From Intake through Reimbursement: Are All of Your Programs Fully Utilizing your EHR?


There is no shortage of challenges for today’s Human Service Agencies. Staffing Levels, Staff Retention, Financial Management, Readiness for Value Based Reimbursement, and dare we mention Growth…are all top of mind for Agency Leadership.


As we begin to enter an Endemic Phase of COVID and assess the impacts, Agencies are looking for opportunities to see and understand Key Performance Indicators that relate to the challenges above. These are the management insights that create competitive advantage.


The Keys are “Standardization, Operational Efficiency, and Control with a wrapper of Consistency”.


Meaningful Investments have been made on Operational and Financial Systems, but two things are lacking: Utilization & Optimization of the EHR across all Programs.


The evolution of the Electronic Health Records (EHR) Systems have been part of the landscape for years. Yet many agencies are not utilizing these expensive systems fully…far from it!


Many Agencies with multiple Service Lines have a bunch of half-baked cakes when it comes to utilization of the EMR/EHR Systems. Some Program areas are using the system for a majority, but not all the system capabilities, while other Program areas are still on Spreadsheets or worse.


This creates a domino effect when it comes to reimbursements. Fiscal staff levels are higher than necessary to compensate for EHR underutilization, which then drives up Human Capital Cost as well as a slower turn getting money back into the Agency. Staff is also performing a ton of manual work to translate and submit reimbursements to payers because of the low level (to no level) use of the EHR. Payers are all too happy to kick them back which now adds to the inefficiencies of the Fiscal staff and then passed on into Service Delivery. It’s a vicious cycle.


And even more important – we lack Clean Data when such a mix of manual and partial automation is at play.


In the end – Those with an “Optimized EHR from Intake through Reimbursement” – win!


Where do we go from here?

  1. Agency Leadership must commit to the goal of improvement. (ALL FOR ONE AND ONE FOR ALL)

  2. “A Plan” must be developed with the goal of defining and standardizing with defined outcomes one Program Area at a time. (START WITH THE END IN MIND)

  3. Programs must form a team of champions to have brutally honest dialog about how they currently manage their area with a goal of identifying how the EHR is being leveraged and how much occurs outside of the system(s). (FIRST SEEK TO UNDERSTAND, RATHER THAN BE UNDERSTOOD)

  4. Cross Reference to Fiscal to determine effectiveness of Services Performed to Reimbursements and identify gaps. (DETERMINE IMPACTS)

  5. Get Outside Help that is knowledgeable, capable, and functions as a partner to build the path forward. (UNBIASED, HONEST INPUT & STANDARDIZED BEST PRACTICES ARE A MUST)

The same must occur if an Agency is looking to change their EHR. There is work that needs to be done in advance of engaging the Software Vendor. This establishes a framework and begins the process of “Defining Accountability” when engagement begins.


To schedule a free EHR System Optimization consultation with a member of the enkompas team, click here.

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