IHP 630 Module Seven Activity Guidelines and Rubric

4/10/24, 10:19 AM Assignment Information

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IHP 630 Module Seven Activity Guidelines and Rubric

Overview

In this module, you learned about the signi�cance of key performance indicators (KPIs) at various stages of a revenue cycle. You also explored how KPIs impact strategic planning and boost

�nancial performance.

In this assignment, you will analyze whether a healthcare organization is meeting its KPIs and write an executive summary to share your �ndings.

This assignment will help you apply revenue-cycle principles to data analytics and evaluate the signi�cance of KPIs in strategic planning and �nancial performance. It will also help you prepare

for section 5 (Revenue-Cycle Process) in the course project.

Directions

Using the provided revenue-cycle dashboard in the Module Seven Activity Dashboard, analyze the data in the dashboard to determine whether the organization is meeting its KPIs. Then write

an executive summary discussing your analysis.

Your executive summary should have short paragraphs for each rubric criterion, with clearly marked paragraph headers. You may refer to the relevant “Activity Reading” resource in the

Module Resources section to better understand how an executive summary is structured. If you need writing support, access the Online Writing Center through the Academic Support module

of your course.

Speci�cally, you must address the following rubric criteria:

1. Revenue-Cycle Dashboard: Summarize at least two KPIs from the front end, two from the middle, and two from the back end of the revenue cycle, as well as why you believe these KPIs

will demonstrate whether the organization is meeting its KPIs or not.

2. Front-End KPIs: Examine the possible cash-�ow issues and operational improvement possibilities of at least two front-end KPIs in the revenue-cycle dashboard of the chosen

organization. Consider the following questions to guide your response:

How would you de�ne the KPIs you identi�ed from the front end?

How would these KPIs inform the organization of potential future cash �ow issues?

How do the KPIs inform the organization of operational-improvement opportunities?

3. Middle KPIs: Examine the possible cash-�ow issues and operational improvement possibilities of at least two KPIs from the middle of the revenue-cycle dashboard of the chosen

organization. Refer to the guiding questions for the “Front-End KPIs” in number 2 above for additional guidance.

4. Back-End KPIs: Examine the possible cash-�ow issues and operational improvement possibilities of at least two KPIs from the back end of the revenue-cycle dashboard of the chosen

organization. Refer to the guiding questions for the “Front-End KPIs” in number 2 above for additional guidance.

5. Metrics Analysis: Analyze the metrics on the dashboard to determine whether the organization is meeting its KPIs or not. Consider the following questions to guide your response:

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How is the dashboard notifying the leader if any metrics are not being met?

How would you determine that the metrics are not being met if the dashboard had no visual cues?

All the claims in your deliverable should be evidence based. Your citations should be from your independent search for evidence (not from the textbook, or module resources) of credible

sources and be current within the last �ve years. You are required to cite a minimum of two sources, at least one of which should be separate from your own research. Refer to the IHP 630

Library Guide located in the Start Here section of the course for additional support.

What to Submit

Submit your executive summary as a 4- to 5-page Microsoft Word document with double spacing, 12-point Times New Roman font, and one-inch margins. Add a title page. Sources should be

cited according to APA style.

Module Seven Activity Rubric

Criteria Exemplary (100%) Pro�cient (90%) Needs Improvement (70%) Not Evident (0%) Value

Revenue-Cycle Dashboard Exceeds pro�ciency in an

exceptionally clear and

insightful manner, using

industry-speci�c language

Summarizes at least two KPIs

from the front end, two from

the middle, and two from the

back end of the revenue cycle,

as well as why these KPIs will

demonstrate whether the

organization is meeting its KPIs

or not

Shows progress toward

pro�ciency, but with errors or

omissions

Does not attempt criterion 10

Front-End KPIs Exceeds pro�ciency in an

exceptionally clear and

insightful manner, using

industry-speci�c language

Examines the possible cash-

�ow issues and operational

improvement possibilities of at

least two front-end KPIs in the

revenue-cycle dashboard

Shows progress toward

pro�ciency, but with errors or

omissions

Does not attempt criterion 15

Middle KPIs Exceeds pro�ciency in an

exceptionally clear and

insightful manner, using

industry-speci�c language

Examines the possible cash-

�ow issues and operational

improvement possibilities of at

least two KPIs from the middle

of the revenue-cycle dashboard

Shows progress toward

pro�ciency, but with errors or

omissions

Does not attempt criterion 15

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Criteria Exemplary (100%) Pro�cient (90%) Needs Improvement (70%) Not Evident (0%) Value

Back-End KPIs Exceeds pro�ciency in an

exceptionally clear and

insightful manner, using

industry-speci�c language

Examines the possible cash-

�ow issues and operational

improvement possibilities of at

least two KPIs from the back

end of the revenue-cycle

dashboard

Shows progress toward

pro�ciency, but with errors or

omissions

Does not attempt criterion 15

Metrics Analysis Exceeds pro�ciency in an

exceptionally clear and

insightful manner, using

industry-speci�c language

Analyzes the metrics on the

dashboard to determine

whether the organization is or

is not meeting its KPIs

Shows progress toward

pro�ciency, but with errors or

omissions

Does not attempt criterion 20

Articulation of Response Exceeds pro�ciency in an

exceptionally clear and

insightful manner

Clearly conveys meaning with

correct grammar, sentence

structure, and spelling,

demonstrating an

understanding of audience and

purpose

Shows progress toward

pro�ciency, but with errors in

grammar, sentence structure,

and spelling, negatively

impacting readability

Submission has critical errors in

grammar, sentence structure,

and spelling, preventing

understanding of ideas

10

Scholarly and Professional

Sources

Incorporates more than two

scholarly, current (within the

last �ve years) sources, or use

of sources is exceptionally

insightful

Incorporates two scholarly,

current (within the last �ve

years) sources that support

claims

Incorporates fewer than two

scholarly, current (within the

last �ve years) sources, or not

all sources support claims

Does not incorporate sources 10

APA Style Formats in-text citations and

reference list according to APA

style with no errors

Formats in-text citations and

reference list according to APA

style with fewer than �ve

errors

Formats in-text citations and

reference list according to APA

style with �ve or more errors

Does not format in-text

citations and reference list

according to APA style

5

Total: 100%

IHP 630 Module Seven Activity Dashboard

The following is a dashboard for a hypothetical hospital. It includes key performance indicators for the front end, middle, and back end of the revenue cycle. Use the data in this dashboard to support your work on the Module Seven Activity.

Area of the

Cycle

Key Performance Indicator (KPI) Target: 100%

January – March Actual

April – June Actual

July – September Actual

October – December

Actual

Front End

Accurate patient demographics (correct spelling of name, middle initial, address, phone number, date of birth) are collected at registration.

89% (Color: Yellow)

87% (Color: Yellow)

92% (Color: Yellow)

92% (Color: Yellow)

Insurance is verified and insurance card is scanned or copied upon initial visit or admission.

71% (Color: Red)

68% (Color: Red)

92% (Color: Yellow)

75% (Color: Red)

Required prior authorizations are obtained before procedures are scheduled.

98% (Color: Green)

99% (Color: Green)

89% (Color: Yellow)

85% (Color: Yellow)

Patients without insurance or potential high out-of-pocket costs will be provided information about the organization’s financial assistance program at the time of registration.

48% (Color: Red)

32% (Color: Red)

30% (Color: Red)

51% (Color: Red)

Middle

Charges are captured for services provided. 91%

(Color: Yellow) 92%

(Color: Yellow) 85%

(Color: Yellow) 86%

(Color: Yellow)

Clinical documentation is completed within 5 days of patient visit/discharge.

93% (Color: Green)

96% (Color: Green)

81% (Color: Yellow)

81% (Color: Yellow)

Area of the

Cycle

Key Performance Indicator (KPI) Target: 100%

January – March Actual

April – June Actual

July – September Actual

October – December

Actual

Members of the medical staff are notified within 2 days of any delinquent (greater than 5 days) clinical documentation in patient charts.

100% (Color: Green)

98% (Color: Green)

99% (Color: Green)

100% (Color: Green)

Coding is completed within 5 days of clinical documentation completion in the medical record.

100% (Color: Green)

70% (Color: Red)

78% (Color: Red)

76% (Color: Red)

Back End

Claims will be “scrubbed” for errors using electronic scrubbing software prior to submission to a third-party payer.

100% (Color: Green)

98% (Color: Green)

100% (Color: Green)

100% (Color: Green)

Denied claims are reviewed/accepted/appealed within 21 days of claims denial.

62% (Color: Red)

53% (Color: Red)

59% (Color: Red)

59% (Color: Red)

Patients will be billed for any account balance within 14 days of insurance reimbursement.

88% (Color: Yellow)

95% (Color: Green)

96% (Color: Green)

95% (Color: Green)

Days in accounts receivable will be less than 47 days at the end of any quarter.

56 days (Color: Red)

48 days (Color: Red)

55 days (Color: Red)

53 days (Color: Red)

The following table explains the color-coding system in the dashboard above:

Meeting Requirements 95% or Greater Green

Meeting Requirements 80% to 94% Yellow

Meeting Requirements Less Than 80% Red