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How to Prepare for Revenue Cycle Changes in 2014

Rene Letourneau, for HealthLeaders Media, January 6, 2014

Kaleida Health is readying for revenue cycle uncertainty through predictive modeling, reallocated staff, and an emphasis on clinical documentation. But the impact of HIX remains unclear.

As hospitals and health systems strive to protect and improve their revenue cycle, one of the greatest challenges they face in 2014 is uncertainty.

With all the unknowns surrounding the eventual impact of healthcare reform, health insurance exchanges, and value-based purchasing payment models, deciding on the right moves to make in order to boost collections and reduce denials isn't going to be easy.

"It's just an era of unprecedented change in the revenue cycle," says Jennifer Nichols, senior director of revenue cycle operations at Buffalo, NY-based Kaleida Health, which has $1.18 billion in annual net patient revenue and an operating margin of 1.6%.

"I haven't seen this amount of concurrent change before or the level of unpredictability of all these simultaneous changes coming together at once," she says.

Preparing with predictive modeling and more FTEs

To prepare for whatever lies ahead, Nichols and her team have done predictive modeling based on different assumptions "to create a playbook for the various scenarios and what-if situations that we can think of so we can be ready," she says.

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