In March 2021, a report by Kaufman Hall on behalf of the American Hospital Association estimated that 39% of hospitals would operate at negative margins through year end.   As we look toward 2022, that now seems both very optimistic and highly unlikely.  That was before we faced the Delta and Omicron variants, causing more waves of COVID. Before the country faced vaccine rollouts that turned into a political issue.  Before organizations faced soaring labor costs and exhausted health care professionals.  Health care organizations are operating under unprecedented financial viability challenges.

With an estimated $260 billion in administrative waste, effective and efficient revenue cycle management has never been more relevant and essential than it is today.   Every dollar counts.  The revenue cycle management rule of three's can be summarized by: Analysis, Action, and Automation.    

Analysis

One thing is consistent about health care data sets in general-the data will surprise you and it is never in a good way.  Many health care organizations lack the internal infrastructure (data lake/DWH) or technical/analytical resources to effectively manage their data asset, much less routinely analyze it in a way that creates actionable insights.  Weekly reports and excel spreadsheets don’t get the job done.  Today’s analytical needs are realtime dashboards that identify anomalies as they happen.  Getting a handle on overall revenue cycle management, having visibility into denials, understanding how your self-pay business is tracking and monitoring reserves (or more importantly, lack thereof) are key.  It is that kind of analysis that leads to action. 

Action

Once organizations have trusted analytics that have been embraced, the focus turns to taking action to solve the problems that have been identified.  Maximizing workforce performance with a platform that is an engagement tool with incentives that measures employee satisfaction, time and attendance is essential as the healthcare workforce faces burnout and continued stress.  Also essential is focusing directly on bottom line financials with realtime data monitoring and customized business rules that segment and distribute tasks according to priority, resulting in enhanced productivity.  Or more effectively managing risk-based payer agreements, surrounding population health efforts and moving to predictive analytics for things like denials.

Automation

All healthcare organizations are being asked to do more with less and creating the necessary administrative efficiency doesn’t happen with people-it relies upon process and technology.  Robotic process automation (RPA) and Intelligent Process Automation (IPA). A 2021 HFMA survey of hospital CFO’s found that more than 90% want to implement automation solutions that are purpose-built for healthcare revenue cycle management, including functions like automated form generation, billing and collections.

As health care organizations are still reeling from the issues they’ve faced with supply chain, patient care and financial viability, there has never been a better time to take a deep breath and focus on maximizing every dollar possible with the help of a trusted partner going forward.

Interested in learning more? The team at VisiQuate is focusing on how we can help hospitals optimize their revenue cycle management. Visit our Revenue Cycle Playbook for step-by-step plays to help you stay on top of the ever-changing landscape of healthcare revenue cycle, or contact us to schedule a demo.

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