How Prisma Health improved cash flow and clinical quality outcomes by outsourcing RCM
Prisma Health, a not-for-profit health organization in South Carolina, had three different companies on three different electronic health records (EHRs), with AR also split across three systems. The result was significant underperformance when it came to financials and low Star ratings, signifying clinical quality issues.
In a recent case study, we explored how Prisma Health turned to HEALTHCAREfirst, now known as MatrixCare, to make changes across their entire organization — delivering higher Star ratings and increased revenue along the way. Here are three steps they took to achieve this success.
1. Leave no staff behind
Offering both one-on-one and group education, the transition to MatrixCare went well beyond the shift to outsourced RCM and clinical documentation review. Education and training are continued through the partnership to keep every facet of the organization in tune with new regulations and compliance measures.
“In addition to group education for OASIS version changes, such as the most recent change to OASIS-E, we had significant immediate improvement in OASIS outcomes with one-on-one training for team members who had more corrections than others.”
– Landace Woods, RN, MSN, NEA-BC, Director, CQI and Accreditation, Post-acute Care, Prisma Health
2. Keep communication open
While weekly meetings may seem like a common occurrence for any business, the commitment to connect regularly is MatrixCare’s hallmark to successful long-term partnerships. These meetings opened discussions to gain an initial understanding of what each other’s needs were and to explore creative ways to tackle the latest challenges.
“We allow ourselves to be flexible to meet or exceed the customer expectation. Then if we can tweak to address a specific business problem, that’s where the partnership comes in.”
–Jeremy Crow, Head of RCM and Survey, MatrixCare
3. Approach it like a marathon, not a race
For long-term, lasting results, Prisma Health needed to trust the process — and they did. While it’s been a long road, their patience and dedication has paid off, and they found a true partnership along the way.
“We can’t fix everything all at once, so we’re going to incrementally improve. And I felt like that was on both sides so that you achieve goals one bite at a time.”
– Liz Snyder, Executive Director of Home Health, Hospital at Home and Hospice, Prisma Health
Significant wins for a significant partnership
Prisma Health and MatrixCare built a deeply trusted partnership that worked to create solutions to challenges, both significant and small. Since onboarding, Prisma Health has seen many significant wins, including:
- Increased cash flow
- Improved Star ratings
- A near-perfect collection rate
This partnership has been a thoughtful approach to truly effective outsourced RCM and clinical documentation review, and has been used across the greater Prisma Health system as something to emulate and learn from.
Connect with MatrixCare today to learn how you can improve your organization.
MatrixCare
MatrixCare provides an extensive range of software solutions and services purpose-built for out-of-hospital care settings. As the multiyear winner of the Best in KLAS award for Long-Term Care Software and Home Health and Hospice EMR, MatrixCare is trusted by thousands of facility-based and home-based care organizations to improve provider efficiencies and promote a better quality of life for the people they serve. As an industry leader in interoperability, MatrixCare helps providers connect and collaborate across the care continuum to optimize outcomes and successfully manage risk in out-of-hospital care delivery.
MatrixCare is a wholly-owned subsidiary of ResMed (NYSE: RMD, ASX: RMD). To learn more, visit matrixcare.com and follow @MatrixCare on X
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