Healthcare organizations operate in a environment fraught with challenges — some familiar, such as the complex, ever-changing regulations and downward pressures on reimbursement from government and commercial payers and others still emerging, such as consolidation of payers and resulting monopolistic hold on providers’ fees. Consider how these and related developments are likely to affect your organization’s bottom line in coming months and years:
Consider these upcoming events and their implications on your organization’s bottom line:
The migration of financial accountability from payers to patients…
The migration of financial accountability from payers to patients. The Affordable Care Act’s healthcare insurance marketplace, as well as employers of all sizes, are introducing more high deductible plans. The surest response to this trend is to take a new approach to revenue cycle management. If it hasn’t already, your organization must quickly adapt its revenue cycle processes to a place where it’s imperative to understand — and collect — each patient’s financial responsibility for using your providers’ services.
The continued spread of automation…
The continued spread of automation. As automation takes hold at all levels of the revenue cycle, it becomes vital to interface traditional billing protocols with new, streamlined approaches. The pressure is on organizations to keep their workforce’s trained to use the tools, resources and processes needed to ensure successful financial outcomes.
The central role of data collection and reporting for payment…
The central role of data collection and reporting for payment. The scrutiny of stakeholders is at an all-time high; government and commercial payers are measuring scores of data about health care organizations — or expecting you to report it. Leaders must learn to navigate new complexities in the revenue cycle as systems and processes are harnessed to ensure timely and accurate data extraction — whether for external programs or internal business intelligence.
In the face of these pressures, now is an opportune time to re-examine your operational processes. You may just find that reengineering the revenue cycle will be the key to surviving – and thriving – in these turbulent times.
Whether you are part of a physician practice, ambulatory surgery center (ASC) or community health center (CHC), the revenue cycle is the core function that your healthcare organization must manage successfully to remain in business.