Academic hospital gains best-of-practice revenue cycle

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SUNY revenue cycle case studyGrant Thornton LLP’s work was instrumental in Epic’s naming of SUNY’s Upstate Medical University as a Top Quartile performer in Epic-generated metrics and awarding of SUNY as the 2014 Epic Revenue Cycle Most Valuable Performer.

Epic is Upstate Medical University’s electronic health record (EHR) management application vendor.

The client The State University of New York (SUNY) Upstate Medical University operates two hospitals in Syracuse and is the only academic medical center in central New York. With more than 9,000 employees, the university is the region's largest employer.  
"Almost two years ago, we engaged Grant Thornton with lofty expectations for facilitating a complete revenue cycle overhaul, assisting us with an extremely critical system conversion to Epic and ultimately optimizing process flows in a post-Epic environment. Upstate is a large public academic medical center, and at the time, our revenue cycle indicators were mediocre at best. We needed a consultant that could quickly survey our organization and processes, develop a plan of attack and help us execute.

"Grant Thornton did just that, and more. Their team of highly competent, professional and diligent consultants (led by Lane Jackson and Matt Oliver) far exceeded my expectations for the engagement. They were truly invested in delivering results.

"In summary, today most of our revenue cycle metrics are in the top quartiles of the country and our Epic transition was characterized as one of the most successful in the country.
Hiring Grant Thornton was the best investment I've made during my tenure at SUNY Upstate!
Stuart M. Wright, CFO, University Hospital

The challenge Upstate’s revenue cycle process and financial performance were not optimal, with lagging cash collections and a rapidly aging accounts receivable. Management desired to appropriately restructure the central business office, while optimizing processes concurrent with an Epic build and implementation. Upstate did not have an in-house team to lead necessary improvements.  

The Grant Thornton solution To gain support for identification and implementation of revenue cycle improvements, SUNY turned to Grant Thornton. The Grant Thornton professionals had demonstrated deep revenue-cycle experience, patient accounting system and IT knowledge, and a collaborative approach to implementing change.

SUNY and Grant Thornton formed an integrated team to build and implement a “best-of-practice” revenue cycle with Epic. The team:

  • Restructured the business office to staff to volume, and to increase individual accountability and productivity
  • Deployed Grant Thornton staff with client leadership in key revenue cycle areas
  • Collaboratively re-engineered processes to aid in achievement of best practices and successful system transition
  • Developed pre- and post-Epic cutover risk mitigation strategies for:
    • Charge routing and testing
    • Legacy system integration
    • Patient-, account- and claim-level work queue development and implementation
    • Transition from Epic Ambulatory to Epic Enterprise
  • Supported design and build to incorporate leading practice workflow with the goal of maximizing revenue realization, and positively affecting operations and financial performance

The outcome A new financial structure, streamlined processes and better-than-expected cash flow were the results of the collaboration between SUNY staff and Grant Thornton professionals. The optimized revenue cycle processes were implemented with cash baselines recovering in less than half the average time.  

Grant Thornton’s significant contributions include the following benefits to Upstate:
  • $30 million in additional one-time cash generated prior to the go-live of the EHR and patient accounting system.
  • $15 million in additional revenue on a recurring annual basis is on pace.
  • The traditional cash decline, encountered by most providers during implementation, wasn’t experienced.
  • An historical cash baseline was obtained in eight weeks, far exceeding the standard performance of 20 weeks.
“The ability to strengthen the financial performance of a hospital enables them to focus on what’s important — patient care quality and how to better serve the needs of their communities,” said Lane Jackson, Grant Thornton Health Care Advisory Services partner and member of the team. SUNY has engaged Grant Thornton to continue with optimization services.

See how Upstate went on to realize a $97 million benefit during the first two years of the Epic implementation.

Lane Jackson

Health Care Advisory Services
T +1 704 632 3510

Matt Oliver
Senior Manager
Health Care Advisory Services
T +1 404 475 0088