Changing a healthcare organization's culture, improving its documentation, and involving patients in payment strategies leads to higher margins.
Of the 32 leaders who responded to a pre-event survey, half cited insufficient integration and collaboration between finance and clinical teams as the biggest barrier to revenue cycle improvements. Organizations are addressing this by upgrading outdated and underperforming electronic tools to accurately capture records and complete revenue cycle activities. But state-of-the-art technology demands a sizeable investment and skills to manage its complex implementation.
Higher deductibles, antiquated technology, information gaps, lax documentation, and increasing denials are top issues facing financial executives. More than three dozen healthcare leaders will discuss these challenges, as well as strategies for maximizing reimbursement, during roundtable discussions at the first HealthLeaders Media Revenue Cycle Exchange this week.
Marrying Financial and Clinical Worlds
Catholic Medical Center in Manchester, NH, is overcoming the hurdle of aged technology. It operates numerous diverse systems, acquired over the past 30-plus years; this impedes precise data collection, and the organization plans to move to a single IT platform in the near future.
"Not all of our systems talk to each other," says Donella Lubelczyk, RN, BSN, ACM, director of revenue cycle at Catholic Medical Center. "This requires a lot of manual effort—making it difficult to pull data and measure our successes, as well as [handle] denials and appeals."
Lubelczyk's clinical background, however, gives her insight into how to mesh the financial side with the clinical. To increase efficiencies, Lubelczyk tasks her team to set measurable goals for improvements and submit monthly reports documenting process improvement. To encourage prompt charge transactions, for example, departments are working with the revenue cycle team to determine what an acceptable number of late charges should be and to reduce the frequency of such charges.
Simply relying on advanced technology is not a cure-all, according to Tammy Thomlison, chief revenue cycle officer for University of Mississippi Medical Center in Jackson, MI, who finds that transforming an organization's culture is a key driver of change.
Julie Auton is the leadership programs editor for HealthLeaders.