Hospital and health system executives are focusing on revenue cycle management improvement over the next 12 months to enter 2025 in a more financially stable position.
There are many opportunities to transform the revenue cycle with technology, automation and staff upskilling to truly make a difference.
Stephen DelRossi, interim CEO and CFO of Bishop, Calif.-based Northern Inyo Healthcare District, said revenue cycle is the most important area for improvement in the coming year.
"With cash collections at 87% of net patient revenue and denial rate approaching 5%, correcting these two items will move the hospital to a positive position," Mr. DelRossi told Becker's. "We are also expanding services and service lines to generate more revenue."
In the last five months, Northern Inyo boosted net patient revenue by more than 14% and decreased costs by 8% with targeted strategic efforts. The hospital's financial position also moved from the red to the black as a result.
Robin Tice, BSN, RN, chief nursing officer at Eastland (Texas) Memorial Hospital, told Becker's her team's most exciting challenge for the next year is also fiscal responsibility. Nurses and clinical leaders play an important role in the revenue cycle process to make sure the hospital collects. She is working with her staff to ensure documentation and charges are correct.
"Nurse administration and I will be focusing on education of proper documentation and always ensuring that our patients are provided with a safe quality experience every time they step into Eastland Memorial Hospital," said Ms. Tice.
Other health systems are making big changes to healthcare delivery for a more efficient revenue cycle and better patient care. Salt Lake City, Utah-based Intermountain Health has developed a prepaid model of care to simplify the revenue cycle process.
"Prepayment, which is really value-based payment, allows us to focus on doing what is right for the people we serve," said Greg Poulsen, senior vice president and chief policy officer at Intermountain. "It may be helping [patients] live a more healthy lifestyle or helping to reduce risk factors or intervening early in a disease to mitigate harm and expense, or it may be a full-on battle against terrible disease or injury."
Mr. Poulsen said the prepaid model rewards simplification and puts the complex requirements for revenue enhancements in the background.
"Many of the complexities of the health system are built around the payment system: complexities to get paid on the provider side and complexities to prevent overutilization on the payer side," he said. "We look forward to gradual progression to a future with greater patient focus and fewer distractions."