FARMINGTON, Utah, Oct. 14, 2024 /PRNewswire/ — REDi Health Analytics, LLC (“REDi Health”) partnered with a state health department to improve data capacity at six rural hospitals, aiming to enhance healthcare delivery and reduce disparities in rural communities.
REDi Health identified over $5 million in potential revenue from contract discrepancies and improved denials management at one hospital while helping another recover over $1 million in under-compensated Medicaid revenue through a system upgrade review.
“This program laid the groundwork for identifying key opportunities, and now rural hospitals are investing in change management to capture savings by redesigning workflows based on data-informed best practices in partnership with REDi Health,” said John Wadsworth, Co-founder.
This initiative focuses on reducing healthcare disparities, particularly in rural areas, by enhancing data-driven decision-making. Rural hospitals often struggle with resource constraints and lack integrated data systems, making it harder to provide equitable, high-quality care. By addressing these gaps, REDi Health is helping these hospitals not only overcome operational challenges but also improve financial stability. The following examples showcase the significant impact of our efforts:
Automation reduced the manual effort of four nurses conducting SSI chart reviews to just 10 minutes per day, covering every case, patient, and surgery with full automation.We identified over $5 million in potential revenue from contract discrepancies at one hospital, while also significantly improving denials management related to registration errors, medical necessity, and timely filing.At another hospital, we identified over $1M in under-compensated Medicaid revenue due to a system upgrade. After our data review, the state allowed the hospital to re-bill, recovering over $1M in much-needed revenue.Reviewing the chargemaster ensured billing codes and prices aligned with Medicare rates, resulting in improved reimbursements—projected to yield over $750K in 2024 and over $1M in 2025 for a 15-bed Critical Access Hospital.
The program works well because it targets the most critical areas—leveraging data-driven insights to streamline operations, optimize reimbursements, and address key financial and operational challenges faced by rural hospitals.
Across six hospitals, 42 clinical registries, including diabetes, sepsis report, medication/opioid use, women and newborn services, cancer registry, readmission report, infant mortality, and COVID, are improving chronic disease management, reducing readmissions, and enhancing operational efficiency for healthcare teams by identifying at-risk patients and enabling timely interventions.The initiative uses demographic data to address healthcare disparities, ensuring culturally competent and appropriate treatment for all patients.Rural hospitals are better prepared for public health emergencies through enhanced data sharing and reporting, allowing them to manage outbreaks and protect their communities.
Using data to improve healthcare in rural areas is proving effective. Much of the project’s success is due to the hospitals that have embraced data analytics—standardizing data collection, automating key tasks, developing clinical registries for proactive care, and training staff to use data effectively.
REDi Health helps rural healthcare providers with practical solutions. To learn more, visit their website at redihealth.com.
About REDi Health. REDi Health partners with rural hospitals to enhance their operational and financial performance through tailored, hands-on analytics. By maximizing the capabilities of hospitals’ existing systems, REDi Health enables sustainable improvements that empower hospitals to better serve their communities while strengthening their financial health. These data-driven solutions create long-lasting benefits for healthcare providers, ensuring they can thrive in today’s complex environment.
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SOURCE REDi Health Analytics, LLC
