If nursing is the heart of a healthcare provider organization, the revenue cycle is its backbone. A healthy revenue cycle not only helps reinforce adequately funded operations—which is especially critical during a crisis situation like that one currently facing organizations all around the world—but is essential in supporting organizational growth strategies to meet the larger mission.
Every healthcare provider organization needs to develop processes and policies for staying financially healthy that account for ever-changing healthcare regulations and new reimbursement models. Even the best-performing organizations should continually assess opportunities to raise the bar on revenue cycle performance. ECG believes that a leader’s approach to achieving or maintaining best practice performance should be a balancing act between relying on tried-and-true practices and implementing new methodologies that have emerged within the industry.
Revenue cycle management has changed dramatically over the last 20 years. With healthcare regulations and reimbursement models continually evolving and the emergence of new technology platforms promising to solve every problem, it’s often difficult to know where to start or what to focus on next when managing the revenue cycle.
Whether your organization is already performing at industry-leading levels or needs significant improvement, there are five strategies all revenue cycle leaders should focus on:
We’ll look at each of these strategies in more detail, below.
BREAK DOWN TRADITIONAL SILOS
Many healthcare organizations are feeling the impacts of not viewing their organization holistically with respect to the bottom line. As consumers continue to educate themselves on available services in the market, a few elements—including the cost of services, ease of access to appropriate care, and the overall patient experience—become key to increasing your overall revenue and collectible dollars. As a result, increased coordination among patient access, revenue cycle, and managed care should be viewed as a necessity for continued growth and financial success. Figure 1 highlights how these three distinct functions are deeply interconnected.
PATIENT CARE ACCESS TO COLLECTIONS CONTINUUM
When coordinating among patient access, revenue cycle, and managed care, keep in mind the following:
- Patient access is no longer a narrowly defined hospital revenue cycle function. It is a multifaceted term that is used to describe how consumers interact with their healthcare providers. Failure to meet consumer expectations can have significant implications on attracting and retaining patients.
- A successful, integrated patient access strategy requires an understanding of patients’ needs and an assessment of your organization’s capacity to meet them. Approaches may differ but can include enhanced online tools; clear, up-front payment collection policies and options; open access scheduling; expanded care settings; and optimized patient financial screening and contact centers.
- Streamlining patient access can increase patient volumes, improve the consumer experience, and create downstream operational efficiencies.
- Timely and regular review of your commercial contracts, which incorporates feedback from your revenue cycle stakeholders, is critical to the bottom line.
- High-performing organizations that can centralize people, process, and technology on both the front and back ends stand to increase collections and decrease bad debt— all while improving the patient experience.
Published December 28, 2020
