Revenue cycle management technology proves imperative to profitability

In today’s rapidly evolving healthcare landscape, providers are facing unprecedented pressure to contain costs—while also contending with ongoing reimbursement and resource constraints.

And despite the ubiquity of technology designed to ease this burden, many providers and practice owners are feeling more frustrated than ever. In fact, according to a recent survey from the Healthcare Financial Management Association (HFMA) and Navigant, leaders in hospitals and other healthcare organizations are having a hard time maximizing the benefits of innovative technology to improve revenue cycle management (RCM)—and thus, their bottom lines.

Of the RCM capabilities or tactics respondents plan to focus on most over the next year, 79 percent are enabled or influenced by technology. These include business intelligence and analytics, EHR-enabled workflow or reporting, revenue integrity, and coding and clinician documentation. The data also showed that providers are struggling to leverage the power of technology—EHRs, in particular—to drive long-term process improvement.

In this era of value-based, data-driven care, it’s clear that technology will play a crucial role in helping organizations maintain and grow profitability. In searching for technology that will positively support the quality, efficiency, and affordability of care, administrators must choose software that streamlines clinical and financial functions—as well as enables the optimization of the patient experience. This holistic approach allows healthcare organizations to automate, scale, and improve processes—and, thus, advance the quality and consistency of all outcomes.

Take it to the cloud.
Organizations that use cloud-based EMR systems understand the benefits of managing patient records in a secure—yet accessible—platform. The cloud is critical to enabling real-time system updates—and with a seemingly never-ending stream of industry and political shifts, the ability to quickly adapt to new compliance and payment demands is imperative.

Choosing the right RCM solution is just as important as selecting the right EMR—and in addition to being cloud-based, both systems should be able to seamlessly integrate. There’s no reason that billing, documentation, and even patient relationship management should remain separate processes—after all, they all impact the bottom line. Integrated software options streamline documentation and revenue cycle workflows, allowing providers to run efficient operations. Furthermore, RCM systems that are integrated with an EMR often feature built-in compliance and coding safeguards that help ensure documentation and billing accuracy. They also provide powerful insights into data sets that directly impact revenue and can help guide strategy. As the HFMA survey revealed, providers who use revenue-integrity programs report significant benefits, including increased net collections and reduced compliance risks.

Improve financial and clinical outcomes with data.
Another area in which new RCM technologies are providing tremendous value is data analytics, which play a key role in the revenue cycle. When organizations can correlate profit and loss trends directly to influencing factors like coding accuracy, services provided, and patient outcomes, providers and executives are better able to work together to improve both clinical and financial success. But, it’s not enough to simply have access to this data. We need systems that can help make sense of it—and turn it into meaningful, actionable knowledge.

Unfortunately, raw revenue cycle data doesn’t provide much value to healthcare providers—just as raw patient outcomes data may be lost on executives. The right software will bring these data sets together, analyze them, and present the information in a way that shows how different functions of the care process are affecting one another.

With this information, executives and providers can better pinpoint gaps in the treatment, documentation, and billing processes—and then create strategies for improving care, reducing denials, and obtaining maximized payments upfront. At the end of the day, connectivity across all facets of care will support improved patient experience and profitability—and adopting the right integrated system will prove key to achieving that goal.

Dr. Heidi Jannenga is president and co-founder of Phoenix-based software company WebPT, the country's leading rehab therapy platform for enhancing patient care and fueling business growth, with more than 70,000 members and 9,800 clinics as customers.

The views, opinions and positions expressed within these guest posts are those of the author alone and do not represent those of Becker's Hospital Review/Becker's Healthcare. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them.

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