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Analysis

To-Do Items on Rev Cycle Leaders' Lists

By Alexandra Wilson Pecci  
   January 14, 2020

HealthLeaders asked revenue cycle executives what action items they are implementing at their organizations in 2020.

With the start of a brand-new year, revenue cycle leaders are motivated to implement new ideas to help their organizations' revenue cycles perform more efficiently.

Many ideas and strategies to improve the revenue cycle came out of the lively discussions at the HealthLeaders Revenue Cycle Exchange in December, and executives were prepared to go back to their organizations with action items.

"I left the discussion groups armed with new contacts doing the same work, as well as a list of things that I needed to dig deeper [into] within my own system," Joann Ferguson, RN, BSN, MBA, vice president of revenue cycle for Henry Ford Health System in Detroit, tells HealthLeaders.

So, it piqued my curiosity to ask leaders, now that they are equipped with ideas and information, what items do they have on their revenue cycle to-do lists that they hope to accomplish at their particular organizations? I posed this question to three of the executives who participated in the Exchange. Here's what they say:

Joann Ferguson, RN, BSN, MBA, vice president of revenue cycle, Henry Ford Health System, Detroit

Ferguson plans to follow up on:

  1. Managed care contracting. "As all health systems see denials increasing, we continue to try to find new and innovative ways to manage this work. Front-end contracting language and peer-to-peer [conversations between provider and payer physicians] were key themes from multiple health systems [at the Exchange]. I am interested in this approach as it is proactive instead of waiting for the denial and being reactive. As revenue margins become harder and harder to achieve, we have to figure out how to reduce administrative burdens."

  2. Payer claim adjudication. "We, like others, are strategically looking at how we can offer patient estimates. Despite our best efforts, we do not have visibility to the full picture when a patient receives services from other providers. Today a patient can call us and get one estimate and call the payer and receive a different estimate. This is confusing, time-consuming, and frustrating for patients. I envision adoption of this model, or some modified partnership with large payers, reducing the administrative burden and positively impacting the patient experience."
     
  3. ED boarders process. "Grady [Health System] demonstrated their success in billing for inpatient care for ED boarders. The automation of the flip to inpatient at time of order would eliminate the manual process of identifying time of inpatient status and appropriately drive the correct charge capture. As a system, we have put a strong emphasis on getting the patient assigned to the correct status while they are inpatient. This … gave me some additional perspective on not just getting the status correct but making sure the charges align with the status that was assigned."
     

Editor's note: Bruce Preston, CPC, director of revenue integrity for Grady Health System in Atlanta, shared a presentation about missed ED boarder bed charges during the Exchange.

Laura C. Dowling, executive director, revenue cycle services, Piedmont Healthcare, Atlanta

  1. Gather the operational leaders to discuss approach to estimates. "We're building out templates and using historical data, then relying on every scheduler/front-office staff to be able to run the Epic tool."

  2. Help organization understand the importance of having strong analytic resources. "We haven't done much in the way of leveraging standard Epic reporting, and have turned to Tableau as the answer. But after hearing other leaders talk about the operational importance of the dashboards/canned reports [at the Exchange], I think for reporting that doesn't need trending beyond 30 days—the Epic limit—we need to use the reports we've already paid for."

  3. Build team to own and manage the life cycle of vendors/contracts. "This has been an enormous benefit to the revenue cycle organization from an efficiency/priority standpoint. We don't have to fight over scarce supply chain resources as well as financial because we have a dedicated team that monitors rates/fees and negotiates better terms—especially as we've grown and thrown more volume our partner's way."
     

Donella Lubelczyk, director of revenue cycle, Catholic Medical Center, Manchester, New Hampshire

  1. Use the OnBase scanning bidirectional portal for payers. "[Payers will] be able to access our medical records and assist with getting our claims paid faster."

  2. Revisit charging for bedside procedures and do more charge audits. "I have already reached out to some vendors to get some quotes for external charge audits. I reached out to GeBBS [Healthcare Solutions] and Xtend [Healthcare]."

The HealthLeaders Revenue Cycle Exchange is one of six healthcare thought-leadership and networking events that HealthLeaders holds annually. Our Revenue Cycle Exchange allows you to share insights and ideas with other revenue cycle VPs and leadership with the same challenges. Transporation, lodging, meals, and activities are covered for qualified executives. To inquire about attending the next HealthLeaders Revenue Cycle Exchange program at the Omni La Costa in Carlsbad, CA, April 20-22, email us at exchange@healthleadersmedia.com.

Alexandra Wilson Pecci is an editor for HealthLeaders.

Photo credit: Laura C. Dowling, executive director, revenue cycle services, Piedmont Healthcare, Atlanta at the December 2019 HealthLeaders Revenue Cycle Exchange. (Spencer Selvidge)


KEY TAKEAWAYS

Be more active with managed care contracting.

Boost the organization's use of analytics.

Charge for bedside procedures.


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