Building the Workforce of the Future: 3 Rev Cycle Leaders Discuss the Rework of Productivity Measures

Revenue cycle leaders share their experiences with measuring staff productivity in this new, remote workforce environment.

Like most of healthcare, the revenue cycle workforce has changed dramatically within the last several years. An entire office floor that previously housed a revenue cycle department is now silent and desolate as most staff have been working remotely for years at this point.

While working remotely has been a success for most organizations and is now a permanent work model, measuring productivity has moved to the forefront of concerns since staff are no longer under physical, constant supervision.

During the recent revenue cycle Healthcare Workforce of the Future virtual roundtable, executives got together to discuss how productivity has changed in recent years and share best practices for measuring productivity in order to get the most out of their fully remote or hybrid staff.

Marvin Mickelson, system director of PFS-shared revenue cycle at University of Kansas Health System, said that the productivity of his customer service team went through the roof when they were sent home at the start of the pandemic. In the office, the team couldn't meet their call documentation goal, which was three minutes. 

"We have a goal of three minutes per call, and our customer service team was hitting four and five minutes a call while still in the office," Mickelson said. "Once they became remote, the team has been below three minutes a call for the past 22 months straight."

However, other departments didn't see the same boost in productivity, Mickelson said.

"Productivity per department is a mixed bag for us too," said Derek Dudley, assistant vice president of revenue cycle operations for Wellstar Health System.

"When we first sent staff home, like Marvin, we saw an immediate boost in productivity", Dudley said. "There was less distraction. Now though, I think distractions have started to creep back in and now we're dealing with the same productivity levels and potential challenges that we did pre-COVID-19."

Remeasuring productivity measures

These ebbs and flows of productivity since the beginning of the pandemic have made it essential for leaders to step up their procedures for measuring productivity across all departments, both in-house and remote.

Revenue cycle leaders now have to be more reliant on reports and work queue volumes. Instead of being able to manage staff in person by walking around, leaders now have to pull reports, activity logs, and manage work by volume.

"Our best gauge of productivity now is running daily productivity reports," says Dudley. "Productivity measures vary by department since the complexity of tasks can differ greatly, such as those writing complex appeals versus simple appeals."

"There's also a degree of variability in value-add tasks," he says. "When it comes to measuring our productivity, that's really what we're looking for: accounts that are being successfully resolved, reports showing system actions, and the staff's time in and out of the system. There is a myriad of ways that we can check from a distance to make sure staff is working effectively."

Mickelson agrees that his organization is similar. "We're also looking at touches on accounts. Staff have to work a certain number of accounts a day to meet the goal for productivity," he adds.

Quality assurance is also a really big part of measuring productivity, Mickelson says. "Staff can 'touch' an account for an hour if they want to, but if they don't do anything with it, it's not helpful. The team will have a lot of re-work to do."

Jason Driskell, vice president of revenue cycle at Lakeland Regional Health, says his organization can see how long staff are in a specific account and what tasks they performed while in that account, which has proved to be helpful when it comes to measuring productivity.

But, Driskell says, they can't see what revenue cycle staff should have done with an account through a report. "It would be more helpful to see exactly what staff should have done based on a work queue designation or denial code to resolve the account. We want to see if staff were able to address any follow-up issues that they needed to and compare that to what they actually did," he says.

The future for the revenue cycle workforce

Now that revenue cycle leaders are working to perfect new productivity measures for hybrid and remote staff, are these new standards here to stay, or will we need to dust off those dirty office cubes since staff will be back in the office full time? These leaders say remote work is the new norm and it's here to stay. At least for them.

"I’ve heard other leaders say that if staff can’t meet their productivity while working from home, we will just bring them back in the office," Driskell says. "I've actually had a complete and opposite approach to that."

"If their job is now at home, bringing them back to the office is no longer an option,” he says. "So, if staff can't manage our new productivity measures, then they have to be placed on a performance improvement plan. At that point, staff have to decide to work faster and more accurately. There isn't an option for coming back in the office to help with productivity because we don't have anywhere to put them at this point—we've eliminated those departments' on-site work areas."

Dudley agrees. "That's the same mentality we have in our organization, " he says. "We have had that transformative shift to remote work, and we aren't looking to bring staff back to an office. And plus, we are downsizing our offices, so we will not have the same level of space anymore."

The option of bringing staff back into the office to encourage productivity is officially designed out.

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