A RelayHealth Case Study

Gaining Actionable Insight into Financial

Systems and Areas Impacting the Revenue
Cycle
Spartanburg Regional Healthcare System

Introduction

Introduction
Critical Issues
Results
About Spartanburg Regional
Healthcare System
Quick Facts
Credible, Relevant Peer
Comparisons Made Easy

Hospital systems across the country are looking to streamline their billing and collection
Tracking Relevant Key Performance
Indicators
processes to become more efficient and better compete in their markets. The challenge many
face is how to turn the data thats already flowing through financial systems into actionable
intelligence that can help hospital executives make important decisions. Putting the data into
a usable form is one challenge; other hurdles include how to quickly drill down into the data to
get the information needed to improve processes and how to compare performance against peer hospitals.
Spartanburg Regional Healthcare System in South Carolina was facing many of these challenges when
it chose to add RelayAnalytics Pulse to its RelayAssurance claims management system. Brian Earnest,
Vice President of Revenue Cycle, says the addition of
Pulse already is paying dividends through verification
Critical Issues
of the effectiveness of the systems billing practices
Lack of ready insight into key performance indicators
and comparison against peer institutions to validate
Inability to gauge financial performance against peer
performance levels or prompt corrective action.
hospitals
I can look at my key performance indicators, and then
Difficulty to investigate billing anomalies
compare them to other hospitals I select, hospitals that
are similar to ours in size, scope, services and government
structure, Earnest says. Thats valuable intelligence that
Results
helps us understand where we are doing well, where
A first pass clean claim rate 16.65% higher than peers
there are opportunities for improvement and how to set
Daily snapshot of key performance indicators
strategic objectives.
KPIs compared to customized list of peer health
systems

Ability to perform root cause analysis quickly

About Spartanburg Regional Healthcare System

Introduction
Critical Issues
Results
About Spartanburg Regional
Healthcare System

Spartanburg Regional Healthcare

System (SRHS) has been serving
the community more than 90 years,
developing into an integrated
healthcare system that provides care
from birth to hospice.
Featuring a full spectrum of services, SRHS is comprised
of three hospitals Spartanburg Regional Medical Center,
a 540-bed research and teaching hospital; Spartanburg
Hospital for Restorative Care, a 97-bed long-term acute care
hospital with a 25-bed skilled nursing facility; and Village
Hospital, a 48-bed acute-care facility. In addition, SRHS
is offers outpatient surgery centers, a multi-disciplinary
physician group, hospice and home health services, and is
home to Gibbs Cancer Center & Research Institute.

Quick Facts
Credible, Relevant Peer
Comparisons Made Easy
Tracking Relevant Key Performance
Indicators

With more than 5,600 associates and

500 physicians on medical staff, SRHS
serves seven counties in North and
South Carolina.
In addition to providing more than $80 million in charity
care annually, SRHS is ranked #1 in South Carolina for
cardiac services by Healthgrades; the Gibbs Cancer Center
& Research Institute received the Outstanding Achievement
Award from the Commission on Cancer; and the American
Nurses Association lists SRHS among the nations top three
percent of hospitals for excellence in nursing.

Quick Facts

Hospital System: Spartanburg Regional Healthcare System, Spartanburg, SC

Solutions: RelayAssurance Plus, RelayAnalytics Pulse
Beds: 588 licensed in two facilities, plus a 97-bed long-term, acute-care hospital
Employees: More than 5,600
Medical Staff: More than 500 physicians

Credible, Relevant Peer Comparisons Made Easy

Introduction
Critical Issues
Results

Brian Earnest certainly believed that Spartanburg Regional

Healthcare System was holding its own against peer
hospitals in terms of billing efficiency and other key
performance indicators (KPI). However, actually getting and
interpreting the data to validate this was a time-consuming
and frustrating process before adopting RelayAnalytics Pulse.
Earnest would pore through research from presentations
he had attended that often contained out-of-date, standard
benchmark information that might or might not be relevant
to he and his peer hospitals. Another tactic would be to
spend a morning with Healthcare Financial Management
Association (HFMA) publications to try and find the data he
was looking for.
With RelayAnalytics Pulse, this information was immediately
available, current and trustworthy. For example, Earnest
explains he can say with certainty not only that Spartanburg
Regionals first pass rate on claims is 84.82% but also that it

compares favorably with the rate

of peer hospitals he has selected.
The first pass rate of those institutions
is 68.17%.

About Spartanburg Regional

Healthcare System
Quick Facts
Credible, Relevant Peer
Comparisons Made Easy
Tracking Relevant Key Performance
Indicators

It takes us a little longer to get claims

out the door following discharge, but
its paying dividends because our pass
rate is better and claims are being paid quicker, Earnest
says. Also when considering the workload and efficiency
impact of denials, including rework and the appeals process,
the small amount of extra time it takes to get the claim out
clean the first time is worth it in staff productivity returns
later. So while it may appear that we are behind on certain
measures, we come out ahead on the metrics that I think are
more important. We would not know this with any level of
confidence without Pulse.

Tracking Relevant Key Performance Indicators

Introduction
Critical Issues
Results

RelayAnalytics Pulse includes data from hundreds of hospitals that is updated daily and include historical
views. The dashboard is highly customizable and quick views of key performance indicators can even be
viewed on mobile devices. Earnest spent a little time during the go-live phase to set up parameters of
peer hospitals, nonprofit facilities of 500 or more beds in urban settings with Level 1 trauma centers.
Now he can look at a wide range of indicators at a glance, comparing Spartanburg Regional against
similar hospitals or against benchmarks, drilling down into areas where he wants more information.

About Spartanburg Regional

Healthcare System
Quick Facts
Credible, Relevant Peer
Comparisons Made Easy
Tracking Relevant Key Performance
Indicators

This gives me a quick snapshot of trends I might not have been aware of, Earnest says. If denials
spike, for example, I can see it immediately and drill down by payer or code to see whats going on. I like the green/yellow/
red indicators {exceeding, meeting or under-performing} that show our performance versus my peers so I know what my
ratio is and see when it changes.
In one instance, after noticing that the systems electronic fund transfer rate was slightly below the peer average, Earnest
looked deeper into the data and noticed one payer wasnt using EFT. That quick fix brought the system back to a normal range.
We choose Pulse because we have a long-standing relationship with RelayHealth, Earnest says. It easily integrated with the
other products we have and uses the claims data already flowing through RelayAssurance. There was virtually no setup on
our side to get it up and running.

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