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Three Billboards Outside Boulder, Colorado: a Value-as-a-Service Parody

Three Billboards outside Boulder, Colorado is a story set in the backdrop of an industry in flux, struggling with the shift from volume to value-based care and the financial pressures of operating in an at-risk world.   Feeling resentment  for “solution” vendors who had historically placed the burden of value realization squarely on the shoulders of its customers, healthcare providers are pushing back demanding they be insulated from the financial uncertainty and professional embarrassment of unmet expectations.

It’s a story about IT companies trying to redeem themselves from the fallout of those unmet expectations yet not buckling to the demands for financial risk sharing.  It’s an examination of one industry’s journey out of the darkness of the misaligned risks and rewards of healthcare IT solutions and into the light of “Value-as-a-Service”.

Plot

As healthcare is coming to grips with increasingly tighter margins thanks to the economic realities of healthcare reform, leaders are demanding that risk be cascaded down to their suppliers and business partners.  Angry over the economic sting from products and projects that fell short, a trio of abandoned billboards are rented outside Boulder, Colorado to call attention to the problem.

Vendors were simultaneously sympathetic yet unmoved to change their revenue models.  The billboards stayed up while the war of wills played on for years.  Finally, a “Value-as-a-Service” (VaaS) model  took shape.

How’d We Get Here?

In the late 1990’s, the Information Age was booming under the belief that technology was a disruptor providing huge competitive advantages when deployed.  Throughout the Dot-com tech bubble, companies spent massively on technology because they were afraid to be left behind.  Technologies were purchased and implemented on-premise without any clear line-of-sight as to how they could realize a return on their investment.  Customers paid a king’s ransom for software licenses, computing infrastructure, and expensive consultants to implement the software.  They added staff to support these new technologies, trained and retrained thousands of end-users with relatively low adoption rates.  They incurred huge upfront costs and steep annual maintenance fees with less than stellar results downstream because the siren of the tech bubble lured them to add complexity they were ill-prepared to use let alone optimize.  Over time, buyers became jaded and suspicious of any vendor relationship where the vast majority of the risk was borne by customer.

Next came the subscription era where customers mitigated the financial burden of front-loaded technology costs by effectively financing the product purchase via a leasing arrangement.  Still, clients were looking at the offering from the same vantage point – paying a hefty price for some expected/hoped for future benefit but now simply spreading those payments over time with the contractual right to terminate the contract  (if they had the appetite to swallow the associated switching costs).  The buyer gained more leverage but no assurances that something of value would be returned.

In the mid-2000s, the “subscription economy” was ushered in by companies like Salesforce.com, Amazon, and Netflix who pivoted to new consumption models: from buying/selling products outright to subscribing for services.  Subscription economy companies realized it was not enough to slap a low monthly price on a product and call it a service. They also needed to re-architect the way products were built, sold, and delivered by adding a service component to manage the entire subscriber lifecycle.

The customer-centric market shift lead to the next iteration: XX-as-a-Service Cloud- computing offerings where “Pay-as-you-Go” models tied vendor compensation to actual capacity or on-demand utilization of their solutions.  Think “Infrastructure-as-a-Service” or “Platform-as-a-Service” from vendors like Amazon and their Amazon Web Services where you paid for the elasticity of capacity without having to overpay for excess hardware and infrastructure to meet peak demands.

Subscription economy vendors focused on customer retention and usage monitoring as proxies for the presumed value customers would receive from their products and services.  But there was still a breach between the presumption of value vs. actual outcomes.   We were getting closer but not quite there yet.

Value-as-a-Service

 

Those three billboard messages outside Boulder…

“PREPAID SUBSCRIPTION FEES”, “UNCERTAIN RETURNS” and “HOW COME?”

were prophetic  statements about over-promised and under-delivered solutions and a harbinger for the reconstruction of customer/vendor relationships.  Consumers had a new set of expectations. They now wanted outcomes, not ownership. Personalization, not generalization. Constant improvement, not planned obsolescence.  Customer success, not satisfaction.

Value-as-a-Service hypothesizes that the future will be much less about the delivery model and will shift to the ultimate focus on measurable value creation.

VaaS promotes the simple vendor promise to deliver something that will lead to quantifiable improvements asking customers, in turn, to pay only for that certain quantifiable value received.  There is no vagueness, no marketing-speak, no presumption of value, it’s all about paying proportionate to the objective results delivered.

The new VaaS frontier establishes a relationship not based on features and functions designed to solve a particular problem but as a business partner paid on the basis of the actual value realized.  Rather than placing your focus on the “product” or the “transaction,” VaaS companies live and die by their ability to focus on the customer.  Whereas, all the preceding models placed the burden on customers to attain success with the products and services they bought and were all priced on variables that were at best proxies for value,  VaaS vendors conditioned their relationships on outcomes; not promises.

VaaS in Healthcare

The shift to value-based reimbursement models creates a new “Fee-for-Value” (FFV) paradigm; a sea change in the delivery and financing of medicine in which care is delivered by an entire coordinated medical community sharing in the responsibility—and risk—of outcomes and costs.  The phrase “doing more with less” has evolved from an inspirational challenge to an industry credo forcing healthcare providers to operate differently to remain solvent.  To mitigate the inherent risks in profitably financing and delivering patient care, providers will need a reorientation to (1) operate more lean, (2) outsource non-core competencies, and (3) mandate that outsourced business processes be priced and paid retrospectively on the realized vs. potential benefits they deliver.  You simply cannot be at-risk and not expect your partners to likewise bear proportionate risk in delivering their part in the overall care delivery/financing equation.

No more squishy ROI projections or business cases that are pillared more on hope than reality.  No more Field of Dreams “build it and they will come” leaps of faith. Business relationships will all be conditioned on iron-clad ROIs with hard dollar profitability and retrospective payments triggered by quantified results.

Epilogue

In the end, Three Billboards Outside Boulder, Colorado is a story of forgiveness.  Holding vendors’ feet to the fire has lead the industry away from the strained customer relationships of the past and into the relationship-centricity of Value-as-a-Service.

The pendulum of risk has swung and with it, the business landscape has forever changed.  When relationships are framed by objective outcomes and the financial obligations are conditioned on actual results, risks are no longer a variable in the contracting process.  With the financial certainty afforded by VaaS solutions, those three billboards on the outskirts of Boulder have been replaced.  VaaS customers no longer have to ask “How come?” but instead ponder “Why not?”.

AcuStream Revenue Assurance – VaaS in Practice

AcuStream, Inc. a pioneer in Revenue Assurance, has been using VaaS to rewrite their customers’ story and reinvent the industry.  At AcuStream, our knowledge, skills and culture are all aligned to our singular objective of delivering value in the form of incremental revenue and newfound insights to our clients; to help them mitigate the margin erosion they’re experiencing and will continue to experience as the shift from volume to value gains momentum in the immediate future.

“Our business model enables us to develop relationships with customers; to be a true business partner aligned to a common goal of optimizing financial performance in the face of margin erosion,” said Jeff Colvin, CEO at AcuStream. “Every day, we find new ways to deliver value to our customers that far surpasses the revenue recovered from missing charges.  That drive and commitment is a byproduct of our VaaS model and the relationship-centric culture it inspires.”

Attributes of Value-as-a-Service

I get it… VaaS is the right revenue model for healthcare.  But what distinguishes VaaS from previous technology delivery models?

1. RAPID TIME-TO-VALUE

VaaS vendors integrate subscriber data directly into the technology ecosystem they host and manage.  They then enable their services quickly—in weeks rather than months – typically generating positive cash flow for customers from the very first invoice.

2. SCALABLE

Infrastructure, know-how and expert resources that ramp up or down to match actual business volume needs.  Clearly superior results and economies of scale than could be achieved in house.

3. STANDARDIZED

Shared services model to standardize and scale processes and delivery. Repeatability is achieved with a multi-client and multi-tenant model.

4. CONSUMPTION BASED

Paying only for what is used rather than committing to services or functionality that may not be needed. Just in time delivery in response to demand.

5. OUTCOME ORIENTED

Working as business partners where both the buyer and provider are committed to specified business outcomes.   Insight teams are embedded alongside the business, data and insights are aggregated and collected. The core team determines the desired outcome, and the VaaS provider handles the execution.

6. SOURCE SYSTEM AGNOSTIC

No dependencies on specific data source systems and no need for integration.   Likewise no dependencies on ancillary systems.

7. INNOVATION ENABLED

Committing to on-going innovations in business processes, infrastructure and applications. Can nimbly add customer-specific personalizations, test new features on-the-fly and iterate with the clients in a matter of business days.

8. FUTURE PROTECTED

Shielding the buyer from the potential disruption of upgrades and future change. Services are always up to date, and buyers have continuous access to innovation, scale and in-depth expertise.

What’s Your “Revenue Cycle Handicap”?

A handicap is defined as a race or other contest in which certain disadvantages or advantages of weight, distance, time, etc., are placed upon competitors to equalize their chances of winning. It’s also a way of benchmarking competitors against an expected level of performance to provide comparative scale.  Handicapping is commonly used to index golf proficiency by comparing golfers’ average scores against the expected standard of shooting “par”. 

But what if there was a way to handicap healthcare revenue cycle leaders or teams against an expected level of revenue optimization?  More importantly, what could one do to improve their Revenue Cycle Handicap and  reach a best-in-class level of performance?  Here are four fundamentals revenue leaders can learn from professional golfers to up their games.

Develop all facets of their game

What separates exceptional golfers from average players is the degree to which they develop all aspects of their game.   Knowing they have 14 clubs at their disposal, a variety of ball placements (tees, first and second cuts of rough, different types of grass, sand, etc.), hazards to navigate and hundreds of shots they want to master, professional golfers balance countless hours on the practice range, putting greens and chipping areas to hone a complete, well-rounded game. They don’t singularly work on one element of golf such as their driving even though the driver is the longest hitting club in their bags and therefore can be expected to cover the majority of the tee-to-green distance.

On par 4’s and 5’s, PGA pros use their woods to carry > 75% of the tee-to-green distance. Therefore, one might conclude that 75% of a golfers practice time should be devoted to just their woods and very little time should be spent on putting which represents <5% of the total yardage on a round of golf. If distance alone were the indicator of success, you would expect PGA pros to spend very little time working on their short games. We know that is far from the truth as chipping and putting is where pros shave the most strokes off their game through practice and repetition. Why?… because in terms of percentage of all shots taken in a give round by a typical professional golfer, the driver is used on less than 20% of their strokes while the putter accounts for over 40%.

As further illustration, consider the difference between a well-rounded successful PGA golfer and someone who specializes in the use of just one club.  On average, the top 200 male PGA golf pros drive the ball approximately 295 yards whereas  long-drive champions who focus exclusively on driving distance routinely drive the ball over 400 yards; a 35% difference!  If distance alone were the key to being a good golfer, you would expect the long-drive contest winners to routinely be at the top of the PGA Tour leaderboards.  And yet, the roster of long-drive winners since 1975 only includes two PGA Tour winners, Lon Hinkle and Dennis Paulson.   Two-time World Long Drive Champion, Jamie Sadlowski won back-to-back titles in 2008 and 2009 before deciding to quit long drive competition in the middle of 2016 in order to pursue the PGA Tour.  From 2011 to 2016, Sadlowski made three cuts in four starts on the Web.com Tour, a level below the PGA Tour, and is currently ranked 1,940th in the world.

Sadlowski

In contrast, revenue professionals likewise need to develop a complete approach to revenue optimization.  Rather than placing all their chips (pun fully intended) on one component of the cycle, revenue professionals must develop strategic approaches to cover the front-, middle- and back-end of the revenue cycle with a balanced focus.  All too often, revenue cycle leaders chose to focus the vast majority of time and resources on one RCM improvement initiative at a time prioritized on the basis of higher expected returns and rationalizing their single-threaded approach under the guise of more focused execution and limited resources/bandwidth to take on additional work.  Putting all their proverbial eggs in that one basket and foregoing process improvement activities in the other aspects of revenue cycle until they feel they’ve solved their top priority is a very short-sighted plan and often generates operational slowdown, weakened financial performance, and employee turnover due to neglect for their area of the business.

Think of the front-end of your revenue cycle as the long-game of a PGA golfer, the back-end of the cycle as your irons/wedges, and the mid-cycle activities related to charge integrity as your putting where you see the most volume and need the highest level of precision to optimize revenue.  Having a balanced strategic plan across all three aspects and committing the time and resources to optimize all three phases equally is the best way to lower your “Revenue Cycle handicap”.

Surround themselves with expert advisors and proactively seek feedback

PGA golfers seek out professional guidance to help them develop their games.  They employ swing coaches, sports psychologists, and professional caddies.  They pick the brains of other golf pros to look for any tips or tricks to shave strokes off their game.  They collect statistical data on their own game and benchmark themselves against others to determine where they need to improve to gain a competitive edge.  They’re voracious in consuming as much information as they can in the hope that they can translate that knowledge into small but critically important refinements that will help them lower their scores.

CamiloVillegas-17-03

Revenue professionals likewise should seek out the guidance of subject matter experts – including consultants and solution vendors who have very specific knowledge, tools and experiences that focus on particular aspects of the revenue cycle –  as well as their peers and their professional association to refine their games.  They should  statistically analyze their performance to look for opportunities to improve.  The old adage ‘what you don’t measure, you can’t manage’ applies equally well to golf as it does to revenue optimization.  If you have a void in terms of objective measures or lack clarity on measurable goals, now is the time to invest in getting the data, benchmarking best-in-class performance, honestly assessing where you stand in comparison and setting realistic goals for where you want to take your organization.

A great example of such a void is in the area of mid-revenue leakage.  If you were asked “does your organization incur leakage?”, the honest answer would be “yes” but if asked where it occurs, how often and what are the financial implications of leakage, few would be able to answer such questions because they simply do not have the means to identify and measure missed charges.  You may very well be missing an opportunity to reduce your Revenue Cycle Handicap simply because you don’t know what you don’t know.

Equipment matters!

There is a reason the old persimmon “woods” have been replaced by titanium and composite carbon fiber metal drivers.  The lighter weight, stronger material, longer and more flexible shafts and larger hitting surfaces all lead to greater club speed and forgiveness which in turn leads to increased ball loft, spin, distance and accuracy.  Every year, there are new technological advances in clubs, balls, apparel, and accessories for which golfers of all skill levels spend billions in their quest for any slight competitive advantage they can gain through the adoption of better technology.

The same holds true for revenue professionals who should be vigilant about innovation seeking out better ways to replace manual processes with automation, to increase coding accuracy, and eliminate unnecessary or non-value-add steps.  He with the best tools often wins so factor expenditures for innovation into your annual budget so you won’t be left behind.

In today’s shift from volume-to-value based care where providers are assuming more of the financial risk to care for patient populations, there is very little room for inefficiencies. A competitive payor market will steer patients to low cost/high quality providers and even if you’re successful in terms of patient acquisition, inefficiencies will erode your operating margins and reduce the amount of money retained or reinvested.  Inefficient revenue operations are the equivalent of a golfer giving away strokes throughout their round.  There are boundless opportunities available to help you lower your Revenue Cycle Handicap by adopting advanced technologies to wring out excesses replacing manual processes with automation and workflow.

Strive for perfection

Professional golfers are driven to perfection.  Knowing the separation between the scoring average of the #1 and the #11 PGA golfer is just 3% (currently, Rickie Fowler’s 67.21 vs. William McGirt’s 69.36),  dropping two or more strokes is the difference between being a top 10 golfer and being just another name in the rest of the field.  The separation from #1 to #3 is only a single stroke or >1.5% variance.  And while PGA professionals are an elite group representing the absolute best golfers in the world, they never rest on being “good enough”, they strive for perfection in every shot they take.

Over the past 10+ years, AHIMA has advocated a 95% minimum quality standard for coding accuracy.   And while the Central Learning 2nd National ICD-10 Coding Contest findings reveal coding accuracy rates far below the 95% accuracy standard (see below), there is still room for improvement amongst provider organizations boasting >95% accuracy.

In the pursuit of perfection, a professional golfer wouldn’t stop at 95% of their personal potential and neither should Revenue professionals.  If you’re one of those organizations that can lay claim to >95% accuracy, kudos to you but don’t stop there.  Excellence is a journey, not a destination and while 100% accuracy may be unattainable, the revenue generated by an additional 1% improvement in coding accuracy can drive millions of dollars to a health system’s bottom-line.

Conclusions:

Revenue professionals can borrow best practices from professional golfers by…

  1. having defined executable strategies for the front-, middle- and back-end of their revenue cycles and committing their organizations to a balanced high-level of performance across all three phases.  Single-threaded process improvement initiatives are like stepping on a leaky garden hose that only enhances the leaks further downstream.  Have a synchronized plan across all three phases of the cycle to drive excellence.
  2. seeking guidance and statistical measures of your own performance.  Don’t put yourself on an island, open yourself to professional help and analysis.
  3. investing in the right technologies to replace manual processes with automation.  Technology has come a long way and if you’ll avail yourself to niche vendors who bring subject matter expertise on these technologies, you’ll stay state-of-the-art.
  4.  not settling for the “speckled ax”.  Sharpen your tools and skills daily, and go beyond “good enough” by striving for perfection.  Perhaps that is why the most watch golf tournament each year is called the “Masters”.

19 Crimes of Mid-Revenue Cycle Leakage

During the Industrial Revolution, Britain’s urban poor skyrocketed as did petty crime.

Throughout 1760-1820, the British court system created lists of crimes punishable by convict transportation to Australian penal colonies to reduce prison congestion (which was soaring) and commute death sentences.

Today, the plethora of Revenue Management vendor solutions has likewise overwhelmed Revenue Integrity professionals leaving them vulnerable to egregious crimes of omission in the fight against margin erosion.

AcuStream, Inc. has now published the following list of “19 Crimes of Mid-Revenue Cycle Leakage” punishable by declining profit margins, underperformance against revenue goals, and misalignment between hospitals and their key physician groups.

  1. Assuming margin compression will resolve itself… the structural changes brought about by the ACA have created a new normal and we have to act accordingly.
  2. Not actively managing a manageable aspect of Revenue Integrity – “Revenue Leakage” – and passively accepting HFMA’s estimate that 3-5% of reimbursable charges don’t get posted when a Six Sigma level of performance would be 10,000-fold improvement!
  3. Chasing revenue unicorns vs. taking a pragmatic approach to revenue optimization. There are very real and immediately addressable problems such as revenue leakage in front of us that we can and should tackle now.
  4. Trivializing revenue leakage or charge capture. Even 0.5 – 1% net income improvement is significant in the wake of an industry whose average profit margin is now <3%.
  5. Inflicting non-productive work on your coding teams in the form of random sample manual charge audits knowing technologic solutions are available that automate audits on 100% of all patient accounts leveraging thousands of rules with better accuracy and consistency.
  6. Blindly believing you have the requisite revenue assurance tools and an accountability culture in place today that specifically guard against leakage. Don’t assume you have either.
  7. Relying on your EMR as a revenue management tool. EMR’s are a system of record; not a tool of choice for managing revenue!
  8. Overemphasizing your CDM as a means for solving leakage. Cosmetic changes to your CDM as though leakage is a book-keeping issue is no substitute for multi-faceted, cross-functional operational PROCESS improvements.
  9. Mistaking Revenue Assurance as a “DIY” (Do it Yourself) opportunity. Outsourcing Revenue Assuranceactivities to an experienced partner with the requisite core competencies, cloud-based technologies and the ability to focus on a singular objective with greater economies of scale is the only cost-justifiable way to treat leakage.
  10. Assuming only pre-bill solutions can effectively solve your leakage woes. The multitude of tools and the resulting frenetic activities of your revenue team to get an initial bill out the door in 3 – 5 days with an industry average 10 – 13% error rate should be supplemented by a post-bill safety net to optimize billing accuracy.
  11. Not aligning HB with PB. You’re pursuing a corporate strategy that hinges on aligning your hospitals and physicians and, yet you still operate your physician billing and hospital billing teams as independent and separate functions.
  12. Allowing your physicians to lose RVUs today and compromise their future reimbursement due to MACRA physician payment adjustments. The size of these payment adjustments will partially depend on the data clinicians submit to CMS. Missing charges and RVUs create data integrity holes in the MIPS Quality Metrics.
  13. Not equipping your Single Business Office (SBO) with a single-vendor solution that covers PB, HB, inpatients and outpatients, and FFS/DRG payer accounts.
  14. Shortsighted thinking that your only lever to combat margin compression is cost reduction vs. revenue optimization.
  15. Looking at outsourced solutions as a cost vs. an opportunity. Worse, looking at revenue leakage defensively as an indictment of the proficiency of your Revenue Team vs. an opportunity to learn, grow and optimize.
  16. Assuming this is a long-term complicated decision-making process. It’s a simple, smart business decision so don’t over analyze it… time is money!
  17. Anticipating IT bandwidth to be a limiting factor that delays the launch of a Revenue Assurance Program. This is NOT an IT project; setting up the data extracts is merely a task in a very brief implementation.
  18. “Kicking the can down the road” by delaying the decision to confront revenue leakage. You can have a Revenue Assurance Program stood up and cash-flowing positive within 90 days with minimal investments of time or money.
  19. Not contacting AcuStream TODAY to start the process.

About AcuStream

AcuStream is a Revenue Assurance specialty company dedicated to the healthcare industry. AcuStream provides automated charge capture auditing technology solutions, value-add professional coding expertise, and decision support tools to the country’s leading healthcare providers enabling our clients to find missed revenue around charges they didn’t know were missing. We are the only organization with proprietary algorithms and custom client specific rules, that can correlate both the hospital data and physician data. This in conjunction with our world class workflow, allows us to find and track missed, miscoded, and misplaced charges.

AcuStream identifies and quantifies missed reimbursable charges for both Physician Organizations and Health Systems. REVBUILDER™’s automated post-bill auditing solution identifies omitted charges while REVREVIEW™ auditors validate charges against your own EMR documentation and payer contracts to ensure you get paid for the services provided.

AcuStream has been privileged to work with one-third of the academic medical centers on the U.S. News and World Report “Honor Roll of Best Hospitals,” seven of the 50 largest integrated health systems, twenty percent of the 20 largest not-for-profit health systems, and 10 of the nation’s largest physician group practices providing immediate financial lift/profitability, management insights and process improvements surrounding Revenue Management.Acustream currently processes over 100,000 doctor’s data on a monthly basis, thanks to our client base of top hospitals and physician organizations in the US. The result of our solution is improved net profit, decreased revenue erosion, and a clear view into departmental efficiencies.

We help you identify the missing pieces to your revenue puzzle, BEFORE you even start to put the puzzle together.

Take Off the Blindfolds… Start Aligning your Hospital and Physician Bills

You’re pursuing a corporate strategy that hinges on aligning your hospitals and physicians, you now employ hundreds of physicians, you’ve spent untold sums of money to have a community EMR, and you’re consolidating your business office.  Yet… you still operate your physician billing and hospital billing teams as independent and separate functions even though they’re addressing the same patient population during the same episode of care, sharing a common patient health record.  As crazy as that seems, that’s the current paradigm for most every U.S. healthcare system.

With technology now enabling the level of physician/hospital collaboration to meet the rising tide of healthcare consumerism, patients and payers expect health systems to present clear, concise and correct patient billing statements.  The public now expects more from providers in terms of price transparency than we demand of ourselves in terms of shared accountability for generating clean, complete and aligned patient bills.  Insulating Physician Billing (PB) and Hospital Billing (HB) teams from one another is a high-stakes, double-blinded experiment costing your organization precious time and money while eroding your margins and consumer confidence.  Now is the time to remove the Chinese wall separating your siloed billing functions by cross-pollinating your PB and HB information to optimize revenues across your enterprise.

Today, approximately 40% of U.S. physicians are employed by hospital systems.  The rise in Accountable Care Organizations and new alternative payment methodologies placing provider organizations at-risk for the quality and financing of health care along with the economic challenges (ex. MACRA) of operating independent physician practices will push this figure over 50% with a projected 14% increase in physician employment between 2014 – 2024.  With the investments made in recruiting, acquiring, managing and providing the technology tools for employed physicians along with the downward economic pressures on reimbursement, health systems must start innovating new ways of realizing the projected financial synergies their integrated delivery systems were designed to yield.

Revenue Assurance is a business activity utilizing data and process improvement methods to reduce revenue leakage thereby increasing profits, revenues and cash flows.  Leakage comes in the form of missed, miscoded or misplaced charges that leach out of your revenue funnel. Missed charges, as the term implies, are the simple omissions when a charge didn’t make its way to the patient’s bill.  Miscoded charges result from the normal variation of professional judgement involved in medical coding while Misplaced charges come from the fragmentation of our revenue cycle when we “park” charges in the various work queues within EMR systems awaiting further validation that potentially delays or prevents cash flow due to timely filing limitations if left unattended.  In growing numbers, Miscoded charges also result from disharmony in the way PB and HB teams independently code for professional and technical services.

In the fall of 2016, AcuStream, Inc., the market leader in Healthcare Revenue Assurance developed the industry’s first set of predictive business rules to detect misaligned PB and HB charges giving healthcare providers a next generation innovative solution to this problem.  Using similar algorithmic logic to that used by payers when reviewing/denying payment claims, AcuStream’s proprietary rules logic has produced the following results.  On average, rules leveraging the HB/PB matching logic produced >30% of the total Revenue Assurance predictions ranging anywhere from 15% – 80% of the total predictions for individual clients performing Revenue Assurance activities across both their HB and PB organizations!   Depending on the size of your organization, HB/PB matching logic can add millions to your net income and basis points to your profit margin.

For organizations looking to attack leakage and combat margin erosion, Revenue Assurance represents the low-hanging fruit of revenue optimization and a quick, certain way to shore up your revenue integrity function in a matter of weeks.  It will also provide you the ability to share billing/coding information allowing your revenue teams to see each other’s work, share their insights, and improve billing accuracy.  It’s time to remove the blinders and see the new possibilities for aligning financially across your hospital and physician organizations.

About AcuStream

AcuStream is a Revenue Assurance specialty company dedicated to the healthcare industry. AcuStream provides automated charge capture auditing technology solutions, value-add professional coding expertise, and decision support tools to the country’s leading healthcare providers enabling our clients to find missed revenue around charges they didn’t know were missing. We are the only organization with proprietary algorithms and custom client specific rules, that can correlate both the hospital data and physician data. This in conjunction with our world class workflow, allows us to find and track missed, miscoded, and misplaced charges.

AcuStream identifies and quantifies missed reimbursable charges for both Physician Organizations and Health Systems. REVBUILDER™’s automated post-bill auditing solution identifies omitted charges while REVREVIEW™ auditors validate charges against your own EMR documentation and payer contracts to ensure you get paid for the services provided.

AcuStream has been privileged to work with one-third of the academic medical centers on the U.S. News and World Report “Honor Roll of Best Hospitals,” seven of the 50 largest integrated health systems, twenty percent of the 20 largest not-for-profit health systems, and 10 of the nation’s largest physician group practices providing immediate financial lift/profitability, management insights and process improvements surrounding Revenue Management.Acustream currently processes over 100,000 doctor’s data on a monthly basis, thanks to our client base of top hospitals and physician organizations in the US. The result of our solution is improved net profit, decreased revenue erosion, and a clear view into departmental efficiencies.

We help you identify the missing pieces to your revenue puzzle, BEFORE you even start to put the puzzle together.

The Five Things You Should Start and Stop Doing Now to Solve your Revenue Leakage Problem

Revenue leakage is a very real concern for Healthcare providers costing hospitals and physician organizations billions of dollars each year in squandered net patient revenues!  Left unchecked, your profit margins suffer a slow ‘death by a thousand paper cuts’ as your organization incurs the cost of patient care delivered without the offsetting reimbursement.

In today’s highly competitive yet uncertain healthcare landscape, margin compression is a threat to financial sustainability. And yet, providers are letting their hard-earned revenue slip through the cracks of their revenue funnel at alarming rates.  Detecting and patching those leaks can provide immediate financial relief and lead to long-term process improvements.   Here then are the five things every provider organization should start doing – as well as the five things they should stop doing – to optimize revenue and avert leakage.

Five things to STOP Doing:

To carve out the bandwidth needed to attack leakage, it’s just as important to define the things you’re going to stop doing to afford your Revenue team the time to tackle the items you want them to start doing.   Practicing the ‘discipline of removal’ reduces the amount of time people waste, and in effect, refocuses their efforts and energy on achieving revenue results.

  1. Stop ignoring the elephant in your Revenue Cycle Room

Optimizing revenue is a two-fold solution.  You need to mitigate the “friction” in your revenue cycle operations to optimize efficiency and you need to restore volume to your revenue funnel by addressing leakage.  To truly manage leakage, you need information and assigned accountability.  Don’t assume you have either.

  1. Stop assuming your EMR is the silver bullet for Revenue Management

EMRs are the source-of-truth but not the tool-of-choice for managing revenue.  Like all enterprise systems, EMRs are too unwieldy to provide end-users or Revenue Cycle leaders ready access to granular, actionable leakage analytics and EMR IT resource constraints are a bottleneck for custom reporting.  As such, provider organizations must look to niche vendor solutions that can play off the EMR data to provide value-add analytics without taxing your already limited IT resources.

  1. Stop thinking you can fix leakage by overemphasizing your CDM

CDM management and charge auditing are separate, interrelated work streams; not interdependencies!  If you ran a retail store where you had 3% inventory shrinkage, you wouldn’t assume you could solve for wastage or theft via a price adjustment. Even if you chose to raise your prices 3% to offset leakage (something not easily done in healthcare), you’d only be masking the underlying problems.   Stop treating mid-revenue cycle leakage as though it is a book-keeping issue, it’s a multi-faceted operational process problem.

  1. Stop thinking you have the scale to ‘do it yourself’

You don’t hire full-time nurses to accommodate peak census levels and you don’t set your floor stock supply inventory levels for maximum demand either so why would you add staff to your revenue integrity department to go after the small percentage of patient charges leaching out of your system?  Outsourcing Revenue Assurance activities to an experienced partner with the requisite core competencies, cloud-based technologies and the ability to focus on a singular objective with greater economies of scale is the only cost-justifiable way to treat leakage.

  1. Stop looking at leakage auditing as purely a pre-bill function

HFMA’s Patient Friendly Billing guidelines call for providers to deliver clear, concise and correct billing information yet we rush to get out initial statements with 10 – 13% error rates by cramming an overwhelming amount of frenetic activity for revenue teams into the first 3-5 days post discharge.  Best practices call for identifying revenue leakage both pre- and post-bill to optimize charge capture.  Putting all your charge auditing eggs in one pre-bill basket at a time when you know your team is distracted and under pressure exposes you to significant financial risk.

Five thinks to START Doing:

Once you’ve freed your organizational mindset from these outdated ideologies, it’s time to champion the cause for revenue integrity!

  1. Start getting serious by attacking the problem

HFMA estimates 3 – 5% of charges never get posted which means the industry’s revenue defect rate is 10,000 times greater than a Six Sigma level of performance!  Active vs. passive leakage management is a worthy investment with a seven-figure net income impact and double-digit returns on your investment.  Don’t be passive, get focused by assigning a business owner, establishing goals and monitoring progress.  Leakage won’t solve itself; it requires leadership, structure and proper tooling to make it happen.

  1. Start aligning your Physician and Hospital Billing functions

Your corporate strategy is to align your hospitals and physicians, you’ve spent untold sums of money to have a community EMR, and you’re consolidating your business office but yet you still operate your physician billing and hospital billing teams as independent and separate functions even though they’re addressing the same episode of patient care.  Now is the time to remove the Chinese wall and break down these silos by sharing billing information.  A Revenue Assurance Program that cross-pollinates PB and HB information presents an innovative opportunity for revenue enhancement across your enterprise.

  1. Start taking the emotion (and defensiveness) out of the equation

Tracing the root causes of revenue leakage should not be a rascal hunt.  More often, leakage results from systemic process problems, obsolete business policies and/or technology gaps than human error.  Treat the management of revenue leakage as a data-driven/fact-based opportunity to learn and develop your staff.  Consider gamification strategies to encourage proactive employee engagement.

  1. Start approaching revenue assurance activities as an investment, not a cost

Recouping incremental revenue for the patient care you’ve already delivered converts directly into net income.  In fact, accretive revenue is more valuable than an equal % of variable expense reduction and can stave off the need for emergent spending cutbacks.  The operating margins on a Revenue Assurance Program are considerably higher and more predictable (shorter time-to-value, too) than front- and back-end revenue cycle management initiatives so it’s a smart and safe investment.

  1. Start looking for a partner vs a vendor

Charge capture auditing tools (i.e., technology solutions) alone can create mayhem for coding teams.  In isolation, automated predictions are prone to generating 50% or more “false positives” that erode the confidence and productivity of coders, who, in effect, are tasked to find needles in the haystack.  A value-add outsourced service that cleanses the predictions before they’re presented to your revenue team transforms the technology tool into a true solution.  If your charge capture vendor is heaping more complexity than value on your haystacks, offering only theoretic predictions vs. reconciling actual revenue recovery to the penny, and is charging you a flat subscription fee that has diminishing returns as you solve your leakage problems, it’s time to reassess the financial and productivity impact of that relationship and evaluate other options.

 About AcuStream

AcuStream is a Revenue Assurance specialty company dedicated to the healthcare industry. AcuStream provides automated charge capture auditing technology solutions, value-add professional coding expertise, and decision support tools to the country’s leading healthcare providers enabling our clients to find missed revenue around charges they didn’t know were missing. We are the only organization with proprietary algorithms and custom client specific rules, that can correlate both the hospital data and physician data. This in conjunction with our world class workflow, allows us to find and track missed, miscoded, and misplaced charges.

AcuStream identifies and quantifies missed reimbursable charges for both Physician Organizations and Health Systems. REVBUILDER™’s automated post-bill auditing solution identifies omitted charges while REVREVIEW™ auditors validate charges against your own EMR documentation and payer contracts to ensure you get paid for the services provided.

AcuStream has been privileged to work with one-third of the academic medical centers on the U.S. News and World Report “Honor Roll of Best Hospitals,” seven of the 50 largest integrated health systems, twenty percent of the 20 largest not-for-profit health systems, and 10 of the nation’s largest physician group practices providing immediate financial lift/profitability, management insights and process improvements surrounding Revenue Management.Acustream currently processes over 100,000 doctor’s data on a monthly basis, thanks to our client base of top hospitals and physician organizations in the US. The result of our solution is improved net profit, decreased revenue erosion, and a clear view into departmental efficiencies.

We help you identify the missing pieces to your revenue puzzle, BEFORE you even start to put the puzzle together.

The Elephant in Your RCM Room

Shhhhhh….There are things we just don’t talk about when it comes to Revenue Cycle Management.  It’s ok to talk about collection rates, days in AR, aged balances and denial rates because we’re all on the same page here in terms of performance benchmarks and the process improvement activities we’re undertaking to address performance.  But what we don’t talk about… the proverbial elephant in the room… is revenue leakage, i.e., charges that were never captured or got lost along the way and therefore never get billed.

If we visualize the Mid Revenue Cycle simplistically as a funnel with patients entering the revenue cycle at the top of the funnel, care being delivered, documented and coded with revenues exiting the bottom, the goal for Revenue Integrity professionals would be to get as close to 100% of the revenue their organization is entitled to receive in the shortest time possible.  In physics, this is referred to as the volumetric flow rate which follows the basic formula Output = Volume/Time.  If your goal is to optimize mid-cycle revenue, you then have two levers to pull…

  1. Make the flow “frictionless” by re-engineering and streamlining processes, AND
  2. Add more volume by eliminating waste in the form of Mid Revenue Cycle leakage (i.e., missed, miscoded or misplaced patient charges that leach out of the funnel).

I’ve emphasized the word “AND” because both volume and efficiency are critical factors in optimizing revenue.  Today, very few healthcare organizations are addressing the volume issue for two primary reasons…

  1. They lack the tools or analytics to measure and monitor leakage
  2. They view leakage to be a performance deficiency instead of an opportunity.

The reality is that leakage occurs in every hospital or physician practice – HFMA has estimated that 3-5% of all charges never get posted – and very little of it is related to human error.  Leakage often results from technology gaps, ill-advised or obsolete billing practices, or upstream process problems that are systematically causing leakage that can easily be re-engineered once the problem is identified, quantified, and analyzed for root causes.

This is why Revenue Assurance Programs are growing in importance.  Whereas revenue cycle management (RCM) solutions focus on streamlining operational processes surrounding known charges, revenue assurance concentrates on the identification of omitted charges that never make their way into your revenue cycle queue or have leached out of your revenue funnel. There are very few companies that focus exclusively on revenue assurance. An even smaller number combine a technology solution with a service component that intervenes to reduce false positive findings while also providing analysis that creates a dialog about codifying best practices. Applying rules-based and predictive analytics to the complex world of medical coding and billing simplifies and automates the labor-intensive process of manual chart reviews. It also yields consistently objective findings to break down silos in healthcare organizations by comparing data from different departments to ensure consistency and identify communication breakdowns.

 “Smart Investment”

Healthcare provider organizations have been compelled in recent years to make “strategic investments” in projects that have strategic importance regardless of the cost or required effort with no direct ROI often because there is an inherent risk if you don’t do it.  Enterprise Resource Planning (ERP) and Electronic Medical Record systems (EMR) fit that description.  And then there are opportunities to place bets on investments big or small because they’re the smart thing to do financially – what we term “value investments”.  We now use Bubble Charts to analyze the various projects in a portfolio to visualize the balance between the value or profitability vs. the size of the required investment vs. the perceived risks involved… namely, how likely is it that we’ll achieve the expected returns, what are the risks of a runaway project that turns out costing 2 – 3 x what we budgeted, and what is the timeline of the project and when do we expect to recognize a return on our upfront investments.

Initiating a Revenue Assurance Program is one of those Smart “Value” investments because of the low barriers to entry, short time-to-value (as little as 60 days), high probability for success and significant financial returns with extremely low operating costs.  The best part of the decision, is that you can now address the elephant in the room and begin measuring and managing your revenue leakage.

About AcuStream

AcuStream is a Revenue Assurance specialty company dedicated to the healthcare industry. AcuStream provides automated charge capture auditing technology solutions, value-add professional coding expertise, and decision support tools to the country’s leading healthcare providers enabling our clients to find missed revenue around charges they didn’t know were missing. We are the only organization with proprietary algorithms and custom client specific rules, that can correlate both the hospital data and physician data. This in conjunction with our world class workflow, allows us to find and track missed, miscoded, and misplaced charges.

AcuStream identifies and quantifies missed reimbursable charges for both Physician Organizations and Health Systems. REVBUILDER™’s automated post-bill auditing solution identifies omitted charges while REVREVIEW™ auditors validate charges against your own EMR documentation and payer contracts to ensure you get paid for the services provided.

AcuStream has been privileged to work with one-third of the academic medical centers on the U.S. News and World Report “Honor Roll of Best Hospitals,” seven of the 50 largest integrated health systems, twenty percent of the 20 largest not-for-profit health systems, and 10 of the nation’s largest physician group practices providing immediate financial lift/profitability, management insights and process improvements surrounding Revenue Management.Acustream currently processes over 100,000 doctor’s data on a monthly basis, thanks to our client base of top hospitals and physician organizations in the US. The result of our solution is improved net profit, decreased revenue erosion, and a clear view into departmental efficiencies.

We help you identify the missing pieces to your revenue puzzle, BEFORE you even start to put the puzzle together.

Healthcare Revenue Assurance… The Deming Way

Edwards Deming is widely acknowledged as the leading management thinker in the field of quality. He was a statistician and business consultant whose methods helped hasten Japan’s recovery after World War II and later he was instrumental in bringing total quality management to the U.S. auto industry. While Deming is most renowned for applying quality management to manufacturing, his approaches have since been applied across all industries and business functions including healthcare revenue cycle management.

The Healthcare Financial Management Association (HFMA) defines revenue cycle management as “all administrative and clinical functions that contribute to the capture, management, and collection of patient service revenue.”  In other words, RCM spans the entire life of a patient account from creation to payment. The objective of RCM is to streamline processes allowing charges to flow through to revenue with minimal friction.

Revenue Assurance is a Revenue Mid-Cycle charge capture function that identifies missed, misplaced or miscoded charges that have leaked out of the RCM work stream.  Revenue Assurance’s focus is to recognize how, when and where leakage occurs and return charges to the top of the RCM funnel. HFMA estimates that 3 – 5% of all patient charges are never posted which in manufacturing terms would be considered “waste”.  Applying Deming’s Total Quality Management approach to RCM, Revenue Management professionals own the responsibility for capturing all patient charges by minimizing the waste of missed, misplaced or miscoded charges.

The implied charter of any Revenue Cycle Management or Revenue Integrity team is to “optimize” the company’s revenues consistent with the patient care services that are delivered.  In other words, to get paid for all the patient care that has been delivered.  To only collect “some of the revenue” and disregard the “waste” of missed charges is a disservice to our caregivers and falls short of our fiduciary responsibilities to properly manage the company’s revenue stream.  RCM and RA are complementary and essential functions that must be architected into the Total Quality Management of revenue because Revenue Cycle Management without Revenue Assurance ≠ optimization.

Six Sigma

Deming’s Total Quality Management approach and statistical concepts later lead to Lean Management and Six Sigma quality management methodologies that are now common place across the healthcare industry. Six Sigma is a disciplined, data-driven approach and methodology for eliminating defects, driving toward six standard deviations of the mean at which an organization would be performing at 3.4 defects per million opportunities.  If HFMA’s estimated 3 – 5% of charges never posted rings true, we’re looking at a Revenue Management defect rate as much as 10,000 times greater than expected at a Six Sigma level!

On the path to Six Sigma performance levels, it is common practice for companies to set targets related to the achievement of a “sigma level” or a “10-fold improvement”.  Assuming HFMA’s high-end estimated 5% charge capture defect rate, a 10-fold improvement would yield a 99.5% charge capture accuracy target; a goal readily achievable via a Revenue Assurance Program.

The revenue recouped through Revenue Assurance goes directly to a company’s net income and has the potential to add percentage points to a provider organization’s profit margin since the expense of patient care has already hit your books.  More importantly, the ability to identify the who, what, where, when and why of revenue leakage allows you to patch holes in your charge capture processes and make permanent fixes that will pay long-term dividends.  Deming would remind us all that the ability to measure leakage is the critical initial step in being able to manage waste out of your system.

Mid Revenue Cycle Leakage… What You Don’t Measure, You Can’t Manage

Since the 2009 passage of the American Recovery and Reinvestment Act (ARRA) and the corresponding HITECH Act, the adoption of Enterprise Electronic Health Records (EHR) has become main stream among America’s leading health systems.  Government funding for EHR adoption touted the promise of better patient care coordination, disease management, reduced medical errors and increased productivity while also providing the technical underpinnings to support essential business processes such as Revenue Cycle Management (RCM) to unify all the administrative and clinical functions that contribute to the capture, management and collection of patient service revenue. As the documentation intermediary between the delivery of patient care and the resulting patient service revenue, EHRs are critical to managing the Mid Revenue Cycle (MRC) which is defined as the phase between patient access and the care provider’s business office where care delivery, clinical documentation, charge capture and coding occurs.

While RCM has historically focused on process inefficiencies to reduce the friction and expedite the flow of charges through the Revenue Cycle, EHR adoption has enabled an increased focus on charge capture and the data analytics that identify and avert revenue leakage enabling providers to turn waste into wealth.  In an industry that is renowned for being “data rich but information poor”, there is increasing evidence that shows we have a paucity of data AND information aimed at Mid-Revenue Cycle leakage that is not being addressed by your EHR.

To that point, PwC’s Health Industries Advisory Group recently presented best practice recommendations with a specific focus on Revenue Cycle Management challenges and financial implications of an Epic EMR conversion.  PwC LeakageTheir findings suggested that the sophistication and complexity of an EMR is fraught with opportunities for revenue leakage and EMR reporting capabilities are less than helpful in identifying, quantifying and resolving leakage.  The use of static reports is seldom “actionable” meaning that it is simply information for the sake of information with a wide chasm between the presentation of data and enacting process improvements. Specifically, ad hoc reports lack in their ability to trace the root causes for revenue leakage and the required actions needed to solve it.  PwC further remarked that the summarized reporting lacks the ability to drill down to detailed findings via the aggregated views which inhibits users’ ability to isolate leakage, compare leakage across locations, specialties, departments or physicians.  Simply put, EMRs are just too big and unwieldy to provide end-users or Revenue Cycle leaders the granular analytics needed to provide insights and take action.

The opportunity cost of not managing Mid Revenue Cycle leakage is highly significant.  PwC Leakage2While charge capture will always be vulnerable to human error, systemic leakage (i.e., process inadequacies that cause recurrent problems) and technology gaps are far more devastating.  Case-in-point, PwC highlights the experience of an 800-bed Academic Medical Center which, by their estimate, had leaked $66M in revenue in just the first 45 days post-go-live!  Similar phenomena occurs with every EHR upgrade as well as all the upgrades, patches, etc. that accompany the peripheral systems that are integrated or feed information back into the EHR.  This represents dozens of technology-related points of failure annually for a health system.

Peter Drucker’s adage “if you can’t measure it, you can’t improve it” has been morphed over the years into “you can’t manage what you don’t measure”.  In that regard, Mid Revenue Cycle leakage has been the forgotten soldier in the war on revenue.

Many healthcare organizations ASSUME that somewhere in their Accounts Receivable report packages they must be collecting revenue leakage performance metrics and therefore it’s just a matter of mining the data they’re currently collecting. Think you’re one of them?  Ask yourself these three questions that serve as a litmus test regarding your ability to measure and manage leakage…

  1. Do you believe your organization incurs leakage? If so…
  2. Can you accurately identify where the leakage occurs (i.e., by location, department, specialty area or practitioner) and quantify its financial impact?
  3. Do you have an accountability structure within your Revenue Integrity area that has a defined “owner” responsible for managing leakage and the resulting financial results and process improvements?

Honest answers to the above questions will tell you whether you have a problem worth solving, whether you have the means for measuring the problem, establishing goals and tracking performance, and whether you have an accountability culture specific to revenue leakage.

PwC Leakage 3

PwC highlighted three critical success factors for Revenue Cycle professionals to consider pre- and post-implementation of an Epic EMR – (1) understand the key differences and considerations around the migration from a legacy system to Epic’s EMR, (2) look for process improvement opportunities post-go-live, and (3) acknowledge the need for value-add next gen analytics to lend revenue integrity insights. Opportunities to specifically mitigate Mid Revenue Cycle leakage include…

  1. Work Queue Management – Epic Work Queues tend to fragment the RC workflow and disperse accounts into multiple silos that if unmanaged, eventually lead to revenue leakage due to Timely Filing limits.  Without a revenue assurance program that is constantly monitoring leakage, hospitals will incur leakage due to “misplaced” charges.
  2. Charge Volume Monitoring – Charge integrity is compromised in every EHR conversion and the ensuing charge leakage spikes from pre- to post-implementation.  This is the predictable surprise that coincides with every EHR conversion AND each and every EHR upgrade.  Pre/post volume alignment reviews are largely designed as a check and balance to detect technology gaps associated with the conversion but they don’t provide the specificity to identify the root causes of the systemic leakage, pin-point where the problems are occurring and make NO EFFORT to track and recoup the associated revenue.
  1. Business Intelligence – EHRs do not provide RCM-specific standard reports and custom EHR reporting is challenging as well as expensive. Third party RC Analytics from niche solution providers can add new, advanced insights that provide the depth and breadth of analytics that EHR reporting simply does not deliver.   PwC suggested that providers strongly consider bolt-on technologies that drive new business intelligence insights and data-driven problem solving.

RCM analytics is a relatively new Business Intelligence frontier and as a result, RCM data analytics are relatively low in adoption amongst healthcare providers.  A recent survey by Navicure noted that  55% of respondents did not have an RCM reporting solution yet 45% were actively looking for one.  Chief concerns amongst respondents in leveraging analytics showed that while resources availability was their top concern, 44% felt they lacked in benchmark information and actionable information that is readily usable.  In short, the results imply that customers want concise, actionable information with benchmarks for what good looks like without a lot of time, effort, or resources committed to data mining.

All indications point to the fact that EHR solutions do not provide the native reporting capabilities required to manage MRC effectively and each conversion/upgrade is a slippery technology slope prone to incurring significant revenue leakage.  Leading health systems have recently reported budgeting for 1-2% dip in annual revenue associated with their EMR conversions.   Niche solution providers such as AcuStream and its Revenue Assurance Program are rapidly gaining market acceptance as essential bolt-on technologies and services in the war on revenue leakage as complements to both EHR solutions and Revenue Cycle Management best practices process efficiencies providing health systems with the specific ability to measure, manage and recover revenue leakage.

About AcuStream

AcuStream is a Revenue Assurance specialty company dedicated to the healthcare industry. AcuStream provides automated charge capture auditing technology solutions, value-add professional coding expertise, and decision support tools to the country’s leading healthcare providers enabling our clients to find missed revenue around charges they didn’t know were missing. We are the only organization with proprietary algorithms and custom client specific rules, that can correlate both the hospital data and physician data. This in conjunction with our world class workflow, allows us to find and track missed, miscoded, and misplaced charges.

AcuStream identifies and quantifies missed reimbursable charges for both Physician Organizations and Health Systems. REVBUILDER™’s automated post-bill auditing solution identifies omitted charges while REVREVIEW™ auditors validate charges against your own EMR documentation and payer contracts to ensure you get paid for the services provided.

AcuStream has been privileged to work with one-third of the academic medical centers on the U.S. News and World Report “Honor Roll of Best Hospitals,” seven of the 50 largest integrated health systems, twenty percent of the 20 largest not-for-profit health systems, and 10 of the nation’s largest physician group practices providing immediate financial lift/profitability, management insights and process improvements surrounding Revenue Management.Acustream currently processes over 100,000 doctor’s data on a monthly basis, thanks to our client base of top hospitals and physician organizations in the US. The result of our solution is improved net profit, decreased revenue erosion, and a clear view into departmental efficiencies.

We help you identify the missing pieces to your revenue puzzle, BEFORE you even start to put the puzzle together.