Helping Practices Develop a Sound Revenue Cycle Strategy
November 11, 2016
Managing the flow of funds in your revenue cycle is one of the most essential and challenging tasks in operating a successful practice. Lately, effective healthcare revenue cycle management has also faced a myriad of new challenges, including adjusting to a value-based care model (instead of a fee-for-service), establishing meaningful use for electronic health record (EHR) systems, and the transition to ICD-10 coding.
If that's not enough, there's also the increased deductibles and higher required payments for many healthcare plans. According to one source, consumers are paying almost twice as much in deductibles today as they were 10 years ago. According to J.P. Morgan, consumers are expected to pay roughly 68 percent more in 2016 in out-of-pocket healthcare costs than they did in 2011-a more than $250 billion increase.
So what does this mean for individual practices? The following are five sure-fire steps to getting your healthcare revenue cycle management strategies up to date. By analyzing your current processes, implementing effective changes, and upgrading your technology, you can avoid interruption to your revenue stream, even during this time of change and upheaval within the industry.
Analyze Workflow and Identify Revenue Bottlenecks The first step in understanding the nature of the changes you need most is understanding how your current revenue processes are actually performing. Perform a workflow analysis that maps every aspect of a patient visit, from beginning to end, so you can better understand where complications may be creeping in to disrupt your revenue stream. You can also use it as a chance to target opportunities for improvement with your entire patient process. In particular, however, you are looking for opportunities to improve efficiency with updated software or patient interaction strategies.
Establish Patient-Friendly Payment Processes Most likely your practice is already dealing with certain challenges related to high deductible health insurance plans. Many consumers have no other option for healthcare but to take on a plan with excessive deductibles. This means that your practice will need to adjust if you hope to avoid turning patients away, because more and more will be dealing with bills higher than they can immediately cover. Consider setting up a system for either financing or payment arrangements. With these systems, along with automated payments and other convenient payment options, consumers will be able to reasonably cover the cost of healthcare without breaking the bank.
Facilitate Payments With Technology. It's well known and well established that consumers love mobile payment options and quick online bill pay options. If you make it simple for your patients to cover their bills, they're more likey to pay them. With mobile payment technology and online bill paytechnology, you can set up easy systems that are user friendly and provide options for your patients. When you explore payment arrangement policies and systems, include payment technology in your list of vital considerations.
Integrate Clinical and Financial Systems. With healthcare revenue cycle management strategies, efficiency is the central goal. One of the biggest causes of inefficiency in many practices is the balancing act they have to play with financial and clinical systems, which often do not work well together. You can fix this by integrating your financial and clinical technology. At this point, financial incentives are available for meeting meaningful use requirements for EHR systems. For many payers, physicians also have to prove that they have met value-based care requirements. All require documentation of treatment and patient interaction.
Without integrated financial and clinical systems, establishing the proper documentation to meet requirements and quickly submit claims is much more difficult. Save yourself time and money by ensuring that your systems are working together. The more efficient your processes and the more money you can secure through incentives or effectively submitted claims, the better your revenue stream will be over time.
Engage Patients and Keep Them Informed. A final concern for many practices in revenue cycle management is the patient element. Some practices wittingly or unwittingly cultivate an adversarial relationship between the practice and the patient when it comes to financial matters. If your practice has started down this road, do everything you can to turn it around. Engage your patients and involve them in their payment obligations and arrangement by informing them every step of the way. Your patients have to choose their course of action with regard to treatment, with that they need to know their financial obligations. It is your job to make sure they fully understand those obligations and feel they can meet them. If they can not meet them, be ready with backup options to help them get the care they need. The more engaged they are and the more control they feel, the more responsibility they will internalize for the financial outcomes of their treatment.
About the Author - Ashley Choate is a native of Jacksonville, FL where she lives with her son, dog, and three cats. She graduated Magna Cum Laude from Jacksonville University with a BA in English and holds an MAED in Adult Education and Training. She lives for reading and writing, learning and teaching, and figuring out the day-to-day traumas and joys of mommyhood.