There are three areas revenue cycle leaders must have shored up to ensure financial and operational effectiveness.
Revenue cycle leaders will continue to fight against poor operating margins, reduced reimbursement, and inflated expenses well into 2024. And at a time when a poor financial experience can negate a five-star clinical experience for patients, revenue cycle leaders are under more pressure than ever to streamline processes.
Financially successful hospitals and health systems have fully optimized three key areas of the revenue cycle, so other revenue cycle leaders need to make sure they are keeping pace.
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Streamlined patient financial experience
If your patients aren’t happy with their billing experience, you’re in trouble.
How patients are billed plays a large role in their overall financial experience and satisfaction with your healthcare organization. Revenue cycle leaders need to help patients navigate the billing process easily if they are going to create a positive patient financial experience.
Paper statements work, but digitization has pushed organizations into offering a modern billing experience. Patients expect digital and automated options when it comes time to pay their bill—and more importantly, the information presented needs to be precise.
"There are quite a few challenges in the market today when it comes to a patient's billing experience," Chris Johnson, vice president of revenue cycle at Atrium Health, said.
For example, when it comes to a patient's bill, it's common for consumers to find the amount of information presented overwhelming.
"Healthcare billing continues to be a complex process especially since you have the provider, patient, and payer all involved," said Johnson. "Quite frankly, when some patients see an insurer's use of CPT and ICD-10-CM codes, it can be like a foreign language, and it can cause confusion."
How can revenue cycle leaders do this?
Cleaning up these bills by omitting unnecessary information and making payments as easy as possible—either via text or patient portal—is a must. Missing the mark on a patients’ financial journey is a make or break for leaders.
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Foolproof leadership development
Maintaining the revenue cycle operations of an organization comes with a unique set of challenges. Labor shortages have been plaguing the healthcare industry for years, forcing revenue cycle leaders to reevaluate the way they remedy staff burnout and responsibility. Part of dealing with labor shortages is having a solid staff development and succession plan.
How do you bring on star revenue cycle staff? More importantly, how do you keep and grow them?
“You have to make recruiting part of your job as a revenue cycle leader. You can't just rely on HR or talent teams,” Bill Arneson, director of revenue cycle process and system support at Moffitt Cancer Center, said.
“Also, you have to assess where your budget is at. If you can’t afford to hire the star IT people, then you have to commit to developing them. Ask yourself, are you the New York Yankees with unlimited money? Or are you the Tampa Bay Rays who have to work the farm system and develop players?” Arneson asked.
“I've had people from both: I've brought in people from Epic, Cerner, and Siemens, as well as home-grown people. I just find the best talent I can—you know, the emotionally intelligent good team members, and then tweak along the way until they find their groove,” he said.
Staff development is never a “set it and forget it,” Arneson said.
“Once you hire someone, you have to constantly be thinking [about] how you can bring them in and find new skill sets. People's interests change over time as well, so be prepared to constantly be growing the team members that you already have. That will help you retain and grow your staff so you’re not always recruiting.”
The revenue cycle workforce will continue to evolve, so recruiting and retaining star revenue cycle staff must be a priority.
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Refined multi-department collaboration
Although the revenue cycle encompasses a large portion of a health systems' workforce, leaders must remember that everyone at the organization plays a role in revenue cycle. Revenue cycle operations are the ultimate team sport and requires physician champions, IT support, compliance, and even legal teams to back everything revenue cycle does.
How are revenue cycle leaders working with all entities across the organization to improve optimization?
Successful leaders have already started bringing in their IT teams to help streamline revenue cycle, said Christy Pehanich, AVP of revenue cycle management at Geisinger Health System.
However, Pehanich said the challenge of this is that leaders must merge revenue cycle domain expertise with IT expertise.
“We have a lot of smart IT engineers and application developers, but they do not have any revenue cycle domain expertise, and we need to merge those skill sets in order to optimize automation in the revenue cycle,” Pehanich said.
“We need to create more opportunities for IT professionals and for revenue cycle experts to merge those skills through education. Just understanding the languages in each department in and of itself can be a challenge,” she said. “There are so many acronyms … when you start talking about automation and revenue cycle, so both teams need to know what the other is saying.”
Once that merger of expertise has happened, the future is limitless, Pehanich said.
Amanda Norris is the Director of Content for HealthLeaders.
KEY TAKEAWAYS
The patient financial experience, leadership development, and multi-department collaboration: Financially successful hospitals and health systems have fully optimized these three areas of the revenue cycle, so other revenue cycle leaders need to make sure they are keeping pace.