How to push the limits of revenue cycle performance

Many healthcare providers are not running their revenue cycle at maximum efficiency and their claims management processes are not optimized for top performance. However, as healthcare reimbursement accelerates toward value-based models, you have to ask yourself, "How can I exceed my current efforts to succeed in the future?"

As uncertainty about the future continues, you need to push the limits of your revenue cycle performance in the here-and-now to find opportunities to increase cash-on-hand and make staff more productive. This will serve as the financial foundation to mitigate the growth of capitation, bundled payments, shared savings, and the like.

In a recent webinar, we asked attendees in a live polling question what would help them most in getting clean claims out faster. The speed within this function is a good litmus test to the health of your overall revenue cycle processes as it attests to:

  • The cleanliness of registration data.
  • Effectiveness of processes used to determine patient coverage.
  • The timeliness and accuracy of documentation and coding.
  • Proper integration of your core system and claims management system
  • The thoroughness, timeliness and accuracy of your edits.

The results of the survey showed a close finish between "Better workflow capabilities" and "Stronger editing capabilities."

While these results provide insight into what your peers believe are the best opportunities for improvement, one of the least chosen answers may actually hold some of the biggest opportunities for pushing the limits in revenue cycle performance:

Using current, easily accessible, and trustworthy revenue cycle analytics data to help you pinpoint and prioritize - by dollar impact - the best and most profitable areas for focused improvement efforts.

As this article explains, building an analytics culture in your organization is step one.  It requires stepping back from other important, daily priorities to find the facts and also mustering the courage to use the data to make improvements. Your insights may not be welcomed at first, but reliable data can empower difficult conversations that lead to truly new improvement opportunities.

Jason Williams is vice president of business analytics and strategy, RelayHealth Financial

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