Eide Bailly Helps Madison Regional Health System Achieve Financial Excellence Goals

Case Study

Madison Regional Health System Logo

An award-winning designated Critical Access Hospital (CAH), Madison Regional Health System in South Dakota provides essential access to healthcare for the rural communities it serves. With one location and 22 beds, the independent organization offers general acute hospital services, emergency care, obstetrics, outpatient care and a wide array of ancillary services.

The hospital is also a certified Medicaid and Medicare home health agency, which serves to coordinate care for people with chronic conditions who receive Medicaid or Medicare. Services include comprehensive care management, care coordination, health promotion, transitional care and follow-up, patient and family support and referral to community and social support services.

Traveling the Road to Efficiency

To best provide healthcare services to residents who would otherwise have to travel long distances for care, Madison Regional Health System is always looking for ways to operate smarter, better and more efficiently. As part of that mission, they have called on Eide Bailly for help with financial feasibility studies ahead of their move to a new facility in 2015, chargemaster reviews, billing and coding reviews, and Medicare cost report assistance to achieve their overall financial excellence goals.

“I’ve worked here for about 22 years, and I pretty much have Eide Bailly on speed dial,” said CFO Teresa Mallett. “They’re our go-to resource for cost report questions.” In addition, every three years, Madison Regional Health System engages Eide Bailly to conduct a chargemaster review that often includes physician education on documentation and reimbursements.

This way we know we’re continuing on the right path with our revenue cycle in terms of optimizing our reimbursement and making sure we're doing everything correctly,” explained Teresa Mallett, CFO of Madison Regional Health System. “We want to stay compliant and Eide Bailly has helped us along that path throughout the years.

Driving Continuous Improvement

When Mallett came on board as CFO, the organization wasn’t estimating its Medicare payable or receivable throughout the fiscal year. Eide Bailly built a model that can be used every month to estimate the Medicare settlement. “That’s helped stabilize our audit entries,” Mallett said, “and gives management and our board a better picture of where we stand on both a monthly and annual basis.”

Mallett can also adjust the hospital’s financials based on what’s actually happening versus having to wait for a yearly cost report to be able to make those changes. And instead of having to put the time and effort into producing interim cost reports, she just uses the model that Eide Bailly built. “It’s customized just for us,” she said, “and is a very useful tool.”

Eide Bailly’s regular chargemaster reviews also reveal areas of potential improvement. As the hospital makes those improvements—some minor and others “bigger ticket items,” according to Mallett—those incremental changes have yielded substantial benefits for the organization.

“Every time we do a chargemaster review we make something better because of it,” she explained. “And because maintaining a good chargemaster is the core driver of our reimbursements, regular reviews also ensure good risk mitigation for our hospital.”

Making the Journey Together

Eide Bailly conducts Madison Regional Health System’s annual audit, handles the tax returns for its 990 and 5500 non-profit filings, and assists in its community health needs assessment process. Those assessments, which are required by the IRS every three years, ensure that the CAH is continuing to meet the needs of its community from the agency’s perspective. From that exercise, the hospital will typically take the top 2-3 issues that emerge and develop a plan for addressing them.

Reflecting on the Madison Regional Health System’s long-standing relationship with Eide Bailly, Mallett said the guidance, support and assistance that this valued partnership provides has helped the hospital maintain its independent status and better serve its surrounding communities.

“By helping us develop better projections based on financial capacity studies and providing advice on how we can best optimize reimbursements, Eide Bailly has played a vital role in helping us maintain our independence,” said Mallett. “Which is, at this point in time, what our community and our board wants.”

A Long-Standing Partnership

Looking ahead, Mallett will be assessing the hospital’s technology needs as its current electronic health record (ERH) platform is being sunset. “That’s going to be the focus of quite a few of our resources over the next year,” she said.

Mallett also expects to continue calling on Eide Bailly for help in solving problems, optimizing the hospital’s financial operations and working toward an even higher level of financial excellence.

I wouldn't keep going back to Eide Bailly if I didn't have the confidence and trust in each and every team member that I work with there. I have much respect for all of them and their wealth of knowledge,” said Teresa Mallett, CFO of Madison Regional Health System. “I learn something new every time I talk to them on the phone. And when I call, they’re always available; I don't know if I would get that from any other accounting firm.

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