The revenue cycle is a complicated circuit with a broad reach. The discrete cogs of administrative, technological, financial and patient-level processes may benefit substantially from streamlining and integration in 2016, say healthcare administrators.
Complicated systems can lead to financial waste, inefficiencies and unaccounted revenue falling to wayside. If revenue cycle and billing processes don't receive proper attention from medical staff, a hospital's financial health can suffer substantially.
Having passed the ICD-10 deadline in soaring colors, healthcare organization financial leaders are turning their attention to patient revenue streams and revenue workflow to improve efficiency and performance.
Below are seven thoughts on future RCM systems:
1. Value-based reimbursement. Revenue cycle management firms are evolving alongside healthcare providers as payment methods shift from volume to value. As payment becomes more dependent on patient satisfaction during an episode of care, registration, billing and collections practices will have a substantial impact on how patient's experience healthcare. Concerned providers will increasingly rely on revenue cycle vendors and departments to understand and improve upon cost and quality targets under value-based reimbursement models.
2. More coordinated RCM/EHR systems. More EHR vendors now offer "suite" systems that combine EHRs with revenue cycle management software. However, there are features in stand-alone RCM systems that as of yet are not included in singular EHR/RCM offerings, according to Expeditive founder Jim Yarsinsky. Because EHR and RCM software manage such discrete functions, many healthcare professionals are wary of any one system can successfully manage and execute both processes. However, increased coordination and interface between EHR and revenue cycle — such as bar code scans in an EMR that record a transaction on the billing side — make an appealing case for improved cash flow.
3. Consolidated RCM practices. A consolidated revenue cycle technology stack has the benefit of providing simple access to various revenue streams across care locations within a single dashboard. By managing various RCM processes and steps within the same platform, financial leaders may easily track key performance metrics to assess problem areas costing providers cash.
4. Educating staff in revenue best practices. "Gone are the days of working in silos," said vice president of revenue cycle innovations at Anthelio Healthcare Solutions. "It is important to educate every member of every department on what revenue cycle is and how their role plays a part of it." Financial leaders can achieve more successful revenue capture by implementing department goals, setting benchmarks, conducting cross-departmental meetings and receiving employee feedback on system processes.
5. Improved point-of-service collections. As consumers pay a higher percentage of care costs, providers will suffer financially should they not collect payment or establish viable payment plans before performing elective services. For some practices, this may involve new technology, for others it may require more effective workflows.
6. RCM with ROI. According to a survey from Black Book, 79 percent of health organization CFOs plan to eradicate financial and coding technology vendors not associated with an advantageous return on investment. As margins shrink ever tighter, provider systems can't afford to cut revenue cycle systems and vendors any slack.
7. Paperless billing capabilities. Other industries, such as banking and real estate, rely on paperless billing capabilities and processes to maintain tight, efficient revenue flow. More than 70 percent of American healthcare consumers prefer to receive their medical bills online, according to a study from Deloitte. Healthcare organizations stand to benefit both in patient satisfaction and financial costs by going paperless in 2016.