One of Monash Health’s six key strategic areas is finance, which encompasses a targeted approach to enhancing our financial performance and management. The Financial Strategy is all about building financial acumen and empowering our people, recalibrating our activity, maximising our revenue, and carefully managing our spending.
Our Business Intelligence (BI) team has been vital in bringing the ethos of our strategy to life, particularly in maximising revenue recovery. This ensures we can capture the revenue for our services and recover the appropriate funding to improve financial sustainability and, ultimately, positively impact our ability to deliver timely, high-quality care.
One focus of the BI team has been implementing initiatives that significantly increase National Weighted Activity Units’ (NWAU) tracking, reporting, and coding. NWAU is a standardised way to measure health service activity and, depending on the unit number, a balanced and fair way to calculate how much funding each service is entitled to. It provides a method of comparing and valuing each public hospital service, whether emergency department presentations, admissions or outpatient episodes, weighted for clinical complexity.
“Our Public Health Services funding increasingly depends on recorded patient activity. Missing documentation for these activities means Monash Health isn’t paid for the work we are doing.” Rachelle Anstey, Chief Financial Officer.
Here, we highlight four notable examples demonstrating the BI team’s commitment and tangible impact on revenue enhancement for Monash Health.
National Bowel Cancer Screening Program, unlocking $276,000 potential
The BI team uncovered inefficiencies in the process that captures patients who qualify for funding under the National Bowel Cancer Screening Program (NBCSP). An analyst within the team developed a search algorithm, revealing 306 elective waiting list admissions, with only 16 having the appropriate funding arrangement captured. Between July and October 2023, the discovery resulted in an additional 290 patients being funded with a potential revenue boost of $276,000.
Emergency Department’s $12.3 million boost
A challenge arose when over 10,000 Emergency Department (ED) presentations that did not have an assigned NWAU value were discovered. A skilled developer within the BI team meticulously traced the issue to missing Emergency Primary Diagnosis codes. Additionally, ED Diagnostic codes introduced for the 2023/24 financial year were missing from the calculation. The result was an additional 2,676 NWAU identified between July and October 2023, resulting in an impressive $12.3 million improvement in revenue.
Sub-acute community NWAU a strategic leap of $5.4 million
Transitioning from block funding to NWAU funding presented challenges, with thousands of sub-acute community contacts not converting to fundable NWAU service events. A programmer within the BI team developed a code to flag these contacts, enabling managers to identify and address conversion issues. Managers rose to the challenge and accepted an NWAU target increase of 20%, amounting to 1,185 NWAU and a value of $5.4 million. As of October, the Sub-acute Community NWAU has achieved an impressive 97% of the new target.
Development of in-house NWAU reporting
Recognising the need for independent reporting, the BI team developed a code to calculate NWAU from Monash Health data sources for Emergency Departments, Specialist Clinics, and Sub-acute Community. The outcome is monumental, with $285 million or 61,890 NWAU now reported in-house. In-house reporting facilitates tracking actual activity against targets and lays a strong foundation for future reconciliation work, offering transparency and potential revenue increases for Monash Health.
“The BI team has been instrumental in driving activities that optimise revenue and enhance healthcare outcomes. I am confident there are many more opportunities that the BI team can assist to improve the revenue position for Monash Health. Congratulations to the team for their outstanding contributions.” Steven Damiani, Director of Performance and Analytics.
“These instances are one of many examples of our Financial Strategy in action. I encourage everyone to review practices and identify any overlooked situations to capture patient activity in our systems. Anticipating more success stories, I eagerly await the positive impact on Monash Health’s revenue through enhanced data capture, a testament to the dedication of our team members.” Rachelle Anstey, Chief Financial Officer.
If you have suggestions on enhancing our data capture methods to boost funding opportunities, please feel free to reach out to Steven Damiani via email – steven.damiani@monashhealth.org.
Approved by Rachelle Anstey, Chief Financial Officer and Steven Damiani, Director of Performance and Analytics.