Using Quality and Productivity Data Together

Revenue cycle leaders are under constant pressure to increase throughput while protecting margin. Productivity targets rise. Denials scrutiny intensifies. Cost-to-collect remains under review.

Yet in many organizations, quality and productivity are still measured separately, tracked in different reports, reviewed in different meetings, and interpreted in isolation.

That separation creates blind spots.

As Holly Harp, Product Owner for Quality Audit & Productivity at Healthrise, explains:

“Historically, quality audit and productivity have been treated as separate programs. One measures speed. One measures accuracy. But workforce performance doesn’t happen in silos, and neither should the data.”

When Productivity Creates False Positives

Productivity is visible and easy to measure. But when evaluated alone, it can produce false positives: strong numbers that don’t tell the whole story.

Ryan Bell, Director of Consulting Services at Healthrise, sees this frequently:

“When productivity is high, but quality is low, managers often acknowledge what’s happening: someone is taking action just to meet a productivity score.”

If a representative is required to touch 50 accounts in a day, are those 50 meaningful actions? Or are they quick deferrals, surface-level reviews, or activity logged to satisfy a target?

“You see productivity through the roof, and the question becomes: are they really taking a quality touch to move the account to resolution?”

Activity does not equal impact.

Without quality context, high productivity can mask incomplete appeals, missed escalation opportunities, and repeat touches that inflate labor costs without advancing payment.

Measurement Shapes Behavior

Metrics do more than measure performance; they influence it.

Tiffany Naughton, Principal Data Scientist at Healthrise, highlights the inherent risk:

“When you start measuring and surfacing metrics, you inherently change behavior. If you’re only surfacing productivity, you risk actually decreasing quality by not looking at them together.”

Teams optimize for what is visible. If speed is emphasized without equal visibility into accuracy and effectiveness, quality can erode. If quality alone is emphasized, throughput may suffer.

The solution is not choosing one metric over the other. It is integrating both.

Defining a “Quality Touch”

The most important leadership question is simple: Did the action taken actually move the account toward resolution?

According to Bell, evaluating the quality behind a touch is critical. That means asking:

• Was the correct denial reason captured during the payer call?
• Was the appeal submitted with complete and accurate documentation?
• Was the claim escalated appropriately?
• Were delays communicated early enough to involve payor relations?

These details directly affect financial outcomes. Many payors now limit the number of appeal attempts allowed. If the first one or two attempts lack the necessary documentation or follow-up, the opportunity to overturn the denial may be lost entirely.

After multiple calls or appeal packets, labor cost can exceed the claim value, quietly eroding margin.

Connecting Workforce Performance to Financial Outcomes

Disconnected performance data also obscures upstream breakdowns.

Front-end workflow gaps, such as missing authorizations, incorrect payor routing, or incomplete registration data, often surface later as denials that require significant effort to track and trend. Without integrated visibility, these issues remain fragmented across teams.

Tying denials back to front-end workflows can significantly reduce AR days and prevent avoidable rework. But that requires a connected view of workforce behavior and quality outcomes.

When quality and productivity are evaluated together, leaders can distinguish between activity and effectiveness and prevent avoidable revenue leakage.

The Venn Diagram of Workforce Effectiveness

Bell describes performance as a Venn diagram.

“We have Mary, who is slow but very effective at overturning denials. And we have Ryan, who is really fast but has a much lower success rate.”

Both contribute value. Neither represents optimal efficiency.

“How do we find the employee in the middle — someone who has a high overturn rate but is also doing more than five accounts a day? That’s the model of efficiency. Someone who works fast and does a good job.”

That overlap, speed and effectiveness, defines true workforce performance. Without integrated data, leaders cannot consistently identify or replicate it.

From Reporting to Workforce Strategy

When quality and productivity are aligned, performance management becomes strategic rather than reactive.

Integrated data enables:

• Targeted retraining based on specific soft spots
• Individualized coaching conversations
• Fair, bias-resistant evaluations
• Objective, defensible annual performance discussions
• Cross-functional visibility across Patient Access, Coding, Revenue Integrity, and PFS

A mature workforce performance strategy is consistent, transparent, and grounded in data that reflects both efficiency and effectiveness.

It does not reward activity alone. It rewards meaningful advancement toward payment.

Elevating Performance with Healthrise Quality Audit + Productivity

At Healthrise, ourQuality Audit + Productivity software was designed to bring these dimensions together.

By aligning audit intelligence with workforce throughput data, organizations gain a unified view of speed, accuracy, and operational impact. Leaders can identify false positives, target coaching where it matters most, reduce rework, and protect margin with greater confidence.

If your organization is evaluating how to move from siloed reporting to integrated workforce intelligence, we invite you to request a demo to learn how Healthrise Quality Audit + Productivity can support that transformation.

Contact us today to learn more about our hands-on approach and premier software designed specifically for health systems and hospitals to optimize performance, improve financial outcomes, and streamline workforce management.

Discover Our Full Technology Product Suite:

Denials Navigator

Centralize and standardize tracking for all denials prevention efforts and results across your health system to proactively tackle denial challenges with unparalleled efficiency and precision.

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Streamline the auditing process, provide comprehensive reporting capabilities, and facilitate staff assessments, all in one user-friendly platform. With QA+P, managers can easily identify areas for education and process improvements across all revenue cycle teams.

Revenue Cycle Analytics

Powered by advanced algorithms and intuitive dashboards, our platform provides comprehensive insights into revenue cycle performance, allowing hospitals to identify trends, pinpoint areas for improvement, and optimize workflows.

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