The healthcare provider industry faces an unprecedented revenue cycle staffing shortage due to a combination of current issues, i.e., COVID-recovery from vaccination mandates to a real staffing shortage. It is time for revenue cycle leaders to look at these headwinds as an opportunity to create the revenue cycle of the future.
Reimagining your revenue cycle
History has demonstrated that successful leaders perceive risk differently and can convert challenges into opportunities. As healthcare providers battle with multiple headwinds- rising costs, reducing reimbursements, labor shortage, COVID-19, and more-RCM decision-makers must think creatively to ensure the financial sustenance of their organizations. It is time that they apply creative thinking to execute new strategies such as automation, offshoring, and improved process management to get a better Rol.
Consider this blog as a guide for your RCM transformation journey.
Implement RCM Workflow Systems
Very few organizations pay attention to the fact that the revenue cycle is a series of interconnected processes. Unfortunately, while most revenue cycle systems can provide a good view of individual processes and enable each team member to do their specific tasks better, they lack the key functionality of coordinating effort across processes. Consider investing in automating the workflows with feeds coming in based on parameters such as denial code issues, or A/R aging, or skills-based routing of the coding work queues. Process workflows reduce time to process and reduce variations in the daily work effort to guarantee consistency across the process. This consistency delivered using automated workflows can help you improve recovery from A/R and reduce days in A/R.
Adopt outsourcing/offshoring
Adopting outsourcing/offshoring can help you reduce your total cost to collect and provide the cash for the sustenance of the healthcare entity. Further, it will help you shift your focus to achieving best-in-class financial outcomes. Moreover, you get access to a trained, certified labor pool that works on best-in-class automated technologies. E.g. leading RCM outsourcing companies like Access Healthcare to employ over 27,000 revenue cycle professionals with more than 2,000 medical coders. Our team processes 200M revenue cycle transactions annually. We accomplish this through the best practices people management engine that sources the right highly skilled, highly educated healthcare specialists from one of the largest labor pools in the world. Our processes help us source suitable candidates, train them, deploy them, achieve efficiency through training and automation, and retain the employees. Armed with the experience and expertise of your outsourcing partner, you can focus on achieving business results that matter to you.
Automate processes. Leverage Artificial Intelligence, Machine Learning, and RPA
Process automation, especially AI, machine learning, and deep learning technologies, have come of age. These technologies are at a point where implementation cycles are shorter, and value realization is quicker. There are many successful use cases of technology deployment, from high-volume payment posting to real-time claims status to automation appeals filing. Revenue cycle managers embrace new tech and consider these solutions as your new digital workforce.
Apply Analytics
The revenue cycle, for most parts, is a very quantitative exercise. With precisely defined outcomes to be achieved, one would think adopting analytics in the industry must be very high. However, more than 75% of hospital CFOs say they see underutilization of analytics in their organizations.
While RCM process managers have historically understood and reported business KPIs, you would rarely find them discussing the productivity of the team members on individual processes.
The shifting measurement ecosystem – KPIs along with secondary level measures. While most revenue cycle systems provide a good view of process-specific business KPIs, the game is now shifting to the productivity and performance of your digital and human workforce. The ability to monitor primary and secondary operational statistics for each agent, i.e., biller/coder/collectors using automated tools, enables accurate secondary measures such as touches vs. resolutions, time to attainment of accuracy levels desired, the adeptness of the callers to resolve claims the first time, training interventions needed for specific people, etc. It is widely recognized that it is not enough to measure high-level KPIs alone. Measuring the secondary level can help decision-makers make data-driven decisions to improve outcomes.
Analytics can help refocus your efforts on improving business outcomes and human/digital workforce productivity. In short, you need to manage your revenue cycle by the numbers.
In conclusion, Adversity breeds innovatioN.
History has demonstrated that adverse times accelerate innovation and invention. For revenue cycle leaders willing to adopt a new mindset and embrace new models, these times are one of opportunity. They can lead the change by leveraging new tech and outsourcing to adapt to market change.