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Healthcare providers hear a lot about improving productivity in the revenue cycle process, but solutions that would remove obstacles blocking that road are few and far between. Chief among these are issues including higher patient enrollment in HDHP coverage plans, changes to the ACA and Medicaid, and shrinking profitability margins.

Consider the following facts:

  • HDHP enrollment has increased 9.2% for 2017
  • The patient’s average out-of-pocket costs have risen to $1,813 – despite only 61% of Americans’ ability to pay a $1,000 emergency bill
  • The uninsured population is estimated to increase by 14-23 million, with 1 million fewer in exchanges already for 2018

Together, these factors have created a Provider Financial Challenge that revenue cycle operations are addressing with four common practices. These tactics improve efficiency from one of your existing, and most scarce resources: Your patient account representatives. They are the important means to address shrinking reimbursement, tightening demands from patients and governing bodies, and rising patient self-pay account volumes.

Here are the 4 tactics to improve productivity in the revenue cycle process:

 

  1. Make use of exception-based workflows

The most efficient healthcare operations today build their workflows by establishing and codifying business rules for operational consistency, before testing them for optimized performance. In doing so, work is only presented to staff when an automated task encounters an exception (like an insurance denial). Automation frees your staff to work only on tasks tracked at the micro process level, and routed according to “next most valuable” activity as determined by the established business. These tactics dramatically increase your revenue cycle’s productivity and scalability, resulting in significant annual net revenue improvements and reduced FTE costs.

2. Take advantage of time management tracking

In the quest for productivity, knowing how your staff spend their time is crucial in determining new strategies to improve efficiency and reduce costs. Truly improving productivity relies on their habits. Time management tracking solutions give you visibility into how much time reps are away from their work areas, while clearly defining and tracking what it means to work an account properly. Particularly sophisticated software even lets you set goals regarding accounts worked for each individual and team, and find ways to eliminate time clicks. Together, these functions add up to important insight about where attention must be paid when it comes managing staff.

3. Make performance a visual display

Visualizing staff performance helps improve revenue cycle productivity by communicating expectations more effectively and incentivizing high-performing employees. Intuitive graphics help show where the individual’s performance is within a team, and can provide real-time updates for staff engagement during the day. Rewarding your top performers, and displaying goals during a work day can also provide advantages that standup or team meetings can’t. In those respects, making performance a visual display gives you an edge unavailable with standard reporting.

4. Perform custom QA evaluations

Rewarding your top performers doesn’t stop with a comparison of accounts worked – Quality matters too. Using new technology, custom QA templates can be created to match the unique needs of your business so important factors can be considered properly against staff goals. For example, healthcare revenue cycle leaders attach recorded calls to accounts so communications can be evaluated properly. Displaying scorecards by individuals and teams gives you a further way to enhance productivity by rewarding top performers and teams not only in terms of account volume, but the way in which they work those accounts.

 

To summarize, productivity improvements in the healthcare revenue cycle come through a combination of strategy and technology. This mix should promote industry best practices through automated workflow that maintains intellectual property and administers your policies and business rules. The ideal system works to move accounts seamlessly through their lifecycle, while escalating those that sit stagnant to prevent them from falling through the cracks altogether. Achieve these lofty operational goals, and you’ll see significant gains on the other side.

 

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.

© 2018 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.

Posted by 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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