Ask astute and forward-thinking business leaders – whether they’re in manufacturing, retail, or even, yes, healthcare – about the key to longevity and the lifeblood of their operations, and they may not emphasize the volume of products shipped out the door, customers moving through their facilities, or patients being treated.
In some ways, that’s like booking sales with little to nothing to show investors or shareholders, let alone federal regulators.
Of course, we’re talking about revenue cycle management, from analytics to integrity to perhaps the most foundational – collections. After all, you can’t measure true return on investment without taking into account available cash.
In healthcare information technology circles, the simmering revenue cycle topic centers on automating the process from end to end. Certainly, IT horsepower can identify areas where fiscal bloodshed occurs, pinpointing with some degree of precision the inefficient and wasteful practices that must be plugged.
Yet without comprehensive integration – not merely interfacing – any improvements toward collecting the millions lost each year are incremental at best.
Ultimate integration weaves a wireless thread through a variety of systems, including patient billing, electronic health/medical records, online accounts payables and receivables platforms, newly emerging patient portals, and even one of the more integral IT functions: The charge data master.
In the last edition of Health Management Technology, Scott Hendrickson, Vice President, Revenue Cycle, Allscripts, pointed out that “many areas of the revenue cycle contain outdated processes and inefficient work strategies.” This affects “charge integrity,” which is critical to the revenue cycle, he argued.
Indeed, “the potential depth and precision of any charge integrity analytics are directly tied to the granularity of the data,” noted Crystal Ewing, Senior Business Analyst and Manager, Regulatory Strategy, ZirMed.
In the supply chain arena, futurists and realists alike agree that simply automating a process doesn’t necessarily make it more efficient; it just means you’ll be transmitting “dirty” data faster. Think of it like adding nitromethane to the gas tank of a poorly maintained 1972 Ford Pinto. During the quarter-mile, your wheelie bar might pop 60 feet from the starting grid and your crankcase might be punctured by a broken rod.
Okay, maybe that’s somewhat of an extremely outlandish comparison. After all, a healthcare facility may not experience the immediacy of a blown engine with questionable revenue data, but the Board of Directors and C-suite will likely blow their tops a few years down the road when the fiscal disconnect emerges from the smoke.
Unfortunately, the challenge of automating the revenue cycle the right way from the ground up means you’ll likely uncover a lot of discrepancies early on. To those who want to coast to their next job opportunity or retirement, this can tarnish short-term results and temper well-dressed reputations. To those who legitimately want to improve the system, however, this represents the temporary black mark necessary to avert red ink.
The decision boils down to motivation. In the quest for healthcare reform and revival, would you rather be bleeding red or green as you strive to improve operations, patient outcomes, and satisfaction? If we’re all going to be patients someday, we can’t afford to be patient with current practices.
