Nevada Rural Hospital Partners
Revenue Cycle Improvement Program (RCIP)
 

Services offered through NRHP, LLC

  

Our Program: We focus on the viability of small and rural hospitals.

Nevada Rural Hospital Partners (NRHP) recognized that maintaining an effective revenue cycle is the bedrock of financial viability. The effectiveness of a hospital’s revenue cycle drives the entire hospital operation because the cycle is the source of the resources needed to maintain a successful facility. NRHP also recognized that to be effective the cycle must be viewed as a whole – success rests in how well the cycle is integrated. And finally, NRHP recognized that small hospitals need hands-on guidance, training, and implementation support. Our Revenue Cycle Improvement Program was specifically developed to enable small and rural hospitals to achieve optimal financial performance in an increasingly challenging financial and regulatory environment.

Our Concept: The outer cycle is possible only when the inner cycle is effective.

A successful revenue cycle is a complex process involving many inter-related components. The graphic below illustrates these relationships and underscores the fact that the effectiveness of the component parts drives the ability to deliver services to patients – the outer cycle is possible only when the inner cycle is effective.

NRHP Revenue Cycle Wheel

NRHP categorizes the components of the revenue cycle as they related to patient access to care:

1. Activities that support patient access to care, such as patient scheduling, pre-registration, preauthorization, financial counseling, registration and point of service cash collection;
2. Activities that reflect the delivery of care from a financial perspective such as a charge capture, utilization review, documentation and chart abstraction, coding, and the maintenance of an accurate current charge master;
3. Activities that generate an accurate bill for that care through billing, accounts receivable, receipt of reimbursement, and contract management;
4. Activities that have to do with the receipt of payment including self-payment, collections, bad debt management, refunds and denials management; and,
5. The utilization of those funds to continue to support the operation of the hospital and patient access to care.

Our Process:

Applying our commitment to an integrated approach, our process typically includes:

• A detailed assessment of your revenue cycle (current state)
• A tailored definition of the desired future state taking resources and capabilities into account
• A gap analysis including an evaluation of current policies, procedures, and forms
• A transition plan that bridges current practice to the future state
• Intensive hands-on implementation support in your hospital
• Recommendations for external vendors if necessary, and assistance with RFPs and coordination of the vendors based on your needs
• Benchmarking using core performance indicators, data gathering tools, and custom facility reports to help you measure and sustain progress
• A period of intensive follow-up to support permanent improvement

Our Engagements:

Revenue cycle improvement initiatives are both challenging and rewarding. While not easy, it has been our experience that a successfully implemented revenue cycle improvement program can make the difference between a viable hospital and one that is failing. NRHP offers the following range of service options to meet your needs:

Comprehensive Revenue Cycle Improvement
NRHP has designed a comprehensive revenue cycle engagement with small hospitals in mind. Our typical engagement includes an on-site and in-depth assessment of your hospital’s revenue cycle practices, followed by a gap analysis (addressing process, policies, procedures and forms), and full report of observations and recommendations for improvement. Throughout the process, NRHP staff works side by side with your staff so that recommendations are appropriate and meaningful within your specific setting. NRHP will develop accustomed implementation plan for your facility and will provide two weeks of intensive, hands-on implementation support at your hospital, designed to help you be self-sufficient after our engagement ends.

To further assist you with this process, NRHP will prepare a facility-specific revenue cycle manual, documenting the full spectrum of your revenue cycle. This manual includes detailed work-flow diagrams, and is an indispensable resource for revenue cycle staff. Additionally, NRHP will supply standard policies, procedures and forms to address issues identified in the gap analysis, and will assist you with the selection and coordination of outside vendors if they are needed. At the end of this process your revenue cycle staff will function as a team with a much deeper understanding of how your cycle functions as a whole.

Finally, a week-long follow up visit will be scheduled to help you monitor quality improvement processes. To help you sustain the benefits of your investment in revenue cycle improvement, NRHP will work with the hospital to collect and aggregate meaningful data that you can use to evaluate the effectiveness of your revenue cycle, pinpointing problem areas so that you can focus on solutions.

On-going Support – Retainer
In addition to our typical engagement, NRHP offers extended support for clients who have previously completed a revenue cycle improvement initiative with us. On a retainer basis, clients may choose a service tailored to their needs by defining the frequency and scope of on-going support. The other option for extended support is a periodic structured tune-up, usually done annually.

On-going Support – Tune Up
A tune up engagement involves an on and off-site review of how well your revenue cycle is functioning, and recommendations for correcting any process or knowledge gaps that may have developed following completion of a comprehensive initiative with us. Tune ups are usually done on an annual basis. Project scope will be determined through more detailed discussion about the hospital’s specific needs.

Self-Assessment through NRHP’s Benchmarking Implementation Service
NRHP also offers a service aimed at improving hospitals’ understanding of where they stand with respect to the performance of their revenue cycle. Our Benchmarking Implementation Service provides clients with benchmark reporting templates and data gathering tools for all of NRHP’s revenue cycle core measures, which are built around Healthcare Financial Management Association recommended indicators. NRHP works on-site with hospital staff to accumulate the necessary data, load it into our data collection tool, and generate quality improvement reports. The result is detailed data that helps hospitals pinpoint problem areas and focus on solutions.

Our Revenue Cycle Team:

The NRHP Revenue Cycle Improvement Program is led by a team with deep commitment to small and rural hospitals and clear expertise in the field.

Steve Boline, CPA, Regional Chief Financial Officer
Since August 2003, Steve has served as the Regional CFO with Nevada Rural Hospital Partners and the Nevada FLEX Program. In his current capacity, Steve is responsible for providing technical and financial management assistance to NRHP’s 14 members, including 13 Critical Access Hospital (CAH), and CAH eligible, facilities. Steve previously served as NRHP’s Regional CFO from 1996 through 1998. Prior to that, Steve was the auditor for both NRHP and some of its member hospitals as a CPA with the Reno firm of Cupit, Milligan, Ogden, and Company.

In between his years with NRHP, Steve worked in a variety of capacities at various Northern Nevada hospitals. Steve has served as the Director of Finance at Carson-Tahoe Hospital, the Director of Finance for Continuum Services at Washoe Health System, and the Director of Patient Financial Services at Saint Mary’s Regional Medical Center. Through this, Steve has gained experience and knowledge in all aspects of healthcare financial management, including extensive experience with the revenue cycle. Additionally, he has experience in both acute and sub acute care, including acute rehabilitation, long term care, and home health.

Steve graduated from the University of Arizona, with a degree in accounting, and is a Certified Public Accountant in the State of Nevada. Steve is also a member of the Healthcare Financial Management Association (HFMA) and a former officer and board member of the Nevada Chapter.

Holly Hansen, MBA, Chief Operating Officer
Holly joined NRHP in December 2008. Her transition to the healthcare field and to NRHP is the culmination of several years of work and planning to find a role that truly “makes a difference” in the community. Her professional experience includes a range of operations management and project management positions for multinational firms
in the high tech industry, and most recently work in academia. She earned a Master of Business Administration degree from the University of Nevada, Reno and is a licensed insurance agent in property, casualty, health and life.

Holly’s current responsibilities include the development and support of new and existing programs and services intended to support the viability of NRHP’s 14 member hospitals, including the Mobile MRI Program, the Group Purchasing Program, and group health insurance services. Holly is the Network Director for Nevada’s Rural Health Information Technology Network Development Program, and is the Senior Program Manager for the Revenue Cycle Improvement Program.  She is also responsible for contract management and negotiations.

Revenue Cycle Assessment Project – Kansas Flex Program

Download the Revenue Cycle Assessment Questionnaire: This tool is designed to help hospital CEOs and CFOs assess the current condition of their revenue cycles, and to determine areas of potential need. Submit the questionnaire to revcycle@nrhp.org.

Technical Assistance – Kansas Flex Program Participants Only

For technical assistance with the NRHP Revenue Cycle Assessment Questionnaire, you may email us and expect a prompt response. Be sure to tell us if you prefer to be contacted by phone or via email. (If you would like a phone call, please remember to provide a contact number and the best time to reach you.)

Email: revcycle@nrhp.org