Since most of us have managed a household budget, this analogy will hit home.
The amount of money coming in matters. The amount of money going out matters even more.
The rate at which the money comes and goes is important.
And the ability to pay our bills on time is paramount.
It isn’t much different at Texas Children’s. Managing the organization’s resources is the work of several team members across multiple departments. Thanks to Epic Tapestry, the health care management system set to launch next summer, their work will be better informed, more efficient, more accurate and yield improved results.
A tale of two departments
For the third story in our series we are focusing on Finance and Claims, two departments that are directly connected to the management of the financial resources at the health plan.
Let’s take Finance first.
“We are thrilled to see Tapestry coming,” said Jenny Little, Vice President for Financial Services at Texas Children’s. “This new system will introduce automation to several functions that are currently manual. This will help free up the team’s time for more in-depth analysis to inform strategic decision-making. It will also help to secure the control environment of the Health Plan, which improves our accuracy and reputation with the State, our members and our peers.”
In addition to automation, Little says that Tapestry will provide more data and insights on how the health plan and the hospital can work together to propel our mission. This will not only inform and improve our financial performance, but it will also inform how we can truly help our members and patients.
“We’re talking about an ability to work more efficiently, and also have better outcomes with the work that we do. It doesn’t get any better than that. Because of this, we are hoping there is also increased job satisfaction for our employees,” Little said.
All of this couldn’t be done without the amazing Health Plan leadership team, including Ryan Thompson, Director of Finance and Christina Milan, Assistant Director of Finance. They are both leading the transition and representing Finance on this important transition.
Great gets even greater
Now, let’s return to our household budget analogy. Remember when we talked about paying our bills? This is where the Claims department comes in.
After our providers take care of our members, they submit a bill for their services – a claim. We accept or deny these claims based on a set of criteria. If we accept the claim, we pay for their services.
The Claims department is already doing an extraordinary job following a restructure and reignition by Director April Riggs. Under Riggs’ leadership, the department is performing better than ever.
“But we never rest on our laurels,” Riggs said. “And we too are excited to see Tapestry coming. Our workflow will significantly improve after the implementation. It will ensure that our systems are robust enough to guarantee the accurate and timely payment of claims.”
Riggs added that the pandemic has introduced new challenges, such as a need to process more claims for telemedicine and telehealth services. Her team has made the adjustments and Tapestry will be a great help if further adjustments are needed in the future.
But why is now the right time?
“COVID-19 showed Texas Children’s just how valuable the health plan is to the entire system,” said Little. “While the pandemic caused the hospital to lose money, the health plan made money – $95 million. In actuality, the health plan really saved us. Any investment in the health plan is an investment in the entire organization.”
Little added that having Mark Mullarkey at the helm during this time is significant. Mullarkey, who is the president of Texas Children’s Health Plan and an Executive Vice President for Texas Children’s, has a strong reputation for his focus on operational efficiency and results.
“We now have the right leader in place,” said Little. “And we know that makes all the difference.”
Missed the other stories in our series? Check them out!
The first one was all about Care Coordination and the Healthy Planet module.
The second one was all about Member Services.