Title : Nurse billing olympics: A strategic initiative to drive charge capture and revenue integrity
Abstract:
Accurate and complete charge capture is fundamental to revenue integrity across healthcare organizations, yet nursing-driven billing remains an underutilized opportunity in many ambulatory settings. Traditional strategies most commonly email reminders often fail to engage nurses in a meaningful or sustained way, resulting in inconsistent billing performance and missed revenue. Gamification has emerged as a promising method to foster motivation, accountability, and engagement by transforming routine administrative work into an interactive and rewarding experience.The Nurse Billing Olympics was developed as an innovative, gamified initiative within Michigan Medicine to increase care management billing among ambulatory nurses. The program introduced blinded leaderboards, pseudonyms, monthly recognition, and friendly competition to drive participation. This study compares the outcomes of this gamified model in Surgical Specialties to a traditional email-based approach used in Medical Specialties.Using a quasi-experimental design, performance was evaluated over a three-month period and compared to the prior fiscal year. The gamification model generated striking results: Surgical Specialties achieved 10,731 billed units compared to a prior baseline of 18,020, representing a 59.5% increase, with an average of 214 units per nurse. By contrast, Medical Specialties using email reminders achieved 2,183 units, a 36.5% increase, with an average of 87 units per nurse. Gamification yielded nearly five times the total billed units and more than double the per-nurse average, demonstrating clear superiority over standard communication. Engagement variability was higher within the gamification cohort, suggesting competitive dynamics elevated performance among high-engagement participants. Documentation accuracy remained high across both groups, with Medical Specialties achieving >95% compliance on quality audits.These results highlight the power of gamification as a leadership-driven strategy to meaningfully enhance billing compliance, revenue stewardship, and nurse engagement in administrative responsibilities. By aligning financial accountability with a culture of fun, recognition, and participation, the Nurse Billing Olympics demonstrates a scalable model that can be adapted across additional specialties. Future work will explore long-term sustainability and broader system implementation of gamified approaches to operational improvement.
