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McKesson develops innovative revenue management solution for health systems

McKesson UK : 19 June, 2008  (New Product)
McKesson has developed Horizon Enterprise Revenue Management which combines innovative rules-based software, connectivity services and the best practices of more than 30 years collaborating with hospitals and health systems, physicians, payors and financial institutions.
The goal of the development is to provide a new, open solution that enables health systems to streamline patient access to services, connect with key business partners such as payors and banks, and determine financial responsibility for all constituents before and during care.

Throughout the care process, clinical integration helps to support decision making and enables continuous medical necessity checking, coordinated care planning and case management. The solution will also better enable financial managers to predict cash flow and net revenue by understanding the payment history by payors and anticipated patient throughput. To date, nine organizations have contracted for the new solution, with initial studies estimating an average of up to $7.4 million in potential annual benefits per organization once the solution is fully deployed.

“Horizon Enterprise Revenue Management extends far beyond the latest hospital information systems, which have failed to deliver incremental workflow efficiencies and financial improvement,” said Pamela Pure, president, McKesson Technology Solutions. “This new solution will reinvent the entire financial process, integrating with the customer’s existing clinical system and helping the organization proactively manage the economic implications of delivering care. Simply stated, McKesson wants to deliver a solution that enables a dramatic positive impact on the customer’s bottom line. That can’t be accomplished by ‘bolting on’ niche products to mature hospital information systems.”

McKesson has built its solution to be ‘open’, working seamlessly with both McKesson and non-McKesson clinical solutions and facilitating real-time connections with patients, payors, banks and suppliers. Horizon Enterprise Revenue Management draws on the power of McKesson’s extensive portfolio, featuring new provider-based software, RelayHealth connectivity services, and access to the InterQual gold-standard clinical decision support criteria used by payors and providers across the USA.

Horizon Enterprise Revenue Management addresses the consumer, healthcare access and business management needs that are common to all healthcare organizations. “With this system, we’re reinventing the way a consumer interacts with the health system, and we’re moving many of the administrative tasks currently performed after care is received to the front of the care process,” said Duncan James, group president, Health Systems Solutions, McKesson Provider Technologies. “By doing so, we estimate that we can help reduce the days to submit a clean claim by 50 percent from the time of discharge. Our ultimate goals are to enable automated, real-time adjudication upon patient discharge, streamline the patient’s interaction with the health system and provide more online capabilities.”

Gwinnett Health System in Lawrenceville, Georgia, USA, will soon go live with Horizon Access Management, a part of Horizon Enterprise Revenue Management, using it as a catalyst to re-engineer scheduling, registration and other patient processes. “One benefit of this new solution will be to enhance workflow and automation management. For example, information we currently have to search for after a patient is gone will be captured electronically at the point of service,” said Cathy Dougherty, assistant vice president, Revenue Management, Gwinnett Health System. “Our goal is to significantly improve productivity and, ultimately, the level of service we will be able to provide to our patients.”

Tommy McBride, executive vice president and chief financial officer, Gwinnett Health System, added: “With the Horizon Enterprise Revenue Management platform, we have the opportunity to completely reinvent our organization, our processes and even our relationships with payors and other constituencies so we will be better equipped to address future revenue management challenges. This is just one of the many ways that we are transforming the delivery of healthcare in Gwinnett through Project PATH, our strategic vision.”

McKesson provides several options to help healthcare organizations manage their journey to improving the economics of care. The company brings a range of Managed Services to ease the transition, including extensive implementation expertise and resources as well as services to accelerate deployment. For organizations that wish to avoid the upfront capital costs and ongoing maintenance of large-scale systems, McKesson provides remote hosting and revenue cycle outsourcing services for a predictable monthly fee. As a result, healthcare organizations are poised to quickly turn their financial results in the right direction, realising benefits such as improved productivity, increased revenues, enhanced billing efficiency and lower cost of ownership.

“With the enterprise revenue management category, we are not just advocating change,” Pure said. “We are making it happen by giving organizations the vision, a powerful solution and the support to reinvent their financial world so they can achieve the success needed to deliver the high-quality care and customer service that patients deserve.”
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