Arlington Orthopedic Associates P.A. is one of the largest orthopedic practices in North Texas, and it’s about to get even bigger. By running all of its business analytics in the cloud, the Lone Star State specialty healthcare provider has discovered new ways to grow its practice, despite increasing regulatory compliance costs and adjusted physician reimbursement rates spurred, in part, by the Affordable Care Act (ACA).
Since its passage in 2010, the ACA has helped nearly 20 million Americans who previously couldn’t afford or qualify for traditional policies get access to health insurance. But unifying the US healthcare industry in a fight against economic inequity requires technology, staff, and expertise that many medical practices can’t afford.
Arlington Orthopedic Associates CEO Barry Howell (center) and staff, including RN Loren Lopez and Dr. Jim Burnett, turned to Oracle Business Intelligence Cloud Service to help deliver higher-quality healthcare at much lower costs. (Photo courtesy of Arlington Orthopedic Associates P.A.)
“The Affordable Care Act legislation has ushered in a new age of healthcare,” says Arlington Orthopedic CEO Barry Howell.
This new age means complying with ACA mandates that include an electronic health record (EHR) system—a digital collection of patient health information covering everything from demographics and immunizations to existing conditions and treatment histories—as well as new fee structures for physician services.
Finding Balance
To increase the quality of healthcare while keeping costs in check and fulfilling ACA requirements, Arlington Orthopedic had to completely restructure multiple silos of physician, patient, and financial data—a difficult process involving more than a decade of mashed-up historical information.
“When we first started this process, our systems were a mess,” recalls Howell. “We had profit-and-loss data loaded into our accounting software, and accounts receivable information sitting in our patient health system.”
Because this data required a lot of manual manipulation in order to view and analyze it, if the project wasn’t mission critical, “it just didn’t get done,” says Howell.
Howell admits that figuring out a viable solution was not easy. “We just didn’t have the resources to hire 200 analysts and software programmers to custom develop our own analytics software,” says Howell. “We also didn’t have the money to buy 40 servers—let alone find a place to put them.”
What Howell and his team did know, however, was that they were going to be held accountable for delivering higher-quality healthcare at much lower costs.
So in January of this year, Arlington Orthopedic moved all of its analytics from an on-premises reporting environment to Oracle Business Intelligence Cloud Service.
According to Steve Chamberlin, managing partner for Sensa Analytics, the implementation partner for Arlington Orthopedic, similar on-premises data migrations average nine months to a year to complete, but “using Oracle Business Intelligence Cloud Service, we were able to start moving Arlington’s data models and create customizable dashboards within a day,” he says.
Tracking the Quality of Care
Because the data coming into Oracle Business Intelligence Cloud Service can be updated nightly, Arlington is able to look at physician productivity on a daily basis, providing the practice with immediate insights into the exact number of patients seen within a single clinic, the volume and dollar amount of accounts receivables, and the rates of patient recovery.
This knowledge “helps us make really important management decisions when it comes to staffing, compensation, clinic operations, and patient health,” says Howell.
- Related: Learn more about Oracle Business Intelligence Cloud Service
Before moving to the cloud, Arlington struggled to make informed decisions, and many of Arlington’s physicians were asking questions that Howell and his executive team couldn’t answer.
“Our physicians wanted to know how they were performing relative to other physicians in our practice, where the majority of their patients were coming from, and what their specific clinic utilization rates were,” says Howell. “We had no way to provide timely and accurate answers with the limited resources we had.”
So when it came time to create the new analytics dashboards, Arlington enlisted its physicians to design them.
Using the configurable dashboard templates and interactive data visualization in Oracle Business Intelligence Cloud Service, physicians now can track the efficacy of their treatments, the time they spend with their patients, and how many patients they treat each day in each of Arlington’s four clinics. In the next phase of this project, physicians will also be able to see how they rank against other physicians relative to population health management and patient recidivism.
Real Cost of Change
With the ACA’s new fee structures for physician services, Arlington also needed a faster, more reliable way to track payment contracts with insurance companies—and then compare the contracted rates against actual, received payments.
But making these comparisons with 16,000 procedure codes for the 70,000 patients it expects to see before the end of 2016 was complicated.
Because just one surgery can have as many as five procedure codes, the sheer volume of billing information made it nearly impossible for Arlington’s staff to efficiently analyze and prepare claims.
“It was really difficult to know if we were submitting the claims correctly or not,” says Honey Ranario, CFO for Arlington Orthopedic. “If we made a mistake and a claim was denied, we ended up with less revenue.”
With the new cloud system, however, alerts are automatically sent to physicians the instant their billings and receivables don’t match. Physicians can then look to see if they forgot to submit the proper form or authorize a claim. According to Ranario, such efficiencies from Oracle Business Intelligence Cloud Service have helped Arlington speed up claim investigations, leading to a revenue increase of 18%.
Manage What You Measure
For Arlington Orthopedic, the future of healthcare—and orthopedic medical practices in particular—is in creating a brand that people want to connect with and can trust. “We want our patients to feel that they are receiving a better service from our practice than they would from another,” says Howell.
That is precisely what cloud analytics is helping Arlington to do. “When we track things and measure things, we don’t just think we’re better; we know we are—and we can prove it,” says Howell.
