Revenue cycle analytics in 2023: Extracting value out of your expanding data universe

The explosion of revenue cycle data in recent years has created an imperative for healthcare organizations to make optimal use of advanced analytics — or miss out on opportunities to improve financial performance.

During a January webinar hosted by Becker's Hospital Review and sponsored by Deloitte, revenue cycle experts discussed the benefits of using advanced data analytics tools to drive revenue optimization. Panelists were:

  • Sam Johnson, ConvergeHEALTH portfolio leader, Deloitte Consulting (Moderator)
  • Matt Lund, chief contracting officer, University of Washington Medicine (Seattle)
  • Curtis Miller, ConvergeHEALTH revenue cycle analytics leader, Deloitte Consulting
  • Chris Murray, ConvergeHEALTH MyRateFinder Go to Market leader, Deloitte Consulting
  • Lauren O'Hanlon, revenue cycle senior manager, Deloitte Consulting
  • Aaron Stapp, system vice president, revenue cycle analytics, innovation & finance, CommonSpirit Health (Chicago)
  • Deb Wierciak, vice president, business support, revenue cycle management, BJC Healthcare (St. Louis)

Three key insights were:

  1. New sources of pricing data are rapidly emerging — and confounding providers. Since 2021, federal regulations aiming to enable visibility into provider prices and payer-provider negotiated rates, including the Hospital Price Transparency Final Rule, the No Surprises Act and Transparency in Coverage requirements, have come into effect. 

Chris Murray said the avalanche of data these regulations have led to has "created a real analytics spring for pricing strategy" but questions abound as to how to extract meaning and apply insights from the data. These issues are compounded by the fact that providers must make the data available in machine-readable files, which are often unwieldy because there are no incentives to make them user-friendly, especially since the data may be used by competitors.

"Working with Deloitte, we've been able to sift out the noise [in MRF data] and understand where we stand against our competitor hospitals," Matt Lund said. 

  1. Innovative analytic techniques can unearth new insights from revenue cycle data. Novel techniques that enable predictive and prescriptive analytics, unstructured data processing and anomaly detection are essential for organizations that wish to gain a granular view of their data and use it to inform revenue optimization, cost containment and patient satisfaction goals. Because they allow user self-service through more mature business intelligence tools, those techniques drive the democratization of data, Curtis Miller said.

"We can compare our payers at a regional level and their performance and behavior across different states we operate in,"  Aaron Stapp said. He noted that one key metric Deloitte's Revenue Intellect tool has allowed CommonSpirit to track is the extent to which payers are pushing contracted rates to patient responsibility, which increases the burden of collection efforts for the organization.

  1. Taking actionable steps derived from novel insights can improve organizations' financial health. For example, developing functional key performance indicators for patient access, health information management, revenue management and vendor performance can help identify improvement opportunities. "Using Revenue Intellect, we could look across various patient accounting systems to identify where there were opportunities for [improved] denials prevention," Deb Wierciak said.

"We can now translate more insights into action-oriented steps, either informing automation or taking action using those advanced analytics," Lauren O'Hanlon concluded.

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.


Featured Whitepapers

Featured Webinars