Population Health and the Revenue Cycle
In preparing to take on the financial risks involved with caring for defined patient populations, healthcare providers are finding value in their billing and coding data.
This article first appeared in the March 2015 issue of HealthLeaders magazine.
Most hospitals and health systems still operate mainly in a fee-for-service environment, but payment reform is on the horizon. As the healthcare industry evolves toward risk-based reimbursement structures and clinical protocols designed around population health management models, the role of the revenue cycle is changing as well.
Some hospital leaders are accessing claims data housed within the billing system to strengthen their organization's ability to provide high-quality, low-cost care and are redesigning finance functions to create processes that can adapt quickly to changing needs.
Shifting toward accountable care
About five years ago, University Hospitals in Cleveland, a 15-hospital system with more than 2,400 beds and $3.5 billion in annual revenues, launched the University Hospitals Accountable Care Organization to establish new care delivery practices for defined patient groups.