Physician groups across the country are challenged to lower costs while driving practice growth and improving care quality, however this can be difficult as operational resources are stretched by competing demands. As providers balance needs ranging from staffing, managing vendor relationships, and patient outreach, a steady revenue cycle is of vital importance. In addition, new payment models are also requiring physician groups to be more proactive in care management initiatives, which are tied to revenue incentives.
Facing so many priorities and pressures, how can group practices also find the capital to invest in the technology needed to streamline their revenue cycle and financial performance? In some cases, physician groups need to merge or better align with health systems to remain financially viable, but for many the fastest way to regain control over their financial future and revenue cycle operations is to strategically align with the right outside partner.
A strategic outsourcing partnership model can provide several distinct advantages to physician groups, including:
- Patient engagement that increases revenue and satisfaction
The right engagement strategy meets patients where they are, reduces collection delays, and improves patient satisfaction and loyalty.
Creating a consistent patient experience and convenience from point of care access to payment is a critical step in ensuring financial viability. Both patients and staff feel empowered when they know what to expect and that each point of engagement will be transparent and consistent across locations.
For example, a patient should be able to get an accurate estimate of the cost of a physician office visit. When patients call to make an appointment, a centralized contact center can confirm a patient’s coverage, process co-pay and any other requirements to get them financially cleared before they arrive for their visit. Then, when they arrive at the clinic, they will experience a streamlined registration process without having to repeatedly share personal information. After their visit, a convenient retail-like payment method can ensure their accounts are settled quickly and easily.
Beyond streamlining administrative functions, access to the right technology and clinical data can also impact the timeliness of care via wellness appointment and care gap alerts.
- Predictive and prescriptive analytics support each decision
As physician groups immerse themselves into the world of data analytics to reduce inefficiencies and improve performance, they are often met with challenges that hinder adoption. These issues typically range from the inability to extract data from connection points across the organization and identifying a single source of data truth, to creating a fully-staffed and experienced analytics department. Many organizations have access to claims and patient data, but it’s what you do with that data to help guide your decision making and how it’s integrated into your technology that sets high performing providers apart from their counterparts. More importantly, once data is collected, how is it leveraged and applied for optimal practice performance?
When identifying a strategic partner, organizations should look for analytics strategies that can:
- Extract data from multiple payment management and billing systems.
- Collect and analyze large volumes of historical data to improve practice operations, such as contract modeling for appropriate reimbursement.
- Convert raw data into actionable insights and real-world process improvements.
- Scalable technology that removes administrative waste and unproductive touches
Artificial intelligence (AI), when applied strategically to the revenue cycle, creates powerful insights and opportunities for meaningful action. But, investing scarce capital resources in new technology may not be the best course of action for a physician group. Instead, leverage a partner that brings proven technology and implementation methodologies and has the resources to continue developing new capabilities that deliver proven returns.
To help evaluate if a partner is a good fit, consider whether their technology strategies can:
- Seamlessly integrate with core systems.
- Eliminate low yield, repetitive tasks with strategically inserting automation
- Analyze large volumes of administrative and clinical data for documentation improvement as well as patient outreach initiatives that uncover care gaps.
- Apply robotic process automation to prioritize accounts based on historical payment behavior.
To create a zero-touch revenue cycle across the front, middle and back, providers must focus on moving from siloed and single pain point resolution technology to end-to-end automation.
Five questions organizations should ask to determine their readiness for outsourcing
Physician groups considering an external revenue cycle partner should ask themselves the following questions to help determine if they could benefit:
- Is revenue cycle management distracting from the goal of patient care?
- Is it difficult to secure capital to keep up with the latest technology and innovation?
- Are patients expressing dissatisfaction and seeking care elsewhere?
- Are physicians frustrated or burned out by revenue cycle operations?
- Is it difficult to keep up with evolving payer rules and industry regulations to remain compliant?
The right partnership model cuts costs, drives growth, and delivers optimal practice performance. We take a 360-degree view of a practice’s operations by looking at the whole picture and pinpoint areas in which data-driven insights and technology can yield the most impactful results.
For more information on how Optum360 Ambulatory Services are helping medical groups achieve optimal practice performance, please visit www.optum360.com.