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Weather Your Health System’s Business Office from Post-ACA Repeal With These 3 Changes to Your Operations

January 19, 2017

 

The Affordable Care Act’s repeal is no longer in question – It’s just a matter of how it will be carried out.

Several paths to the law’s removal exist, but many believe congress will use the budget process to defund two key provisions in the law: Federal Premium Tax Credits, and Federal payments to states expanding Medicaid eligibility. These impending cuts have led experts like the Commonwealth Fund and Linda J Blumberg at the Urban Institute to predict uncompensated care will drive up to over a trillion dollars from 2019-2028, while 2.6 million jobs will be lost, and 30 million people will be moved back to uninsured status. A replacement plan will take several months to deliver. The reimbursement cuts associated with the ACA’s implementation will not be repealed. Together, these factors put health systems in a tough situation, as providers will be forced to do even more with less, and find more efficient ways to increase production and lower the cost to collect.

So how do you start shoring up your business office for the impact? You have a number of options, but here are three things to consider:

  • Establish a single process for your business office – Mergers and acquisitions taking place over the last five years have left many providers with multiple data systems, and thus separate processes for the same functions. The impact may include multiple customer service centers and cash posting departments, for example – But the general effect is inefficiency. To eliminate issues like these, combine those processes into a single platform that manages your revenue cycle to save both time and money.
  • Use automation to work more accounts – It’s impossible to perform manual follow-up on every account. So look for tools that can automate as much of the process as possible: Look at segmentation for self-pay, automated claim status for insurance and denials, missing insurance discovery on self-pay accounts, and financial assistance screening to help get patients qualified for Medicaid and/or charity. Using these tools helps you only deliver the accounts needing attention to your staff, enabling you to dig deeper into your accounts with the same staff, while increasing your return on productivity.
  • Reduce labor-intensive patient calls – With limited staff, finding ways to reduce labor-intensive calls from patients can save a tremendous amount of time. Using a fully-functional self-service option for payments, insurance updates and financial assistance applications can eliminate some of these calls to your service reps. Using an IVR to help with requests for itemized statements, mailing addresses for payments and other routine tasks can increase the amount of time representatives have to work on other, more important activity. It also enables better customer service to the patient as they engage your health system on their terms, improving satisfaction.

When you set up a single process, instill automation for your workflow and reduce the number of labor intensive calls from the patient, the result is better productivity and a greater number of accounts worked. That increases your revenue, reduces days in A/R and lowers the overall cost to collect. In the new post-ACA order, those factors add up.

 

Disclaimer: Ontario Systems is a technology company and provides this blog article solely for general informational and marketing purposes. You should not rely on the content of this material for any other purpose or as specific guidance for your company. Ontario Systems’ advice, services, tools and products described herein do not guarantee compliance with any law or industry standard. You are ultimately responsible for your own company’s actions and compliance efforts. Because everyone’s situation is different, you must consult your own attorneys, accountants, and/or other advisors to obtain specific advice on your company’s compliance, legal, tax, regulatory and/or other business needs. Despite Ontario Systems’ efforts to provide current and up-to-date information, you need to recognize that the information contained herein may become outdated quickly and may contain errors and/or other inaccuracies. 

© 2017 Ontario Systems, LLC. All rights reserved. Information contained in this document is subject to change. Reproduction of this publication is not permitted without the express permission of Ontario Systems, LLC.

About the Author

Shawn Yates

Shawn Yates serves as Director of Product Management for Ontario Systems, defining the company’s strategy for product and service offerings in the healthcare market. With over 20 years of experience managing self-pay receivables and collection operations for a top 20 healthcare system, Shawn’s background also includes working for a national outsourcing company helping clients manage their insurance and self-pay receivables, and Experian Health, the largest data and analytics company in the country.

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