Role of Revenue Cycle Management in Health Equity

Posted in Revenue Cycle Management (RCM)

Healthcare organizations have long understood that revenue cycle management (RCM) plays a leading role in creating a winning financial plan. However, the abundance of data that flows through an RCM system can also be used to inform strategies for patient care and health equity.

Over the last few years, the concept of “health equity” has received increasing attention in the medical community and in the media. It has become an especially significant consideration amid the pandemic.

Healthcare providers that employ an end-to-end RCM solution have access to metrics that can enhance health equity by identifying shortcomings and opportunities for improvement. In conjunction with other data, these analytics can also guide knowledge-backed decisions to optimize an organization’s revenue cycle and profitability, and better the patient experience.

Why Is Health Equity Important?

At its core, health equity is the idea that every individual should have an opportunity to become as healthy as possible. This approach means no person should have disparate access to medical care and services due to age, race, gender or social positioning.

Inequities in healthcare access are evident across several areas, including:

  • Access to treatment
  • Severity of disease
  • Frequency of disease
  • Disability
  • Death rates
  • Quality of life
  • Length of life

It’s no secret that limited or no access to health services adversely affects patient outcomes. On a large scale, the negative impacts extend to family members, healthcare providers and the general public. This, in part, is why healthcare organizations have a stake in health equity.

While there are many ways to assess and improve health equity, a fully integrated RCM system is an excellent place to start.

Health Equity a Hot Topic

Achieving health equity is not a new challenge, but the coronavirus pandemic has magnified the problems associated with unequal healthcare access. Though the virus has affected people from all walks of life, it has a disproportionate impact on minority populations, including the impoverished.

Another factor that has helped the health equity discussion gain momentum is growing support from large healthcare organizations. For example, the role of RCM data in developing and implementing health equity strategies was discussed at a recent Healthcare Financial Management Association (HFMA) conference.

The values of health equity may be evident to healthcare organizations, but less clear are actionable plans to attain it. This is where the wealth of data processed by an RCM solution can offer insights.

Health Equity and RCM Data

By implementing the right end-to-end RCM technologies, your organization can improve health equity, as well as workflow efficiency, profitability and patient experience.

Particular to health equity, an RCM solution allows organizations to monitor socio-demographic data for disparities throughout the care process, from scheduling to prior authorization to claim submission to follow-up.

Some specific data points to consider include:

  • Age
  • Race
  • Ethnicity
  • Gender identity
  • Sexual orientation
  • Language preference
  • Geographic residence (urban, suburban, rural)
  • Disability if applicable
  • Veteran status
  • Education level

Tracking this data and assessing the metrics in conjunction with one another can help form an equitable revenue cycle strategy.

Another step to promoting health equity is to bridge the gap between user experience (UX) and RCM practices. In the past, the patient experience was treated as separate from the revenue cycle. Modern, comprehensive RCM solutions involve the patients more deeply in their healthcare journeys through patient access solutions.

Health Equity and Time-to-Care

An excessive time-to-care can diminish patient outcomes, and prompt access to care is a major obstacle for many underserved populations. Like other health equity barriers, delayed care has been exacerbated by the coronavirus pandemic.

This is another area in which the RCM knowledge base can identify issues and provide data to guide solutions. RCM technologies can track the duration from pre-authorization to patient admission to care administration.

This information can highlight disparities in patient onboarding and indicate opportunities to accelerate patient care.

Health Equity and Billing

Underserved communities have historically faced higher rates of claim denials, a problem that has received renewed awareness amid the pandemic as it further delays the revenue cycle, decreases profitability and erodes the patient experience.

An end-to-end RCM service provides the foundation for equitable billing practices. It also facilitates effective account resolution by reducing initial claim denials and streamlining the accounts-receivable process.

Better billing processes reduce time-to-payment and lead to higher levels of customer service, a critical component of health equity.

Advanced Healthcare RCM

Outdated, legacy RCM systems lack the scalability and data diversity of modern RCM technologies.

GeBBS Healthcare Solutions is a recognized leader in state-of-the-art RCM and health information management (HIM) services. GeBBS is one of Modern Healthcare’s Top 10 Largest RCM Firms, one of Black Book Market Research’s Top 20 RCM Outsourcing Services, and one of Inc. 5000’s Fastest-Growing Private Companies in the United States.

Request a consultation today to learn more about how GeBBS’ fully integrated solutions can help your organization.

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