Holy Spirit Health System: Financial and Operational Improvements

Holy Spirit Health System faced declining payment rates from government and third-party payers, rising contractual adjustments and uncompensated care. Increases in labor and supply costs, as well as the growing need to invest in facilities, equipment and information technology added to the pressure.

In its efforts to achieve high performance, Holy Spirit recognized the opportunity to achieve its financial objectives by developing a comprehensive performance improvement program that would shape the hospital’s mission and ministry for years to come. For help in identifying industry benchmarks and best practices and then assessing specific improvement opportunities, Holy Spirit turned to Accenture. When it came time to implement certain recommendations that Accenture proposed, Holy Spirit once again selected Accenture.

Client Background
Holy Spirit Health System is a 332-bed, full-service hospital located in Camp Hill, Pennsylvania. Sponsored by the Sisters of Christian Charity, the hospital serves communities in the greater Harrisburg area and South Central Pennsylvania.

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In its efforts to achieve high performance, Holy Spirit recognized the opportunity to achieve its financial objectives by developing a comprehensive performance improvement program that would shape the hospital’s mission and ministry for years to come.

For help in identifying industry benchmarks and best practices and then assessing specific improvement opportunities, Holy Spirit turned to Accenture. In addition to having broad consulting expertise and deep insights into the health care industry, Accenture had demonstrated its ability and commitment to helping other hospitals in the area achieve their ambitious financial and performance goals. During this two-month phase of work, Accenture helped develop an improvement agenda that would potentially result in cost savings for Holy Spirit in excess of US$15 million.

When it came time to implement certain recommendations that Accenture proposed, Holy Spirit once again selected Accenture. The decision to hire Accenture for this important phase of work was based on Accenture’s proven ability to work side-by-side with Holy Spirit resources, its commitment to transferring knowledge and skills to Holy Spirit’s managers, and the dedication of its subject matter advisors to launch—and accelerate, as appropriate—improvement initiatives that would lead to high performance.

Accenture worked closely with Holy Spirit resources to build and implement project management, initiative measurement and program monitoring capabilities. To help bolster Holy Spirit’s operating efficiencies and effectiveness, Accenture worked with hospital staff over a nine-month period to:

• Implement patient care unit-based effectiveness dashboards to track and report quality, service and financial indicators on a daily basis.
  
  
• Implement tools, policies and procedures that allow the hospital to continually align patient care staffing levels with patient volumes, despite fluctuations over time.
  
  
• Reduce medically unnecessary patient days by instituting new policies and procedures such as reviewing patient progress in daily nursing “huddles,” tracking excess days by diagnosis and by nursing unit, and realigning care manager case loads to be consistent with industry standards.
  
  
• Develop strategies to improve the effectiveness of the operating room and peri-operative service management activities.
  
  
• Consolidated testing sites and hours of operation of inpatient and outpatient laboratories to maximize service levels and cost efficiency.
  
  
• Redesign inpatient specimen collections processes to improve testing turnaround time.
  
  
• Identify cross-training opportunities for technical personnel within key departments such as laboratory and radiology.
  
  
• Review existing staffing patterns and workflow processes within the radiology department to identify areas for improvement and cost savings.
  
  
• Redesign supply chain processes to maximize pricing, standardization and utilization of medical supplies and purchased services.

At the same time, the Accenture team collaborated with Holy Spirit’s finance organization to drive improvements across Holy Spirit’s revenue cycle. Specific activities included:

• Implementing enterprise-wide charge capture protocols, as well as management, tracking and reconciliation processes to ensure that charges are captured accurately and in a timely manner.
  
  
• Inventorying existing patient accounts receivables, recommending processes for improving the timeliness with which accounts are settled, and overseeing temporary staff charged with minimizing the accounts receivable backlog.
  
  
• Improving reporting and processes to reduce discharged-not-final-billed days.
  
  
• Formalizing transaction coding, guidelines and processes to proactively manage third-party payment denials.

In addition, Accenture developed and maintained a Results Management Office (RMO) to maximize Holy Spirit’s return on investment. As the project was nearing completion, Accenture transitioned the RMO and the management and monitoring of improvement initiatives to Holy Spirit managers through “side-by-side” leadership and mentoring. This approach facilitated the transfer of knowledge and skills from Accenture to Holy Spirit leadership in order to sustain results over time.

With Accenture’s help, Holy Spirit Health System dramatically improved its financial position by launching a series of initiatives aimed at decreasing costs and using capital and labor more effectively.

Throughout the project, Holy Spirit exceeded its monthly cost savings targets. Within eight months of the program’s inception, Holy Spirit’s efficiency initiatives had already generated savings of $10 million, or 87 percent of its three-year goal. Based on this success—and equally impressive results in other improvement categories—the Holy Spirit and Accenture team valued the final improvement agenda at $21.2 million–$27.6 million. This significantly exceeded the original three-year target of $15.9 million.

Clearly, Holy Spirit has forged a path to high performance. Today, hospital managers are continuing to implement and manage the remaining improvement agenda initiatives. With Accenture’s keen focus on transferring project management responsibilities and know-how—as well as its development of enhanced tools such as an executive dashboard, key performance indicators and monthly variance reports—Holy Spirit is well equipped to manage and monitor the operational and financial health of the organization for years to come.

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