"Finding the right vendor to implement and be your partner is so important," one leader says.
As the world of revenue cycle technology continues to evolve and innovate, providers and organizations struggle to find the best solutions for their needs and how to assess their efficacy.
In partnership with FinThrive, Inc., the Healthcare Financial Management Association (HFMA) has launched its Revenue Cycle Management Technology Adoption Model; a peer reviewed, five-stage guide for health systems to “leverage industry benchmarks to assess their current state of RCM technology maturity.”
Shanda Richards, Revenue Cycle Director at Central Peninsula Hospital in Soldotna, Alaska, has been involved with the model’s development, serving as a beta tester and offering feedback throughout the process. When it comes to revenue cycle solutions, from what she’s seen, organizations are mainly looking at technology solutions with features to help with price transparency, software capabilities to automate prior authorization, and claims and denial management.
“We need to take the mundane aspects of these requirements that we have and the repetitive tasks that have to be done and automate them so that our staff can be freed up to perform the analytical portion of that requirement,” Richards told HealthLeaders.
Like most hospitals, Central Peninsula Hospital has been diligent in its efforts to digitalize its revenue cycle. In 2016, the hospital converted Meditech to Epic for their electronic health records. Since then, they have gradually implemented new functions within Epic’s software.
The hospital also tried out smaller, stand-alone solutions from different vendors, but found that they didn’t work as well as advertised or that they weren’t seeing a good return on investment.
There are numerous vendors in the revenue cycle technology market, but most are alike in that they taut the ability to build whatever solution an organization needs. However, because this is a new and continuously evolving market, Richards said, risks like developmental delays and steep learning curves are high.
“Finding the right vendor to implement and be your partner is so important,” Richards said. “If you have a vendor that keeps going through mergers and purchases to where your account manager keeps changing … that’s hard.”
“My best success has been with vendors where I have very strong relationships with the people behind the scenes.”
The model will also help health systems develop their own best practices to optimize their revenue cycle outcomes. The ongoing staffing shortage has more hospitals pressed to implement technology in their revenue cycle, as well as to prevent burnout in current staff, Richards added.
Going forward, she hopes that full-time equivalent (FTE) benchmarking will be implemented as a key performance indicator.
“[You] can use that in trying to get approval from the administration of your C-suite for the cost of a product,” Richards said. “Because a lot of times they ask what the return on investment [will be], and if you have a way to measure that, this a way you can say.”
Jasmyne Ray is the revenue cycle editor at HealthLeaders.
KEY TAKEAWAYS
When looking at potential tools, organizations should have a clear idea of what they're hoping to accomplish.
Vendor partnerships are important and revenue cycle leaders should have strong relationships with account managers and liasons.