The biggest RCM challenges for hospital and health system leaders

Healthcare organizations face a myriad of revenue cycle management challenges as patients take on more financial responsibility for their care.

Employee burnout is a big challenge at New Orleans-based Ochsner Health System, William Thacker, the health system's director and revenue cycle strategic partner, said during a panel discussion at the Becker's Hospital Review 3rd Annual Health IT + Revenue Cycle conference in Chicago. "As we transition to EHRs, everyone's roles have been redefined and their scopes have increased or become more specialized," he explained, adding this can result in employee burnout as the system increases its volume of claims and maintains its staff size. And he noted since Ochsner invests a lot in training for employees, the system experiences direct costs when employees leave.

Other panelists cited different challenges. From a care management perspective, one frustration is inaccurate insurance information, said Colleen Fitzgerald, MSN, RN, director of system care management at Livonia, Mich.-based Trinity Health. She said it is crucial this information is recorded accurately early on in the care continuum to know the patients' benefits for post-acute care.

Gerilynn Sevenikar, vice president of revenue cycle management at San Diego-based Sharp HealthCare, shared concerns about growth of expenses outpacing growth in revenues. "We need to be as lean and streamlined as possible, so we look in areas where we can create efficiency. And areas you can create efficiency without compromising quality is really engaging your patient, engaging them in self-serve — giving them ways to do things themselves if they want to — and if that's setting up the payment arrangement online themselves then find a way to allow them to do it," she said.

Given all of the revenue cycle challenges healthcare organizations face, Carmen Deguzman Sessoms, associate vice president of reimbursement and analytics solutions with Nashville, Tenn.-based Change Healthcare, said her company is trying to help providers automate and streamline repetitive RCM tasks, primarily labor-intensive tasks. Other vendors are trying to do the same. And Ms. Sessoms and Ms. Sevenikar agreed when outsourcing RCM services to a vendor, there must be value-added for the healthcare organization.



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