Cogdell Memorial Hospital is a 25-bed Critical Access Hospital and Rural Health Clinic network in the heart of West Texas. Situated in Snyder, about 90 miles from Midland, Abilene and Lubbock, the campus at Cogdell provides a wide variety of medical services for residents of Scurry County and the surrounding areas, including an emergency department, walk-in clinic, obstetrics, hospice and radiology. As a Rural and Community Hospital, the nearest tertiary facility is 90 miles away.
After migrating to a new Electronic Health Record more than two years ago, Cogdell struggled with its complex chargemaster (CDM) infrastructure that covered multiple sites of service. With total patient revenue just over $70m and processing more than 100,000 claims annually, the health system experienced issues organizing, sorting and managing its chargemaster; the revenue cycle director reported that it was a chore to analyze CDM to identify problems related to unwanted variation and data integrity.
Cogdell started using Stroudwater’s Strategic Pricing Tool in late 2018. The web-based tool, coupled with expert consultation, allowed the hospital to gain control of its pricing methodology while eliminating variability and maximizing pricing integrity. Cogdell uses the Strategic Pricing Tool to monitor pricing compliance and review overall CDM integrity, with a focus on two of its most important, high-volume services: the emergency department and radiology.
What used to take the revenue cycle director hours can now be accomplished in a matter of minutes; issues are easy to identify, fix and modify for the entire revenue cycle team through simple analytics and reporting capabilities that are standardized, transparent and available at any time.
Cogdell now has data insights that allow it to guide discussions with managers across the hospital, especially department heads. For example, if a price below the Medicare fee schedule is identified, the revenue cycle department can easily provide the intelligence for a multidisciplinary team to agree on the most appropriate price – and use those new insights as educational opportunities for clinical staff.
Using the tool, the revenue cycle team complies with state and federal regulations including maintaining a consistent fee structure, calculating new prices based on Medicare fee schedules, identifying any variation (to be eliminated or defended), and isolating different charges for the same services across departments to ensure internal consistency and compliance with organizational policies and procedures.
Cogdell is so impressed with its results, it is now providing access to the Strategic Pricing Tool to even more hospital staff. The revenue cycle team plans to upload an updated CDM to ensure accurate updating of codes and charges that were modified; going forward, a new CDM will be uploaded and reviewed twice each year to develop a consistent, replicable process that ensures regulatory compliance and pricing effectiveness.