Modernizing strategies and approaches used by revenue cycle management (RCM) leaders to maintain adequate staffing while reducing labor costs is a must-do in today's volatile healthcare labor market.
During Becker's Hospital Review's 7th Annual Health IT + Digital Health + RCM Annual Meeting, in a session sponsored by Tegria, Lauralea Tanner, executive vice president of Tegria, led a discussion exploring new solutions to persistent talent retention and cost reduction problems for healthcare organizations' RCM departments. Ms. Tanner was joined by Jamie Watson, vice president of revenue cycle management for Boston Medical Center, and Mike Mullen, vice president of revenue cycle management for Northwestern Medicine in Chicago.
Three key takeaways were:
- To deal with shortages, organizations are recalibrating how they attract and retain talent. The COVID-19 pandemic helped organizations realize the value of allowing staff to work from home (WFH) more than was previously permitted or go fully remote.
Some institutions have implemented WFH privileges as a function of productivity and are relying on EHR vendors' capabilities to determine which employees meet productivity thresholds. This approach reduces the risk of attrition as it gives employees choice about their working environment while ensuring that organizations stay competitive.
In other instances, companies have opted for a fully remote business model. Mr. Watson said that after the pandemic, "We just ripped the Band-Aid off and went with full remote." He noted that his organization had to build the infrastructure to support full remote on the fly, but the unexpected result was that "productivity skyrocketed." Having this infrastructure in place now helps recruit staff who would not be willing or able to relocate to high cost-of-living cities such as Chicago or Boston.
One question raised was in reference to how providers are outsourcing and how performance is monitored. Lauralea Tanner mentioned, “It’s so important for providers [to understand that], when they outsource, their job changes. Now you’re not managing your direct staff but you still have a responsibility to manage that vendor.”
- The "touches" metric is replacing the previous "days in AR" As the new world of RCM is adjusting to the WFH era, productivity is no longer being measured in terms of "days in AR" but instead in terms of "touches." "Touches" is the concept that RCM leaders are using to monitor staff members' discrete interactions with patient or customer accounts.
"Days in AR . . . those days are gone. I want to know how productive my staff is, how many touches they have," Mr. Mullen said. "If we see an individual that has a 20-minute gap from the time they touch the last account to the time they touch the next one, that sends up red flags." He added that organizations are also developing programs to monitor and assess the quality of touches; for example, touches that turn out to be low-value insurance follow-ups may be considered a business category worth outsourcing.
- Automation is one solution to improve on the high cost of claims denials. Chasing low-dollar claims or manually following up on claim denials can eat up a lot of administrative staff's time and can elevate operating costs. To address this challenge, hospitals and health systems are turning to robotic process automation, including bots, which can automatically check insurance eligibility and claim status. Still, one participant acknowledged that automation cannot solve the cost problem entirely because some of it lies with payer behavior. "In collaboration with our Managed Care department, we’ve got to get stronger language in our contracts" Mr. Mullen said.