May 05, 2017
NYC Health + Hospitals today announced plans to implement new, advanced revenue cycle technology to improve efficiency and ensure that the health system is collecting the maximum amount of revenue for the services it delivers. The new Epic revenue cycle product is projected to help the health system capture an additional 5 percent of adjusted patient revenue—or up to $142 million in revenue, based on FY 2016 patient volume. Among the expected benefits are improved clinical documentation to support billed services, reduced claims denials, and accelerated reimbursements.
The new technology will standardize revenue collection in the 11 public hospitals and across dozens of community-based patient care sites, and it will integrate seamlessly with the Epic patient electronic medical record system that NYC Health + Hospitals began to adopt last year. Epic’s revenue cycle technology will create a common platform for all the health system’s providers, who will be able to complete tasks without having to jump from system to system.
“This information technology system is an essential investment that will pay for itself in a couple of years and provide the IT foundation for more advanced population health efforts,” said NYC Health + Hospitals Interim President and CEO Stan Brezenoff. “In addition to its impact on our revenue, it’s also a fundamental component of our health system’s transformation to more streamlined and efficient operations. The result will be a greatly improved user and patient experience.”
“Having revenue and clinical processes in a single system will make a big difference in productivity for the largest public health system in the country,” said Judy Faulkner, Epic founder and CEO. “With more than a million patients treated annually, this critical institution will provide improved care for the people of New York City.”
Benefits and New Functionality
Benefits will be experienced by both patients and providers. Patients will more easily be able to see and understand the costs of their care, and they will be able to pay bills online. For providers, it will present a consolidated and complete patient record to improve efficiency, for example, by making it easier and quicker to admit patients by entering specific care criteria (e.g., if a patient requires a ventilator).
Other functionality and benefits include improved coding and documentation, expedited billing, reduced denials of claims, and accelerated reimbursement. The seamless integration with Epic’s electronic medical records allows for simplified billing, since items are recognized as billable at the same time they are ordered. And it paves the way for powerful population health goals through more refined data on clinical groupings of patients.
Epic’s suite of health care IT products is recognized as “best in KLAS” (by an independent organization that monitors IT developments). The combined, integrated electronic medical record and revenue cycle products are used by some of the top health care systems across the country, including Kaiser Permanente, Cleveland Clinic, Partners Health Care, and Sutter Health. Independent analysis from PricewaterhouseCoopers concluded that an integrated platform was the best model for NYC Health + Hospitals, noting the industry trend toward such integration.
Costs and Return on Investment
NYC Health and Hospitals will invest $289 million over the next five years to fully implement the new system at its 11 hospitals, five long-term care facilities, and more than 70 community-based health centers. The City of New York has allocated $150 million in capital funds, and NYC Health + Hospitals will invest $139 million out of its operating costs, pending approval by its board.
The implementation costs will cover staffing required to customize the integrated platform and training. The revenue cycle software was included as part of the electronic medical record purchase from Epic, so there is no additional software cost.
The rollout of the integrated platform is expected to begin in the fourth quarter of 2018. The integrated revenue cycle and electronic medical record suite is expected to be fully completed in the last quarter of 2020.
The expected increase of 5 percent in adjusted patient revenue is based on the experience of other national and local health systems that have already implemented the product.
The public health care system collects 72% of its patient-care revenue from Medicaid, 15% from Medicare, and 5% from commercial insurance (with the balance from grants and other targeted City support). The system is also one of the largest safety net providers of health care and last year alone served 425,000 patients without insurance.