The COVID-19 pandemic represents one of the greatest ﬁscal challenges to the U.S. healthcare system. The coronavirus cost the system about $500 billion in revenue in the ﬁrst quarter of 2020, according to Dr. David Shulkin, former secretary of Veterans Affairs and former president and CEO of Beth Israel Medical Center, New York. “In general, the average hospital has seen a 40 to 45 percent decrease in operating revenues during this time,” said Dr. Shulkin.
Kaufman Hall’s National Hospital Flash Report said margins improved signiﬁcantly for most hospitals from April to May due to funding from the federal emergency CARES (Coronavirus Aid, Relief and Economic Security) Act and an uptick in volume. But they are still well below 2019 levels. Shortfalls are mainly due to the cancellation of elective procedures and fewer emergency room visits.
With many hospitals in cost-cutting mode via furloughs and other aggressive actions, it seems logical that investing in an active legacy patient accounts archive would be low on their list of priorities. But some reports show that as much as 60 to 80 percent of hospital IT budgets are spent maintaining legacy applications and their mainframe components. An active PA archive can save millions of dollars and avoid data loss that can lead to noncompliance with federal guidelines and issues with cash ﬂow. For example, Yale New Haven (Conn.) Health saved $2.6 million annually in legacy costs when it went from ﬁve EHRs to one and integrated that system with a MediQuant revenue cycle and active legacy data platform.
But even if the expense of an active PA archive is worth it, the task itself can be daunting. There are operational concerns, such as establishing appropriate personnel, workﬂow, policies and procedures for resolving legacy account receivable claims. And there are technological concerns that can lead to incorrect billing and noncompliance if not properly addressed.
Here are some key considerations on how to handle legacy patient accounts data archiving.
Don’t go it alone
Using an experienced partner who is with hospitals every step of the way speeds the process of moving from legacy systems into a data archiving solution. The vendor also will conduct data validation to make sure everything maps accordingly.
Consider the active archive solution
Too often, legacy data is sitting in an old system managed by an outside vendor, resulting in high vendor fees and squandered staff resources. Other times, data is transferred to low-functioning archives that serve as “cold storage.” That means fresh AR collectives can be stuck in archives instead of being available for further run downs, resulting in a revenue hit.
By properly analyzing their needed level of functionality, hospitals can ﬁnd their AR storage and handling sweet spot. Rather than pay to keep the lights on for an out-of-production system or transfer data to what is essentially a dead ﬁle, they can save time and money by transferring patient accounts legacy data to a legacy PA/PM billing and follow-up system archive. This single, secure and active solution allows for continued AR functionality, including work downs. The system may not look exactly like the legacy system, but it should be easier to work with.
Archive and work down accounts
Hospitals often assume everything should be worked down to a zero balance before archiving. In fact, newer technology allows quick archiving while working down accounts, making for an easier and more cost-effective transition and offering improved business productivity. Records remain active for continued billing and reporting, and users have all the necessary functionality of their old system without the unnecessary maintenance expense.
Do a clean sweep
There should be built-in checks and balances to ensure legacy data is accurately transferred to the active archive, with red-ﬂag alerts and ﬁxes along the way. Missing ﬁles, incorrect information and numbers that don’t add up are common, mostly due to multiple information sources (controller reports, balance reports, insurance, etc.), computer glitches and human error. It’s important to do a clean sweep of data.
Set realistic goals
It’s necessary to build in realistic timetables, including cushions for setbacks. Proper archiving of legacy ﬁnancial data can take an average of four to six months to complete and up to nine months before the old system can be retired. But the result — up to an 80 percent reduction in costs — is worth it. Especially now.