3 Unexpected Ways Improving Your RCM Practices Could Improve Hospital Performance

I’ve already discussed the wealth of information to be found in medicine’s oft-forgotten business offices, but today I want to focus on the RCM team specifically. I’d like to go out on a limb and assert that your revenue cycle team may even be the key to improving your hospital’s overall performance.

Leverage Your Revenue Cycle Team’s Insight

With their unique view on the daily operations of a hospital – the rate at which claims are being pushed out, the volume of patients treated, etc. – your revenue cycle team offers a vital perspective on the efficiency of your business.

While your revenue cycle team may be trained to identify faster and easier ways to improve operational efficiency, they should also be consulted on larger trends and be involved in determining important benchmarks. Their ability to mine and analyze organizational data should be leveraged whenever possible. For example, looking at demographic trends in your hospital’s area, combined with clinical insight, can help drive investment decisions, as well as drive outreach programs.

 

Invest in Third Party Input for Long-term RCM Success

Just as your own internal team may offer unexpected insight, bringing in a third party to help assess revenue cycle and operational processes can help guarantee long-term financial success.

The true value of outside assistance lies in their ability to assess the state of your business operations without bias: because they are not immersed in your day-to-day activities, they are better able to evaluate your practices for their long-term implications.

When selecting a partner, make sure they have experience running your class of hospital. Ideally you want a national-level consulting group, as they are more likely to know about larger trends, rather than focusing only your local market.

And when evaluating cost focus on what it would cost a new change leader, so that you have a realistic level view of cost. Something else to consider is what new revenues and cost containment can be driven by the project. Typically, a savings/pickup of 2-4% of Net Patient Revenue is conservative. Also consider asking if your software/hardware vendors offer this service, perhaps as expanded maintenance, or through Application Management Services.

 

Prioritize Field Training In an IDN Environment

Healthcare providers operating within integrated delivery networks must prioritize field training if they hope to successfully manage a central business office. Put differently, ongoing education is key to ensuring financial success.

One of the great challenges of running a true central business office is making sure the member hospitals and providers are all following consistent procedure. Without an education department, it is impossible for IDNs to evaluate whether field staff and registrars are doing what the leadership team expects of them. Trainers should be sent out to the field on rotation to certify staff are following through on verification, maintaining the required financial paperwork, and communicating with patients as appropriate. Furthermore, truly successful education departments learn from the field as well, picking up new ideas, fresh perspectives, and local trends that may impact the IDN as a whole.

A version of this post was originally posted on Becker’s Hospital Review.