Learn how McBee partnered with the agency to tackle their gaps in face-to-face documentation compliance and resolve all of their unbilled revenue with agency-wide education initiatives and adapting best practice order management processes.
Since the implementation of the Patient Driven Payment Model (PDPM) in October of 2019, many skilled nursing organizations have employed a variety of strategies for grading their overall performance against this new reimbursement model.
As the saying goes: “Cash is King”. Maintaining a steady cash flow is one of the pervasive issues that affects many health care providers, especially in a time when economies of scale are rapidly transforming the landscape of health care.
The home care provider was experiencing a high LUPA rates that consistently exceeded 15%. A staffing shortage, particularly with nurses, combined with communication challenges throughout made it difficult to achieve positive patient outcomes.
The health system was unable to successfully fill several key leadership roles within their home care agency after a loss of leadership. Eleven critical positions were vacant within the clinical, quality assurance, and finance departments. As a result, leadership, strategy, quality performance, and compliance profoundly suffered...
McBee developed a work plan for the implementation of a Central Business Office (CBO) scheduling call center. This engagement significantly improved the financial viability of the health system with a $7.8 million increased gross revenue opportunity. The call abandonment rate was decreased from 27% to 2% without increasing the number of full time employees.
By implementing improved processes, physician and staff education, tailored operations strategies and increased admission reviews, this engagement slashed observation rates by a third. As a result of working with utilization review staff to achieve correct patient status assignments, the health system experienced a $1.8M revenue improvement in the first three months of the engagement.
The hospital system had been unable to adequately staff their emergency department with utilization review care managers. The hospital system engaged McBee Care Managers to provide coverage on weekends and expand their coverage until 11 p.m. during the week.
The hospital system had been unable to adequately staff emergency departments with utilization review care managers seven days per week, with a minimum of 12 hours per day. As a result, patient status determinations on an average of 120 admissions per day were not substantiated until more than 24 hours after admission.