Cost is a major issue in healthcare…I know…duh? I am reminded of this every day as we work with some of the largest health systems across the US. Healthcare providers—and departments and administrative staff within—are constantly being asked to do more with less, even while their systems and processes are growing in complexity and scale. Administrative costs—specifically the money needed to process claims, track down bills, and ensure that medical insurance information is accurate—represent 30 cents of every dollar in a medical bill. Hence, the constant process of attempting to clip administrative costs of out of the equation, which currently represent 25.3% of total hospital expenditures, according to Becker’s Hospital CFO Report.
The complex nature and navigation of clinical details, billing information, and ultimately insurance data requires herculean efforts on behalf of hospital administrators. Specifically, with the digitization of medical records and deployment of complex EHRs, hospitals require dedicated staff to assist in the management of medical records, health information management (HIM) professionals. These unsung heroes of hospital administration ensure that the gears of the hospitals continue to turn in order to provide the right care to the right patient and ensure the hospital is compensated for its care. Most organizations are looking to add to their HIM staff in order to deal with both the current pace of their medical records management, as well as the giant backlog of medical record issues, which are usually ignored. ONC has recently stated that the average hospital has roughly a 10% patient duplication rate. This duplication rate drives up the administrative costs for any hospital with redundant medical records for patients receiving care.
One third of denied claims are due to inaccurate patient matching, costing the average hospital $1.5M annually.
Every duplicate record costs health systems $1,950 per inpatient stay.
HIM professionals are plagued by duplicates and forced to deal with them at the potential cost of resolving true medical records issues that are important to provide quality care. Hiring more HIM professionals is not sustainable nor cost effective. An automated solution is needed to be able to address both the backlog and creation of patient duplicates.
Verato Auto-Steward™ is a purpose-built cloud solution that can be paired easily with your EMR and EMPI to automate the resolution of duplicate medical records within your system(s). Verato Auto-Steward has been deployed across the country with large health systems both (1) to save them money by not having to staff up more HIM professionals, and (2) to improve patient safety by automatically resolving 50-75% of patient duplicates.
How can you save $500,000 dollars? Here’s the math:
- If you are a hospital with 2M patient records
- ONC says you have 200,000 duplicate medical records (at a 10% duplicate record rate, which is the national average)
- In order to resolve 200,000 duplicates, you will need 10 HIM staff resolving 5 duplicates per minute (which is a slightly above average pace)
- If the fully loaded cost of those HIM Staff are $50K a year (office space, time off, benefits, etc.), you are spending $500K a year
- Note: this doesn’t even include the value of resolving the 200K duplicates in a matter of days/weeks and the corresponding benefits to billing, patient safety, patient care, etc.
Verato Auto-Steward represent a unique method of driving costs out of your health system while ultimately improving your care and safety of the patient.