3 Ways to Boost Revenue Cycle Efficiency with Process Redesign

By Mark Spinner, President and CEO, AccessOne
Twitter: @myaccessone

As hospitals face rising bad debt and revenue cycle workforce shortages, leading organizations are exploring new ways to ramp up patient financial engagement and efficiency.

One out of four healthcare organizations report rising rates of bad debt and uncompensated care, a survey of healthcare finance leaders found. Meanwhile, one-third of organizations say challenges with staff productivity—whether due to staffing challenges or difficulties adjusting to remote work models—have had a negative impact on healthcare revenue cycle operations.

In this environment, the right mix of operational support could prove vital to powering sustainable gains in performance. Here are three ways hospital revenue cycle teams are leveraging process redesign to drive higher collections, reduce the strain on provider resources and improve the patient financial experience.

1. Leaning into more robust options for self-service. Think about the ways that traditional payment systems add friction to the patient financial experience. When statements are sent by mail, do patients need to find their checkbook and a stamp to mail a payment? Do they need to call a support center to provide their credit card number over the phone? If payment via an electronic portal is an option, do patients need their account number to access the portal and proceed with payment? Each obstacle in this process not only increases patient frustration, but also slows down payment, strangling cash flow.

That’s why more healthcare organizations are applying the technologies and payment mechanisms used for retail purchases to healthcare payment. This ensures that both the communication and collection channel are designed for a smartphone-first world. It also eases pressure on customer service teams and helps eliminate the expense associated with paper-based payment. At a time when four out of 10 smartphone users have relied on contactless payment at least once, self-service options that anticipate patients’ needs and meet them where they are promote positive experiences and results.

2. Investing in automated customer support. Today, two-thirds of healthcare organizations use automation powered by artificial intelligence (AI), including machine learning, to optimize revenue cycle operations, a survey of healthcare finance professionals found. Three of the top areas where revenue cycle teams deploy automation include: adjustment posting (61%), billing edits (52%) and claim status (48%). In these areas, automation presents strong savings opportunities for health systems while reducing the administrative burden for revenue cycle staff.

But at a time when four out of 10 CFOs say their organization is making investments to improve the patient experience, automation also could be a powerful lever in personalizing the patient financial experience. For example, AI-powered automation could help deliver customized estimates that break down consumers’ out-of-pocket costs of care prior to the point of care. Chat functions could assist in answering consumers’ questions after insurance has paid its portion so that individuals feel confident that the amount due is correct, increasing the likelihood of payment. And automation could prompt consumers to take next steps in payment, from bill pay to requesting financial assistance to setting up a payment plan.

3. Putting account management into patients’ hands. The ability for patients to self-manage their accounts through a single platform can have a dramatic impact on revenue cycle efficiency. It enables patients to combine bills into a single payment, communicate their need for patient financing in a private setting and self-enroll in patient payment plans. With the right tech supports, it can also eliminate the need for patients to manually enter their data by prepopulating forms with data from the EHR. This contributes to a more seamless patient financial experience while protecting data integrity and, ultimately, revenue integrity.

One innovative approach undertaken by Atrium Health allows consumers to self-enroll in patient financing via their MyChart account. With a secure log-in, patients click on the tab to explore patient financing options, review their prepopulated application for accuracy and click “submit.” All patients qualify for financing, regardless of income level. At Atrium Health, this emphasis on process redesign helped move one-third of self-pay accounts to digital self-service. It also saved 186 FTE hours for every 3,700 charges.

A Tech-Enabled Approach to Revenue Cycle Efficiency

Three out of four healthcare CFOs expect an uptick in revenue in 2022 as consumers schedule procedures that were delayed by the pandemic, a recent survey shows. Financial gains will depend in part on the extent to which revenue cycle teams can successfully manage the corresponding increase in claims. Now is the time to consider process improvements and tech-enabled supports that bolster efficiency, take administrative pressure off revenue cycle teams and optimize the patient financial experience.