Heading into 2020, having a sound revenue cycle management strategy (RCM) in place is a top priority for hospitals and healthcare organizations trying to navigate the ever-increasing world of healthcare payment.
Most healthcare leaders recognize that chasing reimbursement is getting harder than ever. High deductible health plans (HDHP) are increasing the patient responsibility, so hospitals now have two large groups to consider when collecting – payers and patients. Secondly, the shift to value-based care and alternative payment models such as bundling and quality incentives are making it more challenging for financial and operational leaders to budget, plan and forecast. Finally, complex contracts with health plans and stringent utilization management policies are making more important than ever for organizations to rely on innovative technologies and/or partnering with an RCM vendor to help identify opportunities for improvement as it relates to the revenue cycle.
Surprisingly, a recent research report issued by Black Book Market Research indicated that 26 percent of hospitals lack an RCM solution. Whether you choose to manage your revenue cycle in-house or partner with an outsourced expert, the complexities of the industry aren’t fading anytime soon. The paradigm shift toward value-based care is here to stay – here are a few RCM strategies to help keep you ahead of the curve in 2020.
1. Collaboration is Key. We can’t say this enough – financial and revenue teams can no longer afford to work in a silo. Being fully integrated – or at least aligned with – operational leaders, coding staff, health information management, clinical documentation teams and physicians is critical to RCM success. Working as a multidisciplinary team and educating leaders, staff and providers about the changing landscape and how it can impact every facet of the organization’s performance is imperative. It’s the first key step to getting everyone on the same page and understanding the significance of the shifting economic and regulatory complexities facing healthcare organizations this coming year.
2. Focus on the Front Line. Never has the front line played such an integral role in the revenue cycle management process than they do today. From the documentation provided by the front-line care team to the scheduling and registration staff’s ability to help patients understand and prepare for patient financial responsibilities and up-front collection – more team members are playing a role in healthcare organizations’ financial success than ever before. Education, training and holding team members accountable for following policies and procedures is important for continued success.
3. Take Advantage of Technology. Technology has come an incredibly long way in recent years – and software tools that can help enhance and improve the revenue cycle are popping up everywhere. From artificial intelligence to computer-based coding – finding the right technology solution can elevate the performance of your RCM faster than just about any other strategy. Whether you want a plug and play solution to help your internal team – or you want to partner with an outsourcing expert (who will most likely have their own proprietary technology) – adopting innovative technology solutions can help you pinpoint quickly where you have the greatest opportunity to make a positive impact on your revenue cycle.
As you head into 2020, partnering with an industry leader may be just what you need to kick off the year with greater efficiency and stronger fiscal performance. GeBBS Healthcare Solutions offers a wide range of revenue cycle management solutions to support your efforts in 2020. To learn more, visit gebbs.com or Request for Consultation.