Revenue cycle staffing is a crisis for healthcare organizations. In a June 2022 survey, 41 percent of revenue cycle leaders indicated that between 51 and 75 percent of their revenue cycle management and billing department roles are currently vacant. One solution: outsourcing medical billing.
At the Becker's Hospital Review 7th Annual Health IT + Digital Health + RCM Annual Meeting, in an executive roundtable sponsored by PwC, healthcare leaders shared their thoughts about revenue cycle managed services. This session was moderated by Jacob Shurbet, managing director, and Emily Anne Jacobstein, director, both of PwC, health industries, managed services.
Five key insights were:
- Revenue cycle leaders don't expect vendors to have all the answers, but they want transparent partners. "We don't want vendors who think they know everything," one roundtable participant said. "We want someone who will partner with us and allow us to make suggestions to improve their service. It has to be a win-win partnership."
When selecting a vendor, organizations are looking for innovative technologies, industry experience and an honest assessment of what ongoing support will be needed. - To vet potential vendors, selection teams look beyond references. As part of their vendor due diligence process, many revenue cycle leaders turn to friends and trusted industry colleagues. "We assume that the references provided by the vendors will all provide glowing reviews," one participant said. "We've developed very specific questions like the exact implementation time frames and the vendor's ability to meet target budgets." Another participant said he asks vendors how many contracts they've lost in the last 12 to 24 months.
- Some organizations are turning to vendor management firms to vet and hire revenue cycle management companies. Vendor management firms are responsible for outcomes and are paid contingency rates based on the savings they generate. "When the vendor management company first came in, I was very negative because I thought they would take over the ownership of our vendor relationships," one participant said. "In reality, it's been the complete opposite. They serve as our business partner and have saved us millions of dollars."
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Key performance indicators are used to evaluate vendor performance. One organization uses the same productivity and quality metrics to evaluate both the internal business office team and strategic vendors. "We have weekly reviews and monthly executive summaries where we track vendors on our KPIs," a participant explained. In many cases, vendor penalties and bonuses are tied directly to KPIs.
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Creative partnerships are an effective way to address talent shortages in a flexible way. "We lose five to six people a month in our call center," one participant said. "We had been using an agency that found excellent people, but we paid a premium for that. Now we have a partner with 25 to 30 people working for us all the time in different areas. When I have gaps, I can flex and pull them in. This approach has worked very well."