work processes that improve the quality of patient care. These are welcome collateral benefits of the RevMax program that were particularly important for employees at BMS, who placed a high value on their
relationships with patients and wanted to increase revenue without sacrificing those relationships.

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Published by: pcdc1993 on Aug 23, 2009
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ACHIEVING A NEW STANDARD IN PRIMARY CARE FOR LOW-INCOME POPULATIONS: CASE STUDIES OF REDESIGNAND CHANGE THROUGH A LEARNING COLLABORATIVE
CASE STUDY 3: REVENUE MAXIMIZATION PROGRAM AT THEBROWNSVILLE MULTI-SERVICE FAMILY HEALTH CENTER 
Pamela Gordon and Matthew Chin
to view the overview report.
CENTER PROFILE
The Brownsville Multi-Service Family Health Center (BMS) is located in the Brownsvillesection of Brooklyn across the street from the largest concentration of public housing inNew York City, including apartment buildings dating back to the late 1940s. A single-sitefacility that recently celebrated its twentieth anniversary, BMS has been an integral part of the Brownsville community throughout the center’s existence, providing much neededhealth care to a patient population with complex needs.Most of the center’s 12,500 to 13,000 clients are low-income residents of publichousing. They visit the busy center for an average of 45,000 visits annually, oftenpresenting a complex range of health issues. BMS President and CEO Maurice Reidattributes these complex needs to the high-stress lives patients lead.
 
BMS clients “do notroutinely go for health care. They are so involved in life issues, trying to survive, thatwhen they finally show up they need multiple types of attention,” he says. A typicalpatient may come to BMS to be treated for a cold. Providers often then identify andaddress other pressing medical and behavioral issues.True to its mission as a multi-service facility, BMS offers a myriad of services. Thetwo-floor, 27,000-square-foot building houses administrative offices, waiting andexamination areas, and a WIC (Women, Infants, and Children) program. Patients receiveprimary adult and pediatric care and specialty services such as dentistry, optometry,podiatry, dermatology and acupuncture. Approximately 80 percent of the patients at BMSare African-American, Caribbean, and African; about 15 percent are Latino, mostly of 1
 
 
Puerto Rican descent; the remaining are white. About 80 percent of patients are onMedicaid, 7 percent to 8 percent are on Medicare, and the rest are a mix of self-payingclients and the uninsured.BMS has remained vital throughout its two decades in Brownsville becausemanagement and staff understand what life is like in the neighborhood and are receptiveto patient needs. Patients wanted an on-site drugstore, for example, and in response thecenter recently leased open space in its large entry area to a pharmacy. Opening thepharmacy provided clients with a service they requested, used existing space moreproductively, and served the center’s mission of providing multiple services in onelocation.
CENTER CONDITIONS PRIOR TO REDESIGNThe Need for Productivity Versus Quality Care
Management at BMS was keenly aware that the center was collecting revenueinefficiently. Examples of inefficiency occurred during all phases of the collection process:self-pay patients at the front desk, encounter forms that never reached the billing office,and inaccurate claim forms that were denied payment. Management had tried to overhaulthe collection systems for years, to no avail. “We knew we were looking at fairlyextensive receivables with Medicare, things that were over 120 days old,” says Reid. Butstaff members never were able to catch up with work so they could focus on theseinvoices. Even when BMS “revised our self-pay procedures…everyone was excited aboutthis but it was not making a difference” in bringing in money, he says.The need for revenue was pressing, and the problem was too complicated toresolve by simply imposing new procedures on staff. As Reid puts it, providers and staff were “caught in the vise of needing productivity and needing to service the patient.Although they were somewhat concerned about using time efficiently they didn’t see their  jobs in terms of money. As long as they got the patients in and gave them good care, that’swhat counted.”Quality of care was not an issue. But at the same time, employees felt discouragedthat their efforts did not generate the revenue necessary to keep BMS in financial health.“Patients would talk highly of the center,” says Dr. Camille Taylor-Mullen, headphysician in the BMS adult medicine unit. “Providers and staff were clearly working hard. Yet at staff meetings productivity being reported was not what you would expect. It wasdisheartening that we were doing a lot of work but were not able to generate revenue.”2
 
 
Management turned to PCDC for help. The group has assisted many types of community-based health centers with facility building and program operations for years.Many of these community-based centers operate on slim financial margins, and their ability to support operating costs is severely hampered if they fail to collect all revenue.PCDC understands the challenges centers face in collecting revenue and addresses theseissues in the Revenue Maximization Collaborative, which BMS participated in fromFebruary to June, 2002.
THE REVENUE MAXIMIZATION LEARNING COLLABORATIVETracking, Communication, Teamwork
Revenue Maximization (RevMax) gives health facilities strategies and tools for streamlining financial processes. The goal of the program is to transform revenuecollection systems so that facilities efficiently collect all money to which they are entitled.The transformation of financial systems takes place over the course of an intensive five-to-eight month RevMax Learning Collaborative that is led by national experts. During thistime, teams of participants from different health facilities learn to:
 
Track the path of revenue collection in their facilities
 
Identify breakdowns and loopholes in the collection process
 
Design new procedures to make revenue collection more efficient
RevMax’s Collateral Benefits: Seamless Work Processes, Improved Morale
RevMax helps participants design solutions for managing and expediting self-paycollections, lag times between dates of service and billing, and claims rejections.The program also stresses the importance of communication and teamwork.Enhanced communication and strong teamwork help seamlessly integrate the work of thefront desk with clinical and back-office operations. This seamless process helps RevMaxparticipants generate and collect more money. Moreover, it results in a better workingatmosphere, improved staff morale, and efficient work processes that improve the qualityof patient care. These are welcome collateral benefits of the RevMax program that wereparticularly important for employees at BMS, who placed a high value on their relationships with patients and wanted to increase revenue without sacrificing thoserelationships.“The focus of the program was to improve revenue,” says Mohammed Sadique,BMS’s comptroller and deputy financial officer. “In order to improve revenue, we had to3
 

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