June 21, 2002

Picking up the PACE: Questions about project answered

With a multi-million dollar investment over the next three years, the PACE (Patient Administrative Cycle Enhancements) project represents the largest capital project for this fiscal year. Jointly sponsored by the MGH and the Massachusetts General Physicians Organization, the project is meant to improve the efficiency and effectiveness of the registration, referral and hospital outpatient billing processes. Below are some answers to frequently asked questions about the project.

Why is the PACE project needed?
Patients can access services easily enough, but administratively, problems arise because the hospital's information and administrative systems are too complicated. PACE will make the main administrative operations more consistent, efficient and patient-focused.

The hospital and physician practices also are not getting paid for the services performed for patients. Payors reject claims because insurance information is inaccurate or missing, and referrals are not in place. Insurance information and rules are complex and change frequently, which also contributes to this problem.

How will PACE change the registration and referral process?
PACE will establish a centralized contact center with staff members to verify the patients' insurance and demographic information and help process referrals in advance of a patient's visit. This center will streamline the collection of patient information and improve the efficiency of the administrative process by keeping all the functions together. In addition, the center will enable the quick dissemination of payor information, allowing the hospital to be more reactive to payor changes.

Why is the PACE project so complex?
It will take significant resources to redesign all the information systems that the hospital and practices interact with on a regular basis. The MGH and MGPO will transition from six information systems for registration and billing to two. In addition, the business processes will be simplified throughout all of the practices, ancillaries and billing offices. As a result, significant resources are needed to plan and implement the project.

Because of the complexity of the project, several multidisciplinary PACE teams have been established throughout the hospital to work on various aspects of the project. The Clinical Support Team is one of several PACE teams designing the new proactive, patient-focused administrative process. This team currently is working with other PACE teams to enhance the communication of patient and billing information between the practices and clinical support services.