Getty Images
How Sharp HealthCare is Winning at Revenue Cycle Management
A gamified approach to revenue cycle management increased productivity by up to 31% in some areas, while giving staff and leadership more transparency and accountability.
The business of healthcare is no game, but a new gamified approach is making revenue cycle management more fun and more efficient at Sharp HealthCare.
The San Diego-based health system recently teamed up with athenahealth to design and implement a staff engagement and revenue cycle management optimization tool that rewards staff points and badges for following gold standard workflows.
So, when a pre-billing team member clocks in for the day, the cloud-based game application Gamify uses real-time analytics to track her productivity and quality of work and attach a value to it. The employee can then track her performance using the application’s game board and team members with the most points have their avatars – which they create themselves – displayed on a leader board for all to see.
But it isn’t all fun and games. Within six months of implementation, the health system observed a 31 percent increase in credit balance productivity, a 21 percent increase in customer service productivity, and an 18 percent increase in hold bills productivity.
Additionally, the tool was associated with a 10 percent reduction in task lag and a reduced staff turnover rate of less than 5 percent.
“It gives the team a way, in real time, to see how they're doing for the day, how they're comparing to their best day, how they're comparing to the rest of their team, and it allows their leadership to recognize them and reward them for their performance in real time,” Gerilynn Sevenikar, vice president of revenue cycle at Sharp HealthCare, recently told RevCycleIntelligence.
Making revenue cycle management into a game
Revenue cycle management is poised for gamification, according to Sevenikar.
“When you think about what happens in the revenue cycle, it's pretty much working accounts,” the revenue cycle leader with over 40 years of experience said. “So, you’re taking an account, verifying information, making sure it gets to the right place, making sure we're paid correctly, and then, you actually balance out and account. I describe it as moving a widget from one place to the next.”
“I thought, as this widget moves from one place to the next and each person is handling it, all of those tasks associated with that process could be valued,” Sevenikar stated.
Gold standard workflows ensure the widget moves through the process as efficiently and accurately as possible, resulting in more value for the health system through fewer errors, denials, and follow-up.
Revenue cycle workflows, however, do not always follow the gold standard.
When Sharp HealthCare first teamed up with athenahealth to optimize revenue cycle workflows, the health system uncovered significant variations in how staff performed tasks.
“Anytime somebody's doing something, they may find shortcuts and you tend to find drift,” Sevenikar explained. “As individuals start training other individuals, that drift becomes perpetuated throughout the department. We wanted to get everybody back on the gold standard workflow.”
Getting the gold standard
Through friendly competition and transparency, Gamify gets staff to get back and stay on the gold standard workflow.
The premise of the tool is to identify best practices and assign values to them, explained Sevenikar, who helped designed the application. Then, as employees go about their normal workday, they accrue points based on their productivity and quality of their work, with more points being awarded for following the best practices identified as the gold standard workflow.
Managers have been using the point system to recognize productive and improving staff in the pre-billing department. They have also leveraged analytics in the tool to identify trends in productivity and incent staff to improve workflows that way.
“It's really the analytics that drives the game,” Sevenikar stated. “Since we're extracting those analytics, we do get trend reports and things like that. So, for example, if I have an employee and I pulled their productivity, I can track their productivity by hour of the day and I can see he trends a little lower between two and three. I can lob them the opportunity to gain extra points for productivity between those hours. So, I can influence our productivity during that period of time because of the analytics I received.”
But employees are also taking the initiative on their own since the implementation of the tool.
Improving productivity through transparency
Access to personal and department productivity information, coupled with a dash of competition, has encouraged staff to increase their productivity and efficiency.
“If you give people information, they make decisions on what they're going do based on that information,” Sevenikar reasoned. “So, as we arm people with information as it relates to their productivity for the day, they make a decision: Do I want today to be my best day ever or not? Do I want to pass Jim on the leaderboard or do I not? We give them the information to demonstrate what they are able to do to.”
The information has also facilitated real-time feedback, which enables staff to correct any deviations from the gold standard workflow immediately.
“They aren't waiting until the end of the day, they aren't waiting until the end of the week, they aren’t waiting until cash goals are posted at the end of the month, and they definitely aren’t waiting until the performance review at the end of the year,” Sevenikar stated. “It helps them own and influence their own productivity.”
The game application has been so successful at motivating pre-billing staff that when one employee moved on from the health system, her department asked leadership to not fill the position so they could take on her accounts for extra points.
“It ended up that they were able to manage that workload in addition to the workload that they have been traditionally working with no problem at all. It was definitely an eye-opener,” Sevenikar reported.
The tool has been especially helpful during the COVID-19 pandemic when the health system suddenly transitioned administrative staff to remote work.
“It was always the intent that we prepare this for a work-from-home product for employees and to give leaders a tool to help them manage, monitor, and communicate with their employees,” Sevenikar stated. “The pandemic only accelerated that.”
Not only does the toll give leaders insights into their team’s productivity while they are at home, in real-time, but it also allows staff to interact with each other and share information, again, in real-time, the revenue cycle leader emphasized.
Eventually, Sharp HealthCare hopes to create a store in which employees can exchange points and badges for more tangible rewards, like a gift card for lunch, a voucher for a car wash from the boss, or extra PTO. The health system may even borrow from another well-known game and offer “Get Out of Jail Free” cards for staff on the verge of corrective action.
For now, the health system is refining the tool and expanding its use into new areas of the revenue cycle, including health information management.
“We are in the process of perfecting those analytical tools so that leaders are served the information they need to effectively monitor their employees in real-time and in a way that's engaging,” Sevenikar stated.
