Revenue Cycle Management and IT Operations Improvement at National PE-Backed Integrated Network of Eye Care Centers
October 30, 2023
Case Study Summary
FTI Consulting’s client is a leading national private equity-backed integrated network of full-scope ophthalmology, medical optometry, and eye surgery centers with over 1,000 providers.
In a desire to optimize and support rapid continued growth, the client engaged FTI Consulting to help improve and standardize its revenue cycle management (“RCM”) and IT operations, as well as other compliance and due diligence activities to support continued expansion.
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FTI Consulting completed a Revenue Cycle assessment and identified both short-term and longer-term opportunities for operational transformation and IT platform standardization, and to create greater value. We implemented “quick wins”, and to further drive performance transformation initiatives, the client approved our recommendation to design, develop, and implement a Center of Excellence (“CoE”) framework for integrating and standardizing its disparate practices. The CoE model included due diligence reviews, staffing recommendations, performance data analytics and monitoring, dashboard alignment, and credentialing of new providers.
The CoE rollout plan that FTI Consulting developed was effectively staggered to optimize results. A key component of the rollout plan was the launch of a pilot CoE as a test use case; the successful pilot program became the framework of standard guidelines and compliance for continued growth.
- FTI Consulting’s RCM assessment identified and implemented on an accelerated basis “quick wins” of approximately USD8 million in financial benefit. The recommended standardized CoE was estimated to drive a mid-point opportunity of USD80 million over a five (5) year period.
- FTI Consulting built a centralized revenue cycle reporting program within PowerBI, an interactive data visualization software product, for both client executives and day-to-day practice managers to manage their RCM performance. We standardized a data model for multiple, non-aligned practice management systems data sources, incorporating relevant key RCM performance indicators (“KPIs”) and providing written guidance to support standardized RCM reporting among current and new practices acquired in the future.
- Supported migration to commercially available practice management system from a homegrown solution, as well as an enterprise telephony system and bolt-on for patient intake; outlined minimum viable criteria, developed enterprise platform design, and facilitated system selection, and supported implementation.
- Project managed the centralization of remote call center operations utilizing updated workflows, policies and procedures, and KPIs aligned to leading practice to enhance patient and provider satisfaction. Created and rolled out a corporate wide physician template management policy and procedure. Consolidated appointment events/types by 80%.
- In addition, with FTI Consulting assistance the client selected and configured a new tool to satisfy denial reduction efforts, which now drives digital patient engagement and increased appointment rates. Over one three-month period, the client observed an increase of 14,000 appointments, yielding a net revenue increase of USD1.75 million.
As a result of our successful efforts, FTI Consulting has become a trusted advisor to the client who continues to call upon our team when new challenges arise.