Objective

The Consolidated Patient Account Centers (CPAC) program was a congressionally mandated program that consolidated traditional Veterans Health Administration (VHA) business office functions into seven regional centers across the country. Each medical center maintained ownership of key Veteran-facing revenue cycle functions; e.g., eligibility, insurance capture, and coding, and utilizes medical center staff to provide these services. The remaining revenue cycle functions; e.g., insurance verification, billing, refunds, and co-pays, are performed at the CPACs. This initiative more closely aligned VHA billing and collection activities with industry strong practices and offered the best opportunity to achieve a superior level of sustained revenue cycle management. The CPAC program was mandated in 2008 and the VHA Chief Business Office (CBO) completed implementation of the seven regional centers in 2012.

The overall objective of Consolidated Patient Account Center business process assessment was to provide training/coaching in Systems Redesign methods so teams could facilitate implementation, examine methods to standardize reporting, synthesize strong practice recommendations and develop/utilize tools to facilitate productivity standards aligned with organizational goals in revenue management. The goal of this project was to assess the efficiency and effectiveness of key core business functions within the CPAC.

Methods

This presentation will cover the successes and challenges of the VAs move to a consolidated account center and its quest for continuous improvement in its move to industry leading revenue collection processes.

The engineering team visited each of the seven CPAC sites for two weeks. At each site the team conducted process mapping sessions, created flow maps of the current state process and validated the process through direct observation. The team designed appropriate time studies and obtained cycle time data for each of the processes. Observed cycle time was compared to shift cycle time to check for accuracy. Finally, the team produced a detailed report of the current state and an analysis of findings.

Results

The team collected extensive data during fourteen weeks on the road. The rich data set will form the baseline for CPAC processes and will be the starting point for future improvement projects and details a list of 30 specific recommendations for improvement. The team expects these ample data and recommendation to spawn additional studies and pilot projects. This exploratory project was vital in the CPAC’s quest for continuous improvement. CPAC site visits provided an opportunity to observe and gather data on various departments’ internal business processes. During site visit, strong support and cooperation was shown by leadership and CPAC staff.

CPAC observation and data collection through time study process helped to determined baseline measure for selected departments. Baseline measure is a preliminary approximation as not all CPACs were considered during data collection due to site visit schedule and duration. A thorough study is required across all CPACs and departments to determine an actual baseline measure, standardize processes and implement proper handoff processes. The recommendations provided will have significant impact on per claim processing time, productivity standard and employee satisfaction.

These recommendations are preliminary and determined based on data, staff comments and observation. Further study is required before implementing any solutions.

Objective

The Consolidated Patient Account Centers (CPAC) program was a congressionally mandated program that consolidated traditional Veterans Health Administration (VHA) business office functions into seven regional centers across the country. Each medical center maintained ownership of key Veteran-facing revenue cycle functions; e.g., eligibility, insurance capture, and coding, and utilizes medical center staff to provide these services. The remaining revenue cycle functions; e.g., insurance verification, billing, refunds, and co-pays, are performed at the CPACs. This initiative more closely aligned VHA billing and collection activities with industry strong practices and offered the best opportunity to achieve a superior level of sustained revenue cycle management. The CPAC program was mandated in 2008 and the VHA Chief Business Office (CBO) completed implementation of the seven regional centers in 2012.

The overall objective of Consolidated Patient Account Center business process assessment was to provide training/coaching in Systems Redesign methods so teams could facilitate implementation, examine methods to standardize reporting, synthesize strong practice recommendations and develop/utilize tools to facilitate productivity standards aligned with organizational goals in revenue management. The goal of this project was to assess the efficiency and effectiveness of key core business functions within the CPAC.

Methods

This presentation will cover the successes and challenges of the VAs move to a consolidated account center and its quest for continuous improvement in its move to industry leading revenue collection processes.

The engineering team visited each of the seven CPAC sites for two weeks. At each site the team conducted process mapping sessions, created flow maps of the current state process and validated the process through direct observation. The team designed appropriate time studies and obtained cycle time data for each of the processes. Observed cycle time was compared to shift cycle time to check for accuracy. Finally, the team produced a detailed report of the current state and an analysis of findings.

Results

The team collected extensive data during fourteen weeks on the road. The rich data set will form the baseline for CPAC processes and will be the starting point for future improvement projects and details a list of 30 specific recommendations for improvement. The team expects these ample data and recommendation to spawn additional studies and pilot projects. This exploratory project was vital in the CPAC’s quest for continuous improvement. CPAC site visits provided an opportunity to observe and gather data on various departments’ internal business processes. During site visit, strong support and cooperation was shown by leadership and CPAC staff.

CPAC observation and data collection through time study process helped to determined baseline measure for selected departments. Baseline measure is a preliminary approximation as not all CPACs were considered during data collection due to site visit schedule and duration. A thorough study is required across all CPACs and departments to determine an actual baseline measure, standardize processes and implement proper handoff processes. The recommendations provided will have significant impact on per claim processing time, productivity standard and employee satisfaction. These recommendations are preliminary and determined based on data, staff comments and observation. Further study is required before implementing any solutions.

Shaiju Eapen

Affiliation

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Assessment of Business Processes in Consolidated Patient Account Centers