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San Juan Regional Medical Center updated facility image v2

Fully integrated EHR conversion leads to revenue cycle improvements at San Juan Regional Medical Center

by San Juan Regional Medical Center

Published on 12/3/2020

Prior to a 2017 agreement with Cerner, San Juan Regional Medical Center (SJRMC) had three disparate systems plus several manual processes to schedule and deliver care and process patient billing. Leadership knew they had to move the Cerner ITWorks client to one integrated system in order to provide safe and seamless health and wellness services to SJRMC’s patients and community.

Located in the Four Corners area of New Mexico, Arizona, Colorado and Utah, the nonprofit organization implemented Cerner Millennium® and Millennium Revenue Cycle™ across its acute and ambulatory venues in January 2019. The implementation was called “Care Connect” to showcase the important ways Cerner Millennium and Millennium Revenue Cycle would help the organization make connections; connecting to one health information system and connecting individually to patients, helping to deliver on SJRMC’s mission to personalize healthcare.

That year, SJRMC leaders faced multiple challenges in their financial environment — significant revenue reductions from state supplemental programs, a smaller patient population and shifting payer mix.1

However, in the last half of the year post-conversion, SJRMC improved several key metrics when compared to the same time period the previous year, including:

  • Increased average daily revenue (ADR) by 5.35%.2
  • Improved average monthly cashflow by 7.28%.3
  • Decreased time in billing cycle (DNFB) by 41%.4

The SJRMC implementation leadership team included stakeholders from each of the organization’s operational areas. Utilizing their Core Value of Team Accountability, they collaborated on recommendations and best practices to closely monitor billing metrics and return to baselines. The approach included daily charge reconciliation meetings, documentation deficiency reviews and a focus on addressing claim edits, overseen by a client revenue cycle advisory team.

“Our teams rallied and produced remarkable results during a challenging year. We spent quite a bit of time prior to go-live making sure the system was working properly and claims were populating correctly. People from all areas of the hospital, our clinics, and our Cerner implementation team were involved and there was a high level of dedication to make our billing as clean as possible. The hours spent and the effort provided worked; we sent claims to payers five days after go-live. Getting claims to the payers so fast was the number one reason we could return to baseline metrics as soon as we did. We continued our very intense efforts post go-live and the efforts were reflected in the results,” President and CEO Jeff Bourgeois said.

A community-owned and operated hospital with a long history of serving the rural community, SJRMC was able to persist despite the many challenges. Even with fewer patients, revenue increased, allowing the organization to provide for patients in their time of need.

1 SJRMC faced a reduction in commercial insurance payments, moving towards a primary Medicare/Medicaid payer mix (75%), and adjustments on prior forecasted contractual allowances.

2 Comparing average of $1,755,687 from July-December 2018 to average of $1,849,628 from July-December 2019

3 Comparing average of $19,095,929 from July-December 2018 to average of $20,486,990 from July-December 2019

4 Comparing average of 9.2 DNFB days from July-December 2018 to average of 5.4 DNFB days from July-December 2019

Client outcomes were achieved in respective settings and are not representative of benefits realized by all clients due to many variables, including solution scope, client capabilities and business and implementation models.