A story of positive operational, financial, and cultural transformation.
Regional West made a much-needed decision to move toward a single EHR and patient accounting system throughout the health system, which led to expected and unexpected challenges. Cash pressures were real. Operational processes needed to be revamped. Employees were asked to learn new, complex system. The wind-down of the legacy system proved to be a competing priority. There was talk of restructuring, which brought uncertainty, leaving many important questions without clear answers. In this environment, the CFO made two critical decisions. The first was to bring in a consultant to assess revenue cycle. The second was to outsource revenue cycle end-to-end to a reliable, seasoned partner. These were bold moves based on trust and upheld by transparency.

Partner: Regional West Health Services (Scottsbluff, Nebraska)

• Medical Specialties: 32
• Physician Clinics: 28
• Approx. Employees: 2000

Regional West at a glance.
Regional West Health Services includes Regional West Medical Center, a 188-bed regional referral center and the region’s only tertiary referral medical center, as well as several other care-based entities. Offering comprehensive health care services for the people of western Nebraska and the neighboring states of Colorado, South Dakota, and Wyoming.

Change was everywhere, and it felt heavy.
Regional West made a much-needed decision to move toward a single EHR and patient accounting system throughout the health system, which led to expected and unexpected challenges. Cash pressures were real. Operational processes needed to be revamped. Employees were asked to learn new, complex system. The wind-down of the legacy system proved to be a competing priority. There was talk of restructuring, which brought uncertainty, leaving many important questions without clear answers. In this environment, the CFO made two critical decisions. The first was to bring in a consultant to assess revenue cycle. The second was to outsource revenue cycle end-to-end to a reliable, seasoned partner. These were bold moves based on trust and upheld by transparency.

Understanding “Typical” Results
Any significant system conversion is expected to lead to reductions in cash collections throughout the initial transition. A recent study concluded most hospitals experience significant disruption to revenue cycle metrics and cash flow, including:

• Jumps in accounts receivable days
• Disruption to billing and coding metrics
• Discharged-not-final-billed (DNFB) days increasing up to 86%
• Late charges rising by more than 600%

Regional West has been no exception, experiencing impacts more significant than these stated averages. That said, Acclara’s leadership and laser-focus on business office operations has helped minimize the impact to cash collections during the first several months of the conversion while helping Regional West senior leadership better understand the system set-up and workflow issues that made the Cerner implementation unusually complex.

Emphasizing the power of storytelling
It’s well-documented that corporate storytelling is an effective communication medium for developing stronger engagement with employees and building internal loyalty during periods of uncertainty and change.

The infiltration of the Acclara Mindset — that everything we do is based on the right balance of partners, people, and performance — and the intentional transparency used to communicate with newly transitioned employees resulted in a remarkable transformation. The recognition goes to the revenue cycle employees who accepted the challenge to embrace change.

Uncovering the engagement story through data.
While hospital leaders oversee all areas of the health system with attention to patient care and quality, Acclara’s focus is on revenue cycle employees. This combined with our one-of-a kind, employee-centric culture, led to significant engagement improvement.

Six months after becoming Acclara Team Members, employees took the same survey they had taken during week 2 of their transition. This time, they answered how they felt about Acclara’s workplace and culture, and the resulting employee engagement score climbed 38.9 points to 88.5%, surpassing Acclara’s goal.

What made the change? Visibility and demonstrated care of leadership, open and honest communication through storytelling, listening to employees, and ensuring employees have the resources and tools to do their work. Indeed, the improvement in the latter (resources/tools) is clear confirmation that the decision to move to a new EHR and patient accounting system was the right one.

I’m older (not saying how old) and I’ve worked for a few companies in my career, but none like Acclara. We have only been on board for a few months and the team spirit is amazing! The opportunities are boundless. I am continuing to learn something new each day, and I am so honored to be a part of it. I am so excited to see what the future brings, and actually look forward to coming to work each day.
— Scottsbluff Acclara Team Member

Starting from “now”
With the consultant directing the Cerner transition and Acclara taking responsibility for revenue cycle functions, Regional West was poised for positive (but still hard) change. In a matter of a few weeks, the business office structure was revamped to consolidate physician and hospital billing, 65 revenue cycle employees were transitioned to Acclara, and Cerner went live. Everyone took a deep breath.

• We quickly deployed resources to wind-down the legacy A/R while the local Acclara Scottsbluff team focused on learning the new Cerner system. This dedicated focus produced higher than expected collections out of the legacy A/R during the transition. We provided additional coding resources and oversight. The Acclara coding team worked through backlogs in the legacy systems while also strengthening the team with Cernerspecific knowledge and expertise.
• We enlisted an interim director throughout the transition to specifically focus on Cerner set-up issues, front-end workflow deficiencies and overall process flow inefficiencies. This focus was key to the Regional West’s CFO gaining visibility to his next steps.
• We communicated clearly and honestly with newly transitioned employees. But in reality, there was angst. During the second week of their transition to Acclara, an employee engagement survey asking them to reflect on their experience with Regional West resulted in a 59.6% engagement score, far short of Acclara’s 80%+ goal.

In less than a year, revenue cycle at Regional West has taken a swift, positive turn operationally and financially, giving the CFO visibility to next steps for his organization. Most striking, a 40% climb in employee engagement is evidence of revenue cycle staff taking hold of an opportunity to thrive in a reorganized, energized workplace culture. If you can relate to aspects of Regional West’s story, exploring end-to-end revenue cycle outsourcing with Acclara is your bold next step.