Case Study:

Eastern Washington Hospital Leveraging India

Resources amid Fiscal Pressures

Executive Summary:


The maturity of an organization determines its scalability and operational agility to adjust to shifting reimbursement structures, specifically alternative payment models.

At a 300-bed hospital in Eastern Washington, patient volumes for commercial and federal payers have consistently decreased due to the competitive landscape within the region, a talent deficiency, payer exclusivity clauses, and legacy staff using aged methodologies in a ‘new age’ environment.

Executive predecessors had entered into low-SLA, high-risk contracts with vendor partners, which put the hospital in a problematic situation when cash on hand dropped to under 10 days’ operating revenue, with no quality guarantees to close the revenue gap with the existing partners. The new Executive Leadership looked to leverage the offshore model to clear the backlogs, meet SLAs, establish a business rhythm, and move the organization to steady state.

The new organization leadership looked to Vee Technologies’ India talent pool to close the resource and knowledge gap.

Vee Technologies is a standout top performer among a robust BPO vendor pool in India. India remains the largest source of talent for exported skills, closely followed by China, Malaysia, Philippines and Korea. The Vee Technologies hybrid India/USA solution offers the broadest range of capabilities to address a multitude of midrange to large-scalable offshore solutions.

Clients’ Challenge:

  • Limited talent within the geographic region
  • Decreased revenues due to poor Revenue Cycle practices
  • Financial pressure for a low-cost operating model (Global BPO market cost-competitive locations for offshore service delivery labor rates average 25% to 50% lower than domestic prices, which is still 15% to 25% higher than Vee Technologies India).
  • Vendor partner would need to be operational immediately, with little to no time for process-building or formal implementation plans.

Vee Technologies Solution


Major issues with the existing domestic coding partner required immediate termination of the current contract and transition to another partner.

The Hospital’s request for assessment and contract arrived at Vee Technologies with the caveat that coding operations be active within one week of contract execution. The time from receipt of the fully executed agreement to the launch of the coding implementation process was a mere 24 hours.

The Hospital and Vee Technologies allocated a steering committee to focus exclusively on revenue recognition. Implementation was directed by Vee Technologies’ US Operations division, in tandem with Vee Technologies India and functional leaders from various departments at the hospital. Representatives from the Vee Technologies India Coding Operations team came onsite to the client location and assisted the Hospital with encounter workflow mapping to ensure no patient visits were lost in the transition process.

Results:

Within five business days, the Vee Technologies coding operations team was live in active production, with no loss of charge capture. Because the experience and talent level at Vee Technologies exceeded that of the internal Hospital employees, coding leadership was brought in by Vee Technologies to assist in the training and QA of the internal coding department.

In the first 30 days, the Vee Technologies India coding team had achieved a 96% coding accuracy score and brought all backlogged queues to within 72 hours from DOS.. This quick success prompted the HIM division to outsource all hospital and professional coding to Vee Technologies. Over the next 11 months, the revenue return from the HIM department’s quality output yielded significantly high revenue, replenishing the organization’s cash on hand from (at its lowest point) three days’ operating revenue to 22 days’ operating revenue

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Jeff-Shelmire

Meet the Author

Silas Goldman - Senior Director of Operations

Silas Goldman is currently Senior Director of Operations specializing in healthcare risk adjustment innovation for global professional services firm Vee Technologies, Inc. He has focused on healthcare innovation for twelve years, his mathematics background provides him with a unique and useful perspective to navigate the constantly evolving healthcare system. He has served as an advisory board member to the HFMA’s Strategic Innovation Funding Program, and authored Vee Technologies’ Programs for Innovation component of their 2018 IAOP Global Outsoaring 100 recognition.

Case Study: Eastern washington hospital leveraging india resources amid fiscal pressures

Case Study: Eastern washington hospital leveraging india resources amid fiscal pressures