Trinity Health: Revenue Management Operating Model – Unified Revenue Organization

Shifting market, environmental and regulatory circumstances led Trinity Health toward a transformation of its operating model. Up until this point, Trinity’s revenue management function had been discrete—separated among each of its 20 ministry organizations (MOs).

To truly take advantage of the skill, scope and size of its organization, Trinity landed on creating a shared services organization (called a “Unified Revenue Organization”) to manage the end-to-end revenue cycle functions across all of its hospitals. The Unified Revenue Organization’s (URO) operating responsibility includes managing payer contracts, patient financial services, patient access, health information management and reimbursement activities.

Trinity’s URO leadership chose Accenture to provide strategic and project management support for more than four years—from concept all the way to implementation. We helped Trinity develop a robust business case to sell its ministry organization CEOs and CFOs on the plan.

During the course of the project, Trinity made key decisions around design and came up with solutions to meet its complex operating model needs. Together, Trinity and Accenture determined which revenue management functions would be most effective using local, regional or centralized models.

Trinity ultimately developed an operating model and methodology to migrate revenue management functions to a national or regional shared services model.

Trinity Health’s URO is a striking and significant example of a Unified Service Organization (USO). It operates cohesively within the healthcare system’s Unified Enterprise Ministry strategy, and Trinity leadership and management view the project as a major success. The path we took to develop the URO is a template for similar efforts, frequently used to inform other USOs along a comparable development plan.

The engagement also illustrates the benefits of establishing a regional/central shared services organization. Standardized leading practices and processes helped Trinity reach higher levels of performance.

There were several key factors in the URO’s transformation into a high-performance business:

• A cultural renewal at Trinity Health from a traditional corporate holding company into a true operating model.
  
  
• An evolution for executives and managers at ministry organizations (MO) from largely transaction-based duties to more strategic business development and patient-focused functions.
  
  
• Continual communication and steady involvement with Trinity MO CFOs and functional leaders in the design of the URO to gain overall buy-in on leading practice processes and metrics.

• Trinity has seen incremental and protected revenue of more than $500 million in internally audited value, exceeding its five-year target in just three years.
  
  
• The revenue control environment has shown remarkable improvement with ongoing regulatory updates to more than 900 recipients and an upgrade to a standard net revenue estimation/reporting model.
  
  
• All MOs now have active clinical documentation improvement programs with regular monitoring of critical success factors.
  
  
• Trinity lowered its system consolidated gross days in accounts receivable from 51 days to 45 days.