Lean Management Success: UPG Fee Reduction

UPG strives to serve as an efficient steward of resources by providing high quality, specialized services in a cost effective manner. A vital part of this effort lies in the Lean management practices which have been implemented across all UPG units, and have generated significant value for the Health System for the past several years. We are proud to be a Health System leader in Lean processes.

Among other Lean management accomplishments, UPG has exercised extreme diligence with regard to replacing prominent positions when vacated. We have been able to manage FTEs by attrition, using existing resources when possible to fulfill necessary duties.

One of the benefits that is being realized as a result of ongoing UPG Lean management efforts is a reduction in the collection fee from 8.25% to 8.0%, effective FY19. This reduction translates to a $750,000 savings to clinical units, bringing the aggregate value of UPG Lean practices for the Health System to over $3M to date.

We are pleased to share this development.


Epic Update Metrics: February 2018

Click to Enlarge Image

Points Regarding AR To Note:

*The comparison target was extremely low. At the end of last fiscal year, Days in AR was 30.2.

*Days in AR tends to go down in the 2nd half of the fiscal year.

PFA Project Leadership Announcement

Dear Colleagues,

As of December 11, 2017, UPG Chief of Ambulatory Operations Katie Fellows will serve as the Interim Patient Friendly Access (PFA) Administrator. In this role, Katie will report jointly to UPG Chief of Audit and Billing Quality Melanie Lewis, and UVA Medical Center Chief Operating Officer Bill Fulkerson.

Katie has been an integral part of our PFA Executive Group.  She was instrumental to the successful Epic Phase 2 Implementation in our Clinical Practice Group (CPG) practices, and she will surely be a valuable asset to this project.

In order to support Katie’s transition to Interim PFA Administrator, UPG Manager of Business Development David Stebbins will serve as Interim Director of RPC North Operations, and UPG Clinical Operations Specialist Brigitte Mehl will serve as Interim Clinical Operations Manager.

We greatly appreciate the spirit of collaboration that is being demonstrated during this dynamic time in our environment. Thank you for doing your part to ensure progress and continued success so our patients’ needs are met.


Bill Fulkerson                            Brad Haws

COO UVA Medical Center      CEO UVA Physicians Group




Epic Phase 2 Update: Summary (October 2017)

1.       System implementation is complete. The next phase is to optimize the system within our workflows and business processes.

2.       During the system transition, we are monitoring performance against other Epic implementations of the Professional Billing (PB) functionality.  Comparisons indicate that we are performing above average in most metrics, and in the top quartile for a few metrics (as of week 13, ending September 30).

3.       Based on experience with previous clients, Epic has provided expectations for Days in AR and cash collections.  We are just entering the most difficult period, when Days are highest and Collections are lowest.  Recovery is expected after the turn of the calendar year.

From the CEO’s Desk: Lean Management Update

Brad Haws

We are proud that UPG has led the Health System in using Lean management practices in administrative operations in order to serve as efficient stewards of Health System resources. The following is an update on some important results of those efforts.

  • UPG has had Lean projects in every unit in the past 24 months.
  •  To date, UPG Lean projects have created $2.5M of value for the Health System. 
  • Generated margin in administrative unit in FY2016 and rebated $380K of fees back to clinical units.
  • Last year, UPG was the only organization in the Health System not to add a single FTE. UPG’s FY18 budget continues this trend.
  • Lean Successes include:
    • Zion Crossroads
      • Redesigned scheduling process, reducing rate of errors from 30% to near zero.
      • Reduced referral errors from 30% to near zero so that patient connects with the right physician for their condition the first time.
      • Improved communication between physicians and staff.
    • Life of a Surgical Charge
      • Developed automated OR log in Epic, used by 11 Clinical Departments
        • Estimated increase of $800K/year in collections by adding Accustream to identify missed charges.
        • Time savings of ~960 hours/year.
    • In FY17, Billing and Collections teams have seen a 20% increase in productivity while absorbing a 14% decrease in time processing.
      • Charges and collections are up 8.2%.
      • Timely adjustments are down 60% from $1,217,217 to $481,204.
      • 35 process improvements identified; 33 of which have been implemented.
    • Electronic Enrollment with Medicare, Medicaid and VA.
      • Reduces held charges and increases timely payment
    • Monthly Financial Close Cycle
      • Shortened close cycle from 16th to 10th business day
      • More timely financial statements to the Health System
      • Eliminated waste
      • Team freed up to work on other projects
    • Physician Hiring Platform
      • Creation of a streamlined hiring platform for providers, aligning credentialing and date of hire with ability to bill for services.