Positioning MultiCare Health System to Lead an Industry

MultiCare Health System | NW United States

MultiCare_HospitalProfile

By combining a unique technology platform with their customer-centric approach, XSOLIS has proven to be a valuable, reliable, and trusted partner.

-Debbie Shardt, BS, RN, CPUR  |  Director-Revenue Cycle and Utilization Management

Debbie Schardt began her tenure at MultiCare Health System with a simple mission: building a team that others would model themselves upon. As Director of Revenue Cycle and Utilization Management, Debbie was tasked with revamping financial processes, using technology as a competitive advantage, and creating cross-functional teams that could challenge the status quo and drive positive change within the organization.

Key to this change was creating greater alignment between their technology and the second level (Physician Advisor) case review process. After years of working with their previous Physician Advisor services company, in 2016, MultiCare Health System decided to consider switching to a new vendor. Several needs prompted this search, including customer service changes, response timeframes, inconsistent outcomes and quality, prolonged appeals, and the need for increased oversight. After detailed analysis and thoughtful consideration, MultiCare Health System partnered with XSOLIS for Utilization Management (UM) technology and Physician Advisor Services.

“With any new vendor and service, we had concerns about how the transition would go, changes that we might experience as a result in terms of workflow and process, and of course the unknowns of working with a new business partner. However, I am very pleased to say that the transition was very smooth, and XSOLIS has continued to exceed our expectations,” said Debbie. “Not only have we transformed our Physician Advisor model, but XSOLIS has changed the way we view Utilization Management.”

The XSOLIS Physician Advisor team appeals every case with clinical merit that supports an inpatient status, removing bias from the process and lending integrity to the defense.

MultiCare Health System’s UM staff complete initial case reviews within 12 hours of patient presentation. As XSOLIS’ proprietary analytics begin assessing patient data upon hospital entry, their high levels of accuracy help the UM team make defensible status decisions quickly. The XSOLIS platform also makes it simple to escalate cases to Physician Advisors for second-level review and has streamlined the workflow and communication associated with the second-level review process by consolidating all pertinent patient information into one place. Not only does this facilitate a more comprehensive review with
less time spent searching for requisite information, it exposes the inherent clinical merit of the case more reliably to all clinical reviewers, whether UR nurses or Physician Advisors. And, just as importantly, it offers a far more satisfying review experience for all involved, improving overall compliance with the formal review process itself.

Since accessing and analyzing the most relevant clinical case components with XSOLIS is swift and easy, Debbie’s team achieves daily productivity that eludes other peers: by reviewing cases based on priority and identified risk, they accomplish as much in a day as it would take another organization several extra staff members to replicate. To better tackle the utilization review process, MultiCare’s UM staff includes teams focused on both concurrent and retrospective reviews: backed by XSOLIS’ proprietary analytics and technology platform, both teams are effective and aligned throughout each case or appeal progression as a result

To hear from Debbie Shardt, see the video below:

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