Financial Performance: Focusing on total financial performance to drive bottom line growth

Economic challenges threaten hospital profitability

Hospitals are reeling from the recession. A combination of bad debt, newly covered patients, and changing reimbursement models place already slim operating margins in greater peril. Add health reform, technology adoption, and shared care models it’s easy to see why 74% of hospitals are reporting a loss in revenue.

Grow revenue while decreasing costs

Hospitals face revenue leakage and significant administrative burdens across care episodes. In addition, gaps in financial processes hide revenue, impede cash flow, and complicate the patient experience. In order to survive in the new environment, hospitals will need to grow revenue and thoughtfully manage labor and non-labor costs simultaneously.

End-to-end revenue cycle management

Our High Performance Revenue Cycle Operational Model addresses three critical areas: customer satisfaction, financial integrity, and operational effectiveness for end-to-end revenue cycle management. OptumInsight is the only company in the industry that combines commercialized technology, industry-leading consulting expertise, and managed services to deliver complete revenue cycle solutions resulting in significant and recurring cash improvements for our clients.

A holistic view for sustainable cost management

We focus on operating costs, care management, and care delivery to discover gaps and uncover hidden revenue for year-over-year cost reductions. By implementing our revenue optimization and cost management solutions, we bring demonstrable value to our clients. A southern hospital system reduced A/R over 90 days from 20% to 7.9% for a $41.4 million reduction in receivables in the first 24 months of implementation. A Mid-Atlantic hospital system achieved recurring savings of over $7.5 million over an eight-month period through sustainable cost management strategies in its central purchasing department. Our professionals can work with you to map the right holistic strategy for your organization.

OptumInsight Provider Financial Performance solutions

Tools and Technology

• Patient Access Management
• Enterprise Coding
• Computer-assisted Coding
• Claims and Billing Management
• Audit Management
• Outpatient Charge Capture

Data and Analytics

• Payer Claims Data
• Episode Treatment Groups

Managed Services

• A/R Recovery Services
• Coding Service
• Denial Recovery Services
• Early-Out Self-Pay Services
• Print and Mail Services
• Secondary Funding
• Secondary Claims Management

Professional Services

• Revenue Optimization and Cost Management Consulting
• Organizational Change
• Financial Advisory Services
• Business Process Design
• Care Delivery Planning
• Predictive Modeling

Source: AHA analysis of Telling the Hospital Story survey data from 572 non-federal, short-term acute care hospitals collected in March and April 2010.