In response, the following reports were developed in Power BI:
Visual Claims Report
- Clear indication (via KPI) of greatest variance by RCM step.
- Heat-mapped flowchart illustrating which steps in the revenue cycle cause the most draw-down.
- From contracted rates to actual payments, pertinent info is grouped by procedure code, payer, and facility.
Expected vs. Actual Report
- Clear indication (via KPI) of greatest variance between Expected vs. Actual revenue by claim step, facility, and payer.
- List of transactions filtered by variance and sorted by magnitude to produce highest-value lists of revenue opportunities.
Rate Management Report
- Dynamic, multi-variable, what-if analysis to forecast the impact of proposed rate changes.
With easy ranking of transactions and clear visual indicators of issues impacting revenue, the company was able to focus their attention on the highest-return efforts and reduce the gap between expected vs. actual:
- Revenue variance and shortfalls improved when leadership and management gained the ability to clearly identify sources of variance at the process step, facility, and payer level.
- Operating efficiency increased and errors decreased after management and leadership began developing operating guidelines and procedures based on highest-impact variables.
- Standard Operating Procedure compliance increased through employee use of the heat-mapped, revenue-cycle flowchart because it provided a clear visual depiction of the Revenue Cycle Management Model.
- Profitability increased through code optimization and payor negotiations, as enabled by the Rate Management report. With the included what-if analysis, management was able to calculate the cost/benefit equation of proposed payer terms.