Tasked with the challenge of improving the quality of care while reducing costs, healthcare organizations must take an introspective look at ways to optimize revenue cycle management (RCM). The RCM system, being a major determinant of the success or failure of a hospital, is under constant scrutiny by its stakeholders and also happens to be going through major transformation.
Historically dominated by payer reimbursement requirements, the scope for RCM has broadened to include new demands driven by growing patient receivables. The "retail trend" of patients bearing more of the costs for healthcare services has been shadowed by another trend of healthcare providers choosing to outsource their RCM in varying degrees.
While there are many schools of thought on outsourcing, most would agree that the decision boils down to lowering costs. A business evaluates their core competencies, then delegates peripheral processes or services falling outside of those strengths. Many hospital and health system CFO's decide to work with end-to-end RCM oustourcing partners to reduce operationals costs and concentrate on other areas to improve quality of care. Physicians in medical practices are facing the same quandry, looking for the most effective and profitable ways to manage billing processes under new payment models.
It's logical for healthcare providers to identify the activities related to patient care as their greatest strengths. And it's understandable how a rapidly changing reimbursement model has made traditional RCM processes seem too expensive and un-manageable in the current healthcare environment. But the most effective approach to RCM is relative to each organization and for many, improving the bottom line starts with clearly defining their vision and purpose.
Is Patient Care a Core Competency?
Healthcare's revenue cycle is a complicated engine, with many gears and levers under the hood. The patient has traditionally been a minor part of the reimbursement mechanism, but that's changing in a major way. Patient payments now represent a hefty chunk of provider reimbursement and a different set of tools are required to efficiently capture this revenue stream.
Patients have always stood at the center of healthcare, as the purpose for services rendered by providers and healthcare organizations. With the significant growth of patient receivables, healthcare providers must now acknowledge a new definition for patient care, which encompasses everything from their clinical to financial engagement.
Essentially, patients are the healthcare providers core competency and patient billing is now an extension of that care. An effective approach to revenue cycle management starts with finding processes and methods that truly place patients at the center of it all.
The most popular reason hospital finance leaders pursue RCM outsourcing services is to reduce operational costs. Especially for a financially struggling hospital, handing over the reins to an RCM partner could boost the bottom line dramatically. But true cost savings should be assessed over the long term and with patient retention in mind. Does the RCM partner deploy patient-friendly collection practices? Do they offer self-service tools that foster engagement and improve patient satisfaction? Are your in-house activities supported by accurate and timely information from your RCM partner?
There are many ways to lower costs, but in a changing payment landscape that's now strongly influenced by the patient (as a consumer), an organization cannot afford to skimp on quality.
Re-Focus on Strengths
Outsourcing all or a portion of the revenue cycle management process can stimulate new focus for the self-contained processes retained in-house. Managing patient receivables is one aspect of the revenue cycle that's growing more valuable for the healthcare provider to directly oversee. As new light is shed on the importance of patient-centric healthcare practices, this is an area where the unique infrastructure, technology and staffing resources of an organization could make all the difference. By utilizing intelligent practices and sophisticated technology, patient billing can be managed effectively in conjunction with an RCM outsource partner, or completely independent of one.
At one time, sending the patient statement to a print vendor was considered a major outsource decision. Healthcare administrators were hesitant to relinquish this labor intensive task to an outside business, fearing they may lose "control" of the process. Today, it's rare to find a healthcare provider who is printing, stuffing and mailing their own patient statements. HIPAA laws, Patient Friendly Billing initiatives and rising costs of postage and manpower were all driving factors to a major shift in how healthcare providers chose to manage their statement process. We are now seeing a new story play out with RCM and how providers are looking to outsource some or parts of this complicated, multi-pronged process. We make revenue cycle management better with tools that offer seamless integration for any partner, or software to collect and manage patient receivables through one comprehensive system. iPayX builds virtual payment systems that adapt to any RCM environment, helping connect disparate systems, separate entities of an enterprise and various partner operations. The iPayX payment hub approach is an effective strategy to ensuring that patient care continues to be your core competency.