At the Becker's Hospital Review Annual Meeting in Chicago on May 9, three healthcare experts discussed key strategies for improving revenue cycle performance. Russell Gardner, director of revenue cycle for Mary Free Bed Rehabilitation Hospital in Grand Rapids, Mich., and Kelly Utley, CFO for Sidney (Neb.) Regional Health Center discussed their experiences and observations regarding hospitals' revenue cycles. The session was moderated by Peter Cunningham, CEO of CCO Healthcare Partners in Chicago.
Both speakers agreed that the prime goal of revenue cycle management is to shorten the time between the moment a bill goes out the door until the ultimate amount of cash comes back. To do so involves the right combination of people, processes and technology.
Below is an excerpt from the panel discussion, edited for clarity.
Peter Cunningham: Hospitals, with all the change, [are beginning to] perform more in the retail business. How has that affected your management cycle?
Russell Gardner: I think we're at a point in industry development where we understand we're not like any other business. We're becoming much more of a retail provider of services to customers. There's a tremendous impact on the revenue cycle. My resources are constrained or reduced, so how do we maintain patient expectations while maintaining the bottom line?
One of the things we talk about is people are the deliverers of the service within the hospital, but how do they contribute to the development of the revenue cycle and to their role within the revenue cycle? I've [previously] done a poor job explaining to my staff how they fit into that picture, and that's something I'm beginning to develop more aggressively — [explaining] how people can contribute to the revenue cycle within my facility and how it's important to the overall performance of the hospital.
Kelly Utley: We're at the same place. When you mentioned talking to your folks, one thing we've noticed is, more and more, our acute-care floor [faces] expectations of being a whole lot like a hotel. Patients want the food to be five-star food. Those things don't seem like they would matter to a revenue cycle, but if we take note of how many times we are getting administrative discounts or writing something off, maybe because of someone who was rude to someone else, there is a constant push to pay a hospital less money. There's a huge affect on our revenue cycle when customer experience is not five-star.
PC: Is source of talent an issue?
KU: Talent sourcing is huge. We have maybe 14,000 people in our service area, so it's not uncommon for people in our area to drive hours to come to work. It's not only for frontline staff, but talent sourcing is huge for directors. The one thing we're currently looking at is changing our culture, and to take into consideration how it affects the revenue cycle. How can you attract talent to not just get the right people on the bus, but to make it a bus that somebody wants to ride?
RG: My experience has been focused on the back end of revenue cycle, which is traditionally billing and collections. I've worked in both big markets and small markets. Up until about five weeks ago I worked in Chicago, and sourcing talent was never a problem. There's talent in a major metropolitan area. Moving to a smaller market — the revenue cycle needs haven't changed, but I'm finding we need to train people better. They have been trained by someone who might have trained them in the most [inefficient] procedures you could imagine, so you have to go in and re-train them. [You have to] identify the talent gaps and how to fill them.
If you don't have a talent pool to do it, what's becoming more popular is "cold-sourcing." Companies will bring an employee to your site to work side-by-side with your staff to teach them better behaviors. [The trainers] come in and move out. It ensures folks in these technical positions receive guidance and leadership. Sometimes we don't have the time to sit down and train them appropriately.
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Both speakers agreed that the prime goal of revenue cycle management is to shorten the time between the moment a bill goes out the door until the ultimate amount of cash comes back. To do so involves the right combination of people, processes and technology.
Below is an excerpt from the panel discussion, edited for clarity.
Peter Cunningham: Hospitals, with all the change, [are beginning to] perform more in the retail business. How has that affected your management cycle?
Russell Gardner: I think we're at a point in industry development where we understand we're not like any other business. We're becoming much more of a retail provider of services to customers. There's a tremendous impact on the revenue cycle. My resources are constrained or reduced, so how do we maintain patient expectations while maintaining the bottom line?
One of the things we talk about is people are the deliverers of the service within the hospital, but how do they contribute to the development of the revenue cycle and to their role within the revenue cycle? I've [previously] done a poor job explaining to my staff how they fit into that picture, and that's something I'm beginning to develop more aggressively — [explaining] how people can contribute to the revenue cycle within my facility and how it's important to the overall performance of the hospital.
Kelly Utley: We're at the same place. When you mentioned talking to your folks, one thing we've noticed is, more and more, our acute-care floor [faces] expectations of being a whole lot like a hotel. Patients want the food to be five-star food. Those things don't seem like they would matter to a revenue cycle, but if we take note of how many times we are getting administrative discounts or writing something off, maybe because of someone who was rude to someone else, there is a constant push to pay a hospital less money. There's a huge affect on our revenue cycle when customer experience is not five-star.
PC: Is source of talent an issue?
KU: Talent sourcing is huge. We have maybe 14,000 people in our service area, so it's not uncommon for people in our area to drive hours to come to work. It's not only for frontline staff, but talent sourcing is huge for directors. The one thing we're currently looking at is changing our culture, and to take into consideration how it affects the revenue cycle. How can you attract talent to not just get the right people on the bus, but to make it a bus that somebody wants to ride?
RG: My experience has been focused on the back end of revenue cycle, which is traditionally billing and collections. I've worked in both big markets and small markets. Up until about five weeks ago I worked in Chicago, and sourcing talent was never a problem. There's talent in a major metropolitan area. Moving to a smaller market — the revenue cycle needs haven't changed, but I'm finding we need to train people better. They have been trained by someone who might have trained them in the most [inefficient] procedures you could imagine, so you have to go in and re-train them. [You have to] identify the talent gaps and how to fill them.
If you don't have a talent pool to do it, what's becoming more popular is "cold-sourcing." Companies will bring an employee to your site to work side-by-side with your staff to teach them better behaviors. [The trainers] come in and move out. It ensures folks in these technical positions receive guidance and leadership. Sometimes we don't have the time to sit down and train them appropriately.
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