There is an increasing trend toward faster turnover of patients at the facility level resulting from enhanced care and speedier recovery time. This means that more patients are being admitted at a faster rate, increasing the workload of the MA Specialists who are responsible for assisting patients through the Medicaid pending application process. The increase in volume has brought to the surface the inefficiencies of the current Medicaid pending revenue cycle. The goal of this engagement was to identify all of the flaws and standardize any observed best practices to reduce the revenue cycle time and eliminate bad debt.

Through a series of interviews and work measurement sessions, IET was able to identify best practice methods and also wasted motions or bad habits. All of this information was correlated to develop a process record that visually represented the elements required by each key resource to complete the Medicaid application process along a timescale. Using this visual tool, an optimized standardized process was developed for implementation. The initiatives set in motion focused on customer satisfaction, quality improvement and cycle time reduction.

By eliminating variance in the process, the results could be measured and therefore better managed towards continuous improvement. A specific performance tracking tool was developed to measure the standardized process. The developed tool tracks progress for each patient in real time so that issues can be addressed as they arise rather than retro-actively.

IET’s process improvements will reduce the current revenue cycle from 90 days to 60 days; eliminating bad debt and saving over $500,000 from the aging report. To ensure continuous improvement, a progress improvement reporting structure was also introduced. This tool will be used to mentor Medicaid Pending Specialists and create performance goals based on process defined metrics.