There are many advantages to organizations developing revenue cycle management solutions in-house, like being able to keep knowledge within the organization.
However, developing solutions in-house can potentially be more expensive and time consuming than partnering with a vendor. Because of this, it’s important that everyone from revenue staff to executives understand the importance of ROI in an RCM solution.
One Grady, the billing subsidiary for Atlanta-based Grady Health, has a team of seven developers that build its RCM tools. Jacqueline Samuel, director of revenue cycle integrity, strategy, and analytics, says this team is small compared to larger, non-safety net organizations.
In addition to developing and managing One Grady’s RCM solutions, the developers also support the overall health system with data analytics, process improvement, and automation tools.
“We only have so many resources and time available,” Samuel, a participant in the HealthLeaders Mastermind program on AI in RCM and financial operations, said. “We have an excellent team with an excellent skill set, [but] we need them to able to focus on certain things.”
One Grady staff submit proposed RCM solutions for potential development during quarterly meetings. In doing so, they must detail what that solution should be able to do and identify the return on investment.
“We want [staff] to think through ROI because with the resources that have to be dedicated, the time it takes, and the costs of the tool, we want to make sure it’s worth the effort to implement.” Samuel explained.
The suggestions are later reviewed during governance meetings to determine if they should be added to the pipeline of solutions in development. They’ll also consider alternative solutions that may not require as many resources; for example, leaning into tools built into the system’s electronic health record (EHR) and using them to their fullest extent.
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Jasmyne Ray is the revenue cycle editor at HealthLeaders.
KEY TAKEAWAYS
In-house development can be mre expensive than outsourcing, so staff and executives should consider the potential ROI when pitching or recommending a solution.
Organizations with smaller development teams must prioritize tasks and technological needs so that developers are able to focus their efforts accordingly.