In the United States, the healthcare systems is undergoing a major transformation. The changes are in how patients select health plans? Select which healthcare providers, and pay their healthcare costs? Hospitals must enhance their revenue cycle management capabilities to manage the financial implications of that transition successfully.
Want to improve your revenue cycle? Follow the steps. Here are some significant ways hospitals may improve their revenue cycle while also enhancing patient experience and involvement with the payment process.
Recognize your strength and weaknesses, and seek out best practices.
It’s fine if a company lacks internal experience in revenue cycle management and medical coding and invoicing for medical services. However, a hospital must be able to examine its operations and find areas for improvement. Even if the company has a strong balance sheet and strong margins, it can always improve, learn, and do things more effectively, efficiently, and effectively.
So, where can finance executives seek to learn about their strengths, limitations, and areas for improvement? Three resources come highly recommended:
Ways to Improve Revenue Cycle Performance in Hospitals:
Quote Organizations of peers: Leaders should examine their peer firms’ revenue cycle performance and compare it to their own. What are they doing differently regarding employees, knowledge, process, and technology to achieve enviable sales cycle KPI metrics?
Professional organizations: Leaders should seek information on best healthcare revenue cycle management and medical billing practices from their professional organizations and membership societies.
Professional organizations and membership societies: Healthcare revenue cycle management and medical billing and collection best practices should be sought from professional organizations and membership societies. These organizations also provide a variety of educational opportunities for finance professionals.
Out sourcing third party revenue cycle management
A medical billing company who specialize in revenue cycle management should be consulted for success suggestions, subject matter expertise, and assistance. Billing companies are aware of what is working with each of their customers. Collaboration with a medical billing company and access to their real-time knowledge will pay off handsomely.
Create and use a revenue cycle scorecard.
Create and use a revenue cycle scorecard to keep track of performance regularly.
Organizations who wish to improve their revenue cycle management performance must know that simply checking standard KPIs like days in accounts receivable isn’t enough. Instead, Instead, they should consider generating actionable insights through advanced data analytics, or big data, to boost sales cycle management performance. Displaying traditional and that dashboard should offer that KPI data in a variety of ways:
- Where are the organization’s revenue cycle KPIs at any given time?
- How do the organization’s revenue cycle KPIs compare to industry benchmarks?
- How is the organization’s revenue cycle KPIs trending over time?
That presentation shows hospital executives where their revenue cycle performance is right now and where it’s headed.
Daily Dashboard
Daily dashboards also highlight potential problems, such as increasing the denial rate for a specific medical procedure. It requires extra attention and training for personnel on coding and documentation. The dashboard should also be connected with the hospital’s other IT systems, allowing it to capture events that impact the revenue cycle KPIs.
Ways to improve hospital revenue cycle performance.
Form a revenue cycle committee that includes important stakeholders and clinical champions.
The effectiveness of the entire revenue cycle performance dashboard I presented depends on who utilizes it to make data-driven decisions. A standing revenue cycle management committee within the provider organization should include a core or focus group of the right people. Leaders from the finance department and any other department that is influenced or impacted by revenue cycle performance should be on the committee.
Because of the rise in performance-based and value-based reimbursement contracts, which set payment rates based on satisfying clinical performance indicators, clinical representation on the revenue cycle management committee is critical.
The multidisciplinary revenue cycle management committee should, in terms of operations:
- Give each committee member access to the dashboard.
- Regularly send committee members automated dashboard links by e-mail or secure text message.
- Hold monthly roundtable discussions and brainstorming sessions to discuss and brainstorm areas for improvement.
- Form task groups under subcommittees to address revenue cycle challenges, like prior-authorization denials or ICD-10 medical coding issues.
Enhance and complete existing revenue cycle capabilities.
Given the growing number and complexity of hospitals’ payer contracts and the increasing need to work directly with patients regarding their financial responsibility, the ability to leverage technology and services that are both flexible and scalable is the backbone of any effort to improve the performance of healthcare revenue cycle management. As a result, I would advise hospitals to concentrate on three goals to increase their total revenue cycle capabilities:
Fill gaps in existing revenue cycle capabilities with new technologies or services:
Leaders should acquire new technologies or engage service suppliers to provide support to fill gaps in existing revenue cycle capabilities.
Similarly, Black Book Market claims to optimize existing technologies: Many leaders don’t take full advantage of the available applications in their present revenue cycle management systems; therefore, they should optimize existing technologies to benefit their revenue cycle capabilities fully.
Examine patient-centric technologies and services: Leaders should look at new patient-centric solutions that make the medical billing and collection process more transparent and user-friendly. Applications that help patients estimate out-of-pocket costs call centers that can improve scheduling, referral management, or work with patients on financing and payment plans, or online portals that allow patients to validate demographic information and look up insurance information are examples of such solutions.
Outsourcing all aspects of a healthcare call center can help save money while improving patient satisfaction.
Set revenue cycle goals and track progress against them regularly.
It’s been said that you can’t improve what you don’t measure, and healthcare revenue cycle management is no exception. Collecting, reporting, and analyzing revenue cycle KPIs using industry expertise, technology, scorecards, and committees are all crucial, but only if hospital executives know where they want to go with those KPIs. Here’s what I think you should do:
- At the start of the fiscal year, leaders should set objectives and targets for each of the KPIs, and they should be visible on everyone’s scorecard.
- For each of the KPIs, leaders should set their expectations and targets.
- Senior management should keep an eye on things and hold the departments and teams in charge of the results accountable.
The objectives should be reasonable, and achieving them will not happen immediately. Those KPIs will improve gradually and steadily in hospitals that use this deliberate approach.
Organizations who do so are positioning themselves for success in healthcare revenue cycle management as the market evolves. They must understand that what may not be a problem today could become one in the future. Be a proactive change agent in your company.