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Paving the way for the revenue cycle of the future

For healthcare finance teams, leading and managing the revenue cycle has evolved into an increasingly complex role—requiring in-depth knowledge of regulatory changes, payer contract management, staffing, value-based reimbursement and the patient experience. As attendees at the fifth annual Becker’s Health IT + Revenue Cycle Conference weighed in on their revenue cycle challenges, several key takeaways emerged:

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  1. Patients must become more active in both their healthcare and their financial responsibility. Many factors—regulatory changes, high-deductible health plans, the shift to value-based payment models, digitization and consumerism—have drastically shifted the healthcare landscape. Patients can significantly benefit by embracing these cultural changes and becoming more involved in their healthcare and its costs. A health system’s revenue cycle team is well-positioned to help them navigate this role. “Just as a provider would counsel a pre-diabetic patient on how to monitor blood sugar levels and modify diet and fitness habits, we can educate patients about their care costs and help them plan for payments, thus helping them become more proactive about addressing their financial responsibility,” said Jennifer MacDowell, revenue integrity analyst for AMITA Health.
  2. Healthcare organizations should position themselves as providers of both excellent patient care and financial care. Patients generally consider their physician to be an expert on providing high quality care. The revenue cycle team can play a similar role by providing a high quality financial experience. “Our team is proud of the way we treat every patient with kindness and empathy,” said Lesa Ellis, director of financial counseling and assistance at Providence Health & Services. “We’ve redesigned our front office team to be more focused on the patient experience, and in our centralized billing office, our entire staff knows how to financially counsel patients and determine if they qualify for charity care.”
  3. Creating a positive patient experience isn’t just about technology—it’s also about people. In recent years, many healthcare executives have implemented technology that fosters a positive financial patient experience. The other necessary component is people—having the right team, processes and training in place to support your patients. “Everyone in rev cycle talks about ‘digital’ and ‘automation,’ but these things must be balanced with people, and how staff helps patients through the financial process,” said Ellis. Angela Confoey, senior director of revenue cycle at Beth Israel Lahey Health - Mount Auburn Hospital, said her team examines processes to make sure they evolve to meet the patient’s needs. In particular, “In addition to resolving our patient complaints, we use them as a learning tool. We review them to determine how we can improve processes and service."
  4. Automating a bad process won’t improve efficiency. Many healthcare financial executives plan to automate their revenue cycle through technology such as Artificial Intelligence and Robotic Process Automation. However, before they can automate, they must determine their key pain points. “The revenue cycle team traditionally works in silos, which must be eliminated before we can truly become efficient. If we work collaboratively and understand each other’s roles, we wouldn’t need to touch claims so frequently,” noted Lindsey Langmaid, lead billing and collections at Ascension. “Every time someone touches a claim, we lose efficiency—which means we lose revenue."
  5. Finance executives can increase revenue by addressing staff issues. Revenue cycle staff such as patient access staff or coding often have high turnover, which can contribute to reduced reimbursement. New staff may not fully understand how to use technology, make more errors, or not be experienced in providing an ideal patient financial experience. Regular training and a positive, fun learning environment can help reduce errors while raising morale and lowering staff attrition. When applicants apply for a registrar position, Ellis pointed out, they may not realize a major part of the job is patient collections. “We use training across the revenue cycle and try to make it fun with skits and presentations. We have modules on regulatory changes and bring in collections agencies to share their techniques,” Ellis said. She believes these strategies have contributed to low turnover, indicating some of her team members have been with the organization for 30 years. Confoey believes revenue cycle teams must embrace benefits that are common in other industries, such as flex hours and telecommuting. “Many revenue cycle professionals are attracted to the benefits vendors offer and leave the provider setting,” she said. “We need to make it appealing for talented staff to stay."

And the main takeaway:

If revenue cycle teams focus on doing right for the patient, everything else falls into place. Healthcare organizations’ main goal is caring for the patient. If revenue cycle teams keep a laser focus on helping the healthcare organization to meet that goal, they’ll be more collaborative and find success. By putting every task through the lens of, “Am I doing what’s best for the patient?”—from counseling them on their financial responsibility to seeking charity care to helping them set up a manageable payment plan—they’ll rally around a common goal: fostering the best patient experience.