During an executive roundtable at Becker’s Hospital Review’s 13th Annual Meeting, sponsored by Altera Digital Health, Kelly Johnson, Managed Services program director at Altera, asked revenue cycle leaders and other professionals about their most pressing challenges and best practices for navigating these challenges.
Four key takeaways were:
- Costs are rising and the current financial situation is not sustainable. According to the CEO of a managed care organization on the West Coast, “We’re facing medical inflation and more demand for healthcare services, so it’s very difficult. Pharmacy inflation is about 16 percent and labor costs are way up. We really can’t charge much more in the market because I think we’re at a tipping point on affordability. And financial performance is required to sustain the organization, especially with the adversity that we’re seeing.”
The CIO of an East Coast provider organization shared additional challenges. “Maryland is an all-payer state, which means the prices of our services are capped,” he said. “When the cost of everything from labor to supplies has gone up, we don’t have the freedom as an organization to flex up with it. When the [reimbursement from] the state goes up by 1 or 2 percent, we can’t catch up with the 7 to 9 percent cost increases.”
- Altera is fostering strong vendor partnerships to help clients reduce their administrative costs. “We are starting to look at partnerships that will help with transactional and cleanup work that isn’t happening within the EHR,” Johnson said. “It helps to minimize the number of people that we have to get involved. So that’s one of the things we’re really focusing on.”
- To maximize revenue cycle improvements, it’s critical to update policies and workflows and have organizational alignment. Johnson shared the importance of aligning the organization around revenue cycle changes. “We have seen so many clients who fail to update their policies and workflows,” she said. “Then they wonder why they’re losing money. Take the extra time to align workflows and make sure your providers are happy. It’s worth doing some extra due diligence.”
- Improving visibility into data can support better decision-making. “At Altera, we’re focused on giving our clients the visibility they need so that they could make positive rev cycle changes,” Johnson said. “Within revenue cycle right now, there are a lot of changes and a lack of standardization, so it’s hard to keep up sometimes. Increasing visibility was our ultimate goal.”
