Healthcare revenue cycle management grows increasingly difficult as the industry shifts to alternative payment models and patients take on more financial responsibility. To maintain financial health during this transition, it's vital for hospitals and health systems to seek improvements in RCM.
Here are three tips for improving revenue cycle management, gathered from experts in the field.
1. Invest in human resources. As patients take on more financial responsibility for their medical care, the professional criteria for successful registration and billing department employees has changed, according to Bruce Haupt, CEO of patient financing company ClearBalance. Revenue cycle leaders need to consider new applicants with a high-level of financial and insurance expertise who are capable of engaging patients in productive conversations about their benefits. Hospitals have a vested strategic interest in developing and recruiting RCM personnel with a higher skill set, and that requires capital investment.
2. Engage clinicians in RCM strategy. When healthcare professionals think of value-based care, they think of reducing variability, participating in shared savings and really leveraging evidence-based care and best practices. All of this is going to increasingly involve the clinical staff, according to Dan Mowery, executive director of industry relations and market intelligence at McKesson Technology Solutions. He says organizations need to educate and support clinical staff when it comes to RCM. For example, give clinicians access to a complete view of patient population data. This view must incorporate total utilization and cost, integrated with relevant content to help identify gaps in care, patients at risk for hospitalization, as well as other opportunities for cost savings or care interventions, according to Mr. Mowery.
3. Connect with IT teams. It's important for revenue cycle leaders to be in touch with their IT teams and revenue cycle departments to stay aware of best-in-class changes for IT, according to Tim Pranks, senior vice president of finance and revenue cycle at San Francisco-based Dignity Health. For Dignity, switching to an end-to-end revenue cycle service was advantageous because Optum360 [a patient-focused RCM service provider that Dignity Health helped develop] can quickly update and implement new tools. The coordination between IT, Optum360 and clinical teams is what makes Dignity nimble and more capable to take on the changes for its delivery system, according to Mr. Pranks.
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