How UC San Diego's CRO Leveled Up RCM Efforts

How do health systems evaluate mission-critical tech in RCM efforts?

There are numerous rev tech solutions in the marketplace and just as many vendors. With financial pressures from inflation and poor payer rates, revenue cycle leaders and CFOs are examining digital transformation initiatives to level up their financial wellbeing.

Miguel Vigo is the chief revenue officer at UC San Diego Health, and he shared the significant improvement he saw in his organization after using an RCM assessment tool. Vigo spoke about how his health system was still able to implement the benchmarks from the tool without having to stray away from their original plans.

“We didn’t want to stray away from our strategy road map, but worked to be able to see more through it,” Vigo said.

What’s The Strategy?

Revenue cycle leaders and CFOs should examine where even their organization’s smallest challenges lie in order to move towards improvements. Financial leaders should ask themselves what adjustments can be made to their system’s most valuable, mission-critical areas. What adjustments will have the most positive impact for the organization?

By focusing on realigning resources to the most valuable and critical parts of the organization, financial leaders can create a straightforward map towards solutions to their biggest challenges.

“[...] we have either improved our metrics considerably which has had a massive value gain, or we have clear transparency on stabilized KPI’s/metrics (within good ranges),” Vigo said.

“To which we have pivoted resources and realigned strategies given those are now in a more protected and steadied state.”

A discussion panel at the HFMA conference highlighted the Revenue Cycle Management Technology Adoption Model as one option that can help point health systems in the right direction on the RCM path. The free benchmarking assessment tool is a product of the collaborative effort of FinThrive and HFMA, identifying the wins and shortfalls in RCM performance and providing custom KPIs measured against industry benchmarks.

Out of the five stages of adoption that the tool uses, Vigo saw his health system was at stage four, meaning the system was doing well in some areas, and needed work on others. “We wanted to put all our cards on the table, and my team stepped up to do that,” Vigo said

Vigo said that one of the best parts of going through this process to improve technology outcomes was how it brought his team together. Everyone had to come together to evaluate the areas they could do better in, and this model gave them a guidebook.

Seeing Results

With meticulous tracking, UC San Diego was able to tackle its biggest challenges throughout the year. A couple areas where UCSD saw the most improvement after using the tool were point of service collections and clean claims rates. According to  Vigo the system’s point of service collections increased by over $2 million dollars in a single year.

Prior to RCMTAM, UCSD’s point of service collections percentage of net patient service revenue stood at 0.8%. Afterwards, it increased to 1.1%. UCSD’s clean claims rate also jumped, going from 93% to 97.6%.