The right revenue cycle management technology can create a transparent, seamless patient experience, which benefits the bottom line.
For the longest time, revenue cycle management has been the man behind the curtain. Healthcare organizations have focused on improving the clinical experience using technology and provider education while telling patients and providers to pay no attention to the financial processes occurring in the background.
The separation of the clinical and financial experience may have worked in a world with few high-deductible health plans. But as patient financial responsibility steadily rises, healthcare organizations are having to draw the curtain back on revenue cycle management to create value for patients.
The average family in the US now spends about 11 percent of their income on healthcare, with about a quarter of those expenses attributable to co-pays, deductibles, and other out-of-pocket health costs, according to data from the Kaiser Family Foundation.
With patients spending thousands of dollars on healthcare each year, healthcare organizations need to deliver a quality financial experience in addition to exceptional clinical care.
Revenue hinges on providing an excellent experience from patient registration to account resolution. Hospital revenue attributable to patient balances after insurance increased by 88 percent from 2012 to 2017, a recent TransUnion Healthcare analysis showed. Hospitals with better patient-reported experiences also had higher profitability, Deloitte reported.
The data underscores the importance of addressing the patient experience from both the clinical and financial perspectives. To achieve that, healthcare organizations need to modernize revenue cycle management.
“We’re spending extra money billing the Blue Crosses and Uniteds of a world when we really should be engaging the patient, especially in light of high-deductible plans,” says Carrie Moneymaker, MBA, vice president of solution design at Zotec.
“Patients should be involved in the entire process just as they are involved with their clinical care,” she stresses. “We need to extend the conversations had during the clinical encounter and through the EHR to the entire patient experience, including scheduling, registration, and other revenue cycle processes to mitigate friction and frustration for patients, providers, employees, and the community as a whole.”
To achieve an all-around quality patient experience and reap the benefits of such an encounter, healthcare organizations need to leverage revenue cycle management technology.
Automating revenue cycle management
Using the power of technology to modernize revenue cycle management is key to improving the patient experience and the bottom line.
Healthcare consumers are demanding a more digital financial experiences in which they can pay medical bills online, access clinical and financial information via patient portals, and receive communications through email or text. Many patients are also willing to switch providers due to poor digital experiences.
Healthcare organizations have yet to meet patient demand for revenue cycle management automation. Research shows that few healthcare organizations have automated more than a quarter of financial processes, with many lagging with modernizing patient-facing revenue cycle activities, such as patient collections and patient access.
“People are afraid of change, and it’s overwhelming and expensive. Technology is expensive,” Moneymaker explains. But healthcare organizations can achieve significant ROI by investing in revenue cycle management technology, she emphasizes.
For example, investing in technology that engages patients with the financial aspect of care even before the clinical encounter can result in organizations going from collecting co-pays at the point of service to setting up payment plans before patients even walk through the door. And that engagement leads to improved patient satisfaction, as well as higher collection rates.
Healthcare organizations can see significant gains by investing in revenue cycle management technology, especially systems that engage patients with the financial process. However, not all technologies are created equal.
Investing in the right technology
The fears and concerns resulting in key revenue cycle management processes remaining manual have also spurred some organizations to add more people or bolt-on technologies to meet patient and revenue demand for an improved patient experience.
“They think that’s a fix because they bought into these big box solutions, and those products can’t help the organization automate within its infrastructure,” Moneymaker states. “So, they need another bolt-on to help make a slicker and more seamless experience. But in reality, they’re not. They are making themselves clunkier and less transparent across the enterprise, creating a very siloed operation.”
Operating with a patchwork of bolt-on revenue cycle management technologies leads to bottlenecks and burnout among providers and staff who are increasing their number of clicks and turning to manual processes as workarounds.
Revenue cycle management automation that delivers a transparent process from scheduling through the clinical encounter to patient collections will help organizations realize the gains of technology, Moneymaker says.
Healthcare organizations should be looking at the revenue cycle as a whole as they consider automation. This type of mindset will “provide you the transparency, and I’m not just talking about reporting, but within your workflows,” she explains. “If someone wants to look into a workflow, they can do so easily and then provide that transparency to the patient from the point of that scheduled service.”
Investing in an end-to-end revenue cycle management system or technologies that can at least communicate data across systems will help team members understand the entire revenue cycle and its relation to the clinical experience, Moneymaker says.
“People are breaking revenue cycle off as separate conversations. Then, breaking each type of conversation into mini conversations. You have to look at the big picture from the moment the patient comes in the door or before to the very end of it. It should all be part of what you’re looking at to improve your revenue cycle,” she highlights.
Automating the revenue cycle as a whole will require a transformation that many healthcare organizations are too hesitant to take right now. But as patients become a significant revenue source and consumerism creates new demands on providers, revenue cycle technology will play an increasingly important role in not only boosting the bottom line but also creating value for patients.
“I get that it’s overwhelming. It can feel like your mouth is on a fire hydrant, but it’s so doable and so very necessary,” Moneymaker stresses. “You need to use data from across the entire enterprise to tell the same, valuable story to patients.”