client

Client

Large urban academic center

situation

Situation

Client needs included:

  • Decrease Medicaid patient “no shows” in client’s clinics
  • Identify socioeconomic and cultural factors contributing to this problem
howwehelped

How We Helped

  • Measured current “no show” rates in outpatient settings
  • Determined what has been done to date to reduce “no shows”
  • Conducted focus groups to determine socioeconomic and cultural factors that may decrease “no show” rates
  • Performed root cause analysis for “no shows”
  • Implemented sustainable, short and long term process workflow and operational improvements

Consultant Team

  • 1 experienced revenue integrity analyst, 1 socioeconomic analyst, and, 1 or 2 cultural analysts and 1 experienced project lead in socioeconomic/cultural cues related to scheduling or operations
  • Experienced professionals and data analysts trained on process improvement methodologies with prior healthcare delivery, revenue integrity and revenue capture experience
outcome

Outcome

RGP’s Project Team contributions:                

  • Increased lost Medicaid revenue
  • Increased Medicaid revenue margin from “sunk costs”
  • Improved clinical outcomes for patients, particularly in areas like infusion therapy, neurology, and dialysis
  • Prevented unnecessary ED visits by patients
  • 5-10% reduction in Medicaid patient “no shows” in client’s outpatient clinics
  • 5-10X ROI depending on the total number of patients and individual Medicaid reimbursement