Healthcare's 2020 mission critical: Reduce cost to collect and improve patient revenue

As hospitals begin to recover some COVID-19-related volume losses, administrators are looking for ways to reduce cost to collect and increase revenue streams. 

According to data compiled from The SSI Group and Ensemble Health Partners, hospital claim volumes have recovered to 82 percent of pre-COVID-19 levels through June 8.

"The data suggests we truly are in a recovery phase," Justin Shafer, executive vice president of Ensemble Health Partners, said during a July 28 webinar hosted by Becker's Hospital Review and sponsored by Ensemble Health Partners. "However, getting back to pre-COVID baseline is really going to depend on a number of factors and questions."

Many of the questions pertain to how hospitals and health systems can run their revenue cycles more effectively. Here are five takeaways from the webinar, which also featured Ensemble Founder and CEO Judson Ivy.

1. The timing and degree of volume recovery will be influenced by a variety of external and internal factors. Internal factors include location and market share, hospital capacity, case mix and patient access. Some external factors are COVID-19 spread and decline, shelter-in-place regulation and state regulations on elective procedures.  

"What I think we've all realized as we've gone through this process is that navigating the path to recovery is truly a winding road of advancements and setbacks," Mr. Shafer said.

2. It's challenging for hospitals to identify their true cost to collect. While it's often measured by total revenue cycle cost divided by total cash collected, variability persists in clinical documentation integrity, patient accounting software and especially third-party vendor contracts.

3. When it comes to vendors, fragmentation is one of the biggest challenges in the revenue cycle. A multi-vendor structure may present several drawbacks to hospitals and health systems by hindering root cause investigations, decreasing cross-department compatibility, increasing IT burden and leading to higher costs and lower returns. 

"The average hospital is using 10-plus vendors across their revenue cycle just for services, not to mention technology," Mr. Ivy said. "Hospitals with this many vendors don't have the ability to scale." 

4. The ability to scale is necessary to manage cost to collect. Unifying the revenue cycle under a full outsource through one vendor gives hospitals and health systems a single source of truth. A full outsource reduces IT and vendor management resources, lowers cost to collect and increases revenue, the presenters said.

5. Looking forward, the speakers outlined steps you can take toward full recovery:

  • Start with a standard baseline based on a comprehensive review of cost to collect
  • Inventory your existing vendor contracts and understand your ROI
  • Identify opportunities for shifting risk to vendors 
  • Complete an assessment to identify revenue lift increases and cost decreases
  • Consolidate vendors to obtain scale in pricing 
  • Contact Ensemble to complete a full assessment

To view a recording to the webinar, click here.

To learn more about Ensemble, click here

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