In the world of revenue cycle, there are dozens of sound strategies that can help busy hospitals and healthcare organizations drive greater efficiency – but at the end of the day, there’s only one method that truly works. Sounds easy, right? Unfortunately, when you’re considering the complexities of the revenue cycle – nothing is as easy as it sounds. That’s why healthcare organizations that are successful in streamlining and improving their revenue cycle know that the answer is this: It’s all about the perfect union of People, Process, and Technology.
The People, Process, and Technology line of thinking dates back to the 1960s when ivy-league-trained psychology professor Harold Leavitt established it as a formal framework used to help explain how to drive organizational change. Since then, it’s been used by companies all over the world looking to improve the operational efficiency of their employees and tools. It’s all about the way people, process, and technology interact.
When it comes to revenue cycle, the people doing the work are one critical element. While you’ll often hear ‘It’s all about the process,’ your process can’t be its best without the best people to implement, follow, and refine the process along the way. As it relates to people, the focus is on healthcare organizations ensuring they’re hiring, training, and retaining top talent. At the top of the chain, executives need to be focused on revenue cycle excellence and understand what key performance indicators contribute to revenue cycle success. Also, on the people side, medical billing and coding teams have to be experts in their fields and staying up-to-speed on compliance and the latest industry changes. It also includes expert billing and revenue collection teams – as well as front-line providers like doctors, nurses, and other clinicians who document care. Focusing on the ‘people’ element means providing ongoing education, encouraging staff to get involved in performance improvement initiatives, and delivering regular and open communication about what the priorities are and what opportunities for improvement exist. Regardless of whether your resources are in-house, outsourced, or a combination of both – focusing on the people is the first priority.
Understand and Refine the Process
Process is defined as the series of actions taken to complete a task or achieve a particular goal. When attempting to solve revenue cycle challenges, a thorough evaluation of the processes involved is a critical first step. Harold Leavitt believed that every step of the process needed to be evaluated to identify potential waste. Within the revenue cycle, this means looking for unnecessary activity and/or rework – which most revenue cycle experts know is common practice when experts are worried about loss of revenue, regulatory compliance concerns, and more. With that said, you can still perform exceptional processes without the need for rework. It’s all about understanding the process and determining where checks and balances are needed – and when they’re overkill. To truly understand process, revenue cycle change drivers will need to hear directly from staff and leaders involved in every step of the processes being evaluated. Keeping the people involved in the process will not only provide greater visibility into what can be done better, it will help engage the staff who may need to implement and support future process changes. This will lead to greater success and better change management. While internal staff and leaders are critical to this process, oftentimes an outside look can also be exceptionally helpful. Engaging an outsourced revenue cycle management partner can help avoid inside-out thinking and can share best practices seen across multiple organizations.
Implement the Right Technology
Last but certainly not least – technology plays a critical role in the success of today’s complex revenue cycle management. Technology systems designed to streamline and enhance the revenue cycle abound – but choosing the right option can be overwhelming and some organizations go overboard by adopting numerous systems that can complicate processes even further. In fact, a 2018 study polling senior-level decision-makers showed that 70 percent of health systems use more than one vendor for revenue cycle management, which has been shown to lead to higher denial rates.
In the world of technology, today’s revenue cycle management automation tools can save time and improve efficiency. From computer-assisted coding (CAC), machine learning (ML), artificial intelligence (AI), and natural language processing (NLP), new technologies that can improve performance are everywhere you turn. Before you jump the gun – it’s always best to make sure your people and processes are where they need to be before adopting a new technology platform. Too often, organizations think a new technology product or tool can solve all their problems, but it truly has to start with people and process first.
In conclusion – the one simple strategy for revenue cycle success isn’t so simple, but it is definitely effective. Having the perfect integration of people, process, and technology will help healthcare organizations drive greater efficiency, improve compliance, enhance revenue, and streamline the end-to-end revenue cycle process as a whole.
GeBBS Healthcare Solutions is a leading provider of technology enabled revenue cycle management solutions to healthcare providers and payers. To learn more, visit gebbs.com or request for consultation today.