The Exec: A Systemwide, 12-Month Strategy to Collect $12M

With rev cycle tech at the helm, AUMC created a 12-month strategy to increase point-of-service collections.

As hospitals and health systems battle to increase margins and improve efficiency to remain financially healthy, revenue cycle and finance leaders have been looking to shore up processes in the revenue cycle to increase their bottom lines.

Augusta University Medical Center (AUMC) is no exception. The health system realized it was missing opportunities by not prioritizing pre-service and point-of-service payments and lacked user-friendly automation, which led to a negative patient financial experience, collecting pennies on the dollar, and writing off bad debt.

AUMC includes a 478-bed adult hospital, a 154-bed Children’s Hospital of Georgia, the Georgia Cancer Center, and more than 80 outpatient clinics across Georgia and South Carolina, so streamlining these processes was essential to its financial health.

HealthLeaders recently chatted with Sherri Creech, AVP of patient access services at AUMC, on a 12-month strategy she implemented to save big, streamline front-end processes, and help ensure financial stability moving forward.

HealthLeaders: AUMC runs a huge operation, so what sort of gaps were you seeing that made you realize you needed to implement a change to its revenue cycle processes?

Sherri Creech: Patients are providers’ second largest payers, so collecting payment prior to or at the time of service is critical to the overall financial health of the organization and our ability to serve the community with quality care.

When I joined AUMC in 2021, I could see we were missing opportunities by not prioritizing payment discussions or collecting payment up front. We collected just pennies on the dollar, and sometimes nothing at all. Historical data showed that annual point-of-service collections should total $12 million, and we were sitting at around $3.6 million annually.

There were several factors that contributed to this deficit. The patient access department lacked the automated technology to generate accurate cost estimates for patients, and staff were not trained or held accountable on collecting payment up front. Once we identified the root cause of the issues and set the financial target, we developed a 12-month strategy to get there. It would take system-wide participation to reach our goal and would include a combination of technology, training, and accountability.

In June 2021, we added a price estimation tool from AccuReg to our existing patient access suite. With tools already in place to ensure registration data accuracy and perform real-time eligibility verification on patient benefits, we had the foundation for generating accurate cost estimates and improving the financial patient experience.

With new technology in place, we revamped new-hire trainings and retrained existing staff and supervisors on how to engage patients financially. Attempting to secure payment prior to or at the time of service was no longer just encouraged, it was part of the job and a service we provide to patients.

HealthLeaders: Budgets are tight, so did you receive support when deciding to implement new tech?

Creech: Our CFO was supportive of the strategy and understood that meeting our goal would require a combination of technology, people, and processes. Staff needed to be equipped with the tools to confidently engage patients in financial discussions. Our vendor provided training on the software and our internal team conducted trainings on process and procedures around payment collection.

HealthLeaders: Because of these tight budgets, organizations need to be strategic when investing in technology. Since cost efficiency is so important, how were you able to ensure a positive ROI when investing in this new tool?

Creech: By and large our process for collecting prior to and at the time of service was manual. In the absence of having a systematized way to go about it, staff relied on various inputs to compensate. As far as cost goes, it was an easy decision because automation has enabled us to do more with less.

HealthLeaders: Since your previous collection processes were entirely manual, I’m assuming adding in tech was worth it?

Creech: Yes. One year after launching the price estimation software and establishing new trainings and protocols for payment collection, we reached $9 million in point-of-service collections. While short of our original target of $12 million, that’s a 150% increase from where we started, and that’s a huge achievement. The team couldn’t believe it, how small changes every day, like collecting a copay, can add up over time.

Additionally, by alerting staff to registration errors for real-time resolution, the quality assurance tool saved AUMC $1.4 million in back-end rework.

Staff are much more confident in their roles because they now have the tools to help them succeed. Automating cost estimates saves time and frees staff to provide a more personalized patient experience. Our staff visit with every patient to help them understand their bill and discuss obligations for partial payment or payment in full.

Like any change, it took time. But patients appreciate the cost transparency because it gives them choice and control over their healthcare.   

HealthLeaders: When looking back, what are your thoughts on the overall process?

Creech: It can be difficult to discuss the financial aspects of healthcare with your patients, but at the end of the day, it is our duty as providers to educate patients on what they owe. We help our staff understand that it’s not just about collecting, it’s about providing a service for your patients. An informed patient is a happy patient, and that begins with understanding their costs.  

Improving the patient access experience was a system-wide goal for us and we were committed to changing how we approached payment. It took all of us, from front-end staff, analysts who created the goals, people working behind the scenes, the staff who invested in training the department, to the leadership who championed the results.