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Healthcare leaders share four key insights on RCM innovation

Healthcare leaders share four key insights on RCM innovation

Revenue cycle management comes with complexities in any industry. In the multifaceted world of healthcare, however, ‘complex’ is an understatement.

Organizations must comply with changing legislation, keep up with rules from dozens of payers, navigate various billing systems, and meet the demand for specialized staff, all while coping with the financial challenges from an unprecedented public health crisis. In this volatile landscape, adapting and evolving is critical for survival. 

In a recent panel discussion, we tapped a group of healthcare leaders to discuss what’s on the horizon for RCM. What role does technology play? How do we make the most of the data at our fingertips? Where does the patient fit into it all? Here are four key takeaways from the conversation.

  1. The right data is about more than just numbers

It’s hard to think of a field that generates more primary source data than healthcare, yet many organizations still struggle to leverage it.

Although 80% of healthcare executives say high-quality data is crucial to make informed decisions, a mere 20% say they fully trust their organization’s data.1

Reliable data requires a centralized analytics platform that can generate actionable business intelligence. “We are looking for insights, not numbers,” said Elevated Advisory Service CEO Sarah Armstrong.

Employee-specific productivity metrics are one such example. With more RCM employees shifting to remote work, having access to detailed productivity metrics has become more important.

“We can make the data say what we want it to say but ideally, I’d love to see who is most effective and what [we can] model across other staff.”

When it comes to employee productivity, that goes beyond merely tracking what workers are spending their time on and looking to the results of that time.

“What is the success rate? How can we make sure the time spent is valuable?” said Kem Tolliver, president of Medical Revenue Cycle Specialists, LLC.

2. Simplifying technology assists staff while controlling costs

It’s obvious that technology has a starring role in the future of RCM.

Too much technology, however, can do more harm than good and be a major drain on resources. For example, employees spend about five hours each week hunting for fragmented information across many different apps.2

Consolidating technology vendors can alleviate the time-suck.

“Simplify the job,” said Tolliver. “There are too many health systems where there are too many vendors. Make it easier for your staff to work so they can do the job you’ve asked of them.”

Tech consolidation also aids with the data piece, as streamlining data from multiple systems reduces complexity and brings insights within closer reach.

3. A strong patient experience is built with the revenue cycle in mind

In healthcare operations of the past, an organization’s clinical and financial activities were siloed. As patients become more savvy, digitally conscious consumers, providers must consider RCM part of the continuum of care. “Of course we want to have patients pay, but the engagement with patients is opening a dialogue,” said Caroline Balfour, vice president of revenue cycle for Huntington Hospital. “I’ve been finding more and more that patients want to discuss their finances while they are with us because they don’t want the burden of a bill when they go home.”

With tools that assess a patient’s propensity to pay at intake, providers can begin the financial conversation early on. This not only helps prevent unpleasant billing surprises and makes it easier to collect, but improves the overall patient experience.

“In a lot of ways, the experience the patient has with the revenue cycle determines their feelings toward the health system as a whole,” Tolliver said. “We have a duty to our staff to empower them to be the foundation of who we are.”

Mapping the patient journey from a revenue cycle perspective can help healthcare leaders better understand and optimize that journey.

4. Treating the patient as a person, rather than an invoice, is a strategy for stronger revenue

Treating every patient as an individual is a given on the clinical side of healthcare. It’s necessary for doctors and nurses to properly assess a patient’s condition and decide on the best course of treatment.

Panelists say RCM leaders can learn a thing or two from this approach.

“When you’re in your work queue and you transfer a balance to a patient, you need to know who you’re sending that bill too,” said Armstrong. If Patient A has a high likelihood of payment, for example (another innovative use of our available data), sending a bill in the mail makes sense. If Patient B has a lower propensity to pay, a better approach might be to seek out unknown or undisclosed insurance coverage so the bill can be turned into a payer claim.

“If we humanize the revenue cycle, we will treat patient balances differently,” said Armstrong, an approach that ultimately leads to a stronger balance sheet.

  1. “Most healthcare executives don’t trust their organization’s data, survey finds,” Anastassia Gliadkovskaya, Fierce Healthcare, October 21, 2021, https://www.fiercehealthcare.com/tech/majority-healthcare-executives-don-t-trust-their-organization-s-data-survey-finds
  2. “Nearly half of employees say too much digitalization hurts productivity,” Hannah Mitchell, Becker’s Healthcare, October 1, 2021, https://www.beckershospitalreview.com/digital-transformation/nearly-half-of-employees-say-too-much-digitalization-slashes-productivity.html

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