Revenue Cycle
Patient Experience

Joe PolarisSeptember 14, 2018

Healthcare Innovation: Debunking the Myths of Revenue Cycle Management Outsourcing

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Revenue cycle management (RCM) outsourcing continues to grow in popularity as healthcare organizations face tighter budgets and growing payer reimbursement complexity. Decades ago, hospitals owned laundry services, food prep, and other services that others do better, and at a lower cost. So why should a provider focus scarce resources on internal RCM troubleshooting, when instead a specialized and focused RCM partner can offer differentiated performance at a lower cost?


Even with increasing RCM outsourcing acceptance, several myths about the services linger. The truth is that a technology-enabled RCM partner will help you create a long-term, sustainable strategy to improve efficiency, reduce costs, and maximize performance. In fact, according to data gathered from an R1 RCM earnings report, a typical $3 billion health system can expect a $100 million income statement and $125 million working capital improvement over three years working with an RCM partner.


The following are five common RCM outsourcing myths and the facts on a true RCM vendor partnership:


Myth #1: I will lose visibility and control of my RCM operations

Fact: A partnership with an RCM service company is a collaborative effort where both parties establish shared operating procedures and performance measures to achieve agreed upon financial goals. Outsourcing RCM to a true partner offers greater real-time performance visibility on a much more granular level than most healthcare financial leaders are accustomed to seeing within their existing systems. Executives can view up-to-date insights on more than a hundred RCM operating measures, including those involving accounts receivable (A/R) days, collections, denials, and many others.


Myth #2: Outsourcing RCM is too expensive

Fact: On the contrary, healthcare organizations could save 20% to 30% on their cost to collect by outsourcing with a technology-enabled partner. An organization heavily invested in its RCM technology and workforce yields much greater long-term financial performance improvement, as well as markedly improved patient experience.


With patient out-of-pocket healthcare spending and high-deductible health plan enrollment continuing to grow, patients are bearing more of their healthcare costs. That means their experience, both with RCM staff and self-service technology, is more important than ever for retention, as well as for Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) performance.


Myth #3: My EHR system’s RCM platform delivers all the functionality and features we need

Fact: Efficient and effective revenue cycle performance requires knowledgeable and highly-trained operators using technology designed specifically for their workflows. EHRs were built from the clinician’s point of view and can be seen as a product that has “everything but the kitchen sink.”


And because the revenue cycle is often both the first and last touchpoint for patients, it is even more important to find a highly accountable partner who prioritizes the patient’s experience across scheduling, registration, and billing, as these areas will materially impact your ability to attract and retain patients.


Myth #4: Keeping all RCM operations inside our organization will keep data more secure

Fact: Leading RCM outsourcing vendors make data security and regulatory compliance a top priority because they are entrusted with safeguarding such a large volume of protected health information (PHI). Reliable partners invest not only in security of their own operations, but also extend a strong perimeter of highly stringent requirements around their entire supply chain to maximize security.


Myth #5: Outsourcers won’t fit into our culture

Fact: A true technology-enabled partner understands the challenges of complex, multi facility organizations and has the systems and people to support such enterprises and to ensure the right fit, culturally. The right RCM partner will work hard to blend seamlessly into your organization.


What to look for in an RCM partnership

  • A vendor focused on revenue cycle; one that has built their solution using a proven, results-driven methodology with the patient in mind, and has a staff dedicated to helping you increase your overall organizational results.
  • A team that offers an inclusive, collaborative and unselfish approach in seeking the best outcomes for your organization.
  • A partner that will help drive short- and long-term cost reductions and improvements, enable revenue growth and viability for the future, and improve the patient experience so your providers can focus on what they do best—delivering high-quality patient care.

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