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Hospital Execs Name Top Revenue Challenges

Rene Letourneau, for HealthLeaders Media, March 18, 2013

With changing reimbursement models and an increase in the self-pay population eating into margins, healthcare executives know it's becoming more important than ever for hospitals and health systems to collect all the money they are owed for services rendered.

No one can afford to leave money on the table because their revenue cycle processes don't run as smoothly as they should. But raising collection rates is more easily said than done. And it's among the biggest challenges facing three healthcare financial administrators with whom I recently spoke.

Collecting more up front

H. Jeffrey Brownawell, chief revenue officer at Memorial Hermann Health System, a Houston-based organization with 3,508-beds, says the principal challenge he sees is finding ways to collect as much money as possible before services are provided.

"One thing I would say is, man, you really need to go get all the money you are owed. As an industry we haven't done that as well as we should have. We're trying to look at how our process can be more efficient up front. On the hospital side, you need to collect money up front because the likelihood of collecting drops if you don't," Brownawell says.

He admits that there is room for improvement around upfront collections at his organization but says the nature of emergency care makes it tough. "We are collecting a lot of cash up front, but we are not doing as well as we could. Right now you can't go to any other part of healthcare—to the dentist or a physician's office—and have service without paying up front. But people still come into the hospital all the time through the ER, and there is no good way to collect up front."

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