Case Study: RCM Overhaul Yields $74M Benefit
A new case study highlights the impact of RCM optimization. JTS Health Partners reports its collaboration with Mason Health on a new RCM and HIM model resulted in a 45% reduction in Discharged Not Final Coded (DNFC) accounts and a $74 million financial benefit in just 12 months.
The engagement between JTS Health Partners and Mason Health tackled several deeply rooted operational challenges. Mason Health was contending with management roles in transition, an electronic health record (EHR) system with numerous non-standard workflows, and a need to optimize laboratory and charge services productivity. A key goal was to create a long-term, sustainable model for Mason Health's Revenue Cycle Management (RCM) and Health Information Management (HIM) departments. This involved not just process improvement, but also restructuring the management and staffing allocations to support long-term growth. The collaboration instituted standardized workflows and created specific policies and training to better synchronize the movement of accounts between the coding and revenue cycle teams. This was designed to speed up the submission of clean claims and eliminate the unnecessary transfer of accounts. Beyond the 45% reduction in Discharged Not Final Coded (DNFC) accounts, the initiative successfully brought the DNFC metric to 1.98 days. This achievement was a core component of Mason's broader Clinically Driven Revenue Cycle (CDRC) environment.
