By Sondra Akrin, Hayes Management Consulting
Twitter: @HayesManagement
Eight out of ten hospitals under 100 beds are engaging in Revenue Cycle Management outsourcing because of lack of skilled staff.¹ The graying of the baby boomer generation and the resulting retirements is putting a personnel strain on all businesses and the healthcare industry is no exception.
Healthcare organizations are being hit particularly hard in regard to physicians and nurses, but they are also seeing a lack of trained personnel in unseen, under appreciated but critical areas. One particular skills gap involves revenue cycle management personnel, a workforce that operates in large part behind the scenes but one that is crucial to optimizing a healthcare organization’s revenue stream.
Filling revenue cycle roles can be difficult because historically these jobs haven’t been valued as much as other positions in the organization. That’s a major mistake and failing to change that attitude can lead to serious negative financial impacts.
From the beginning of the cycle where front end staff checks in patients to the back end business office where A/R representatives, payment posters, cash control representatives and customer service representatives toil in relative anonymity, the process relies on dedicated, trained personnel, operating at peak performance.
Individuals in these roles must understand a multitude of payer requirements and recognize the interrelationship of every step in the cycle. They have to know the process thoroughly and understand their customers intimately. Finding and retaining staff for these positions should be a high priority for any organization.
Unfortunately that’s not always the case. Many organizations underestimate the complexity of these jobs and the skillset required to carry them out effectively. Here are four things to consider to attract and retain the right people to keep your revenue cycle flowing smoothly.
Conduct a positions analysis
Your first step should be conducting a pay grade and benefits analysis of each of these important RCM positions. The varying sizes of healthcare organizations make comparing front-end positions in other organizations especially difficult, however.
These roles are not always clearly defined and the responsibilities and tasks can be very different depending on the organization. At larger organizations, the roles may be more specific and individuals normally perform narrowly defined tasks on a repetitive basis. Smaller organizations may require more versatile staff members who are asked to carry out many different revenue cycle tasks.
The key is to understand your needs, define the roles appropriately and strive to find similar organizations with which you can benchmark salaries and benefits.
Back end roles are easier to evaluate and compare with other organizations since these positions are typically more consistently defined regardless of the size of the institution.
Analyzing and evaluating your revenue cycle positions is especially important if you are in a competitive market. For example, Medical Row in Houston contains a number of large, local healthcare organizations on the same street. Employees can easily “shop” themselves around to other organizations without disrupting their living arrangements or daily commute. If you find yourself in this type of heavily concentrated, competitive market, it’s especially important to do a pay grade and benefits analysis to prevent your staff from wandering.
Get creative with compensation
To stay competitive and develop a reputation as a “place to be” for potential employees, get creative with your incentive and benefit packages for RCM staff. Although salary is important, it’s not the only way to attract and keep valued personnel.
Healthy organizations can be quite innovative by offering bonuses and other incentives to front-end staff who they view as valuable members of the team. Focusing on front-end staff is especially important since these are the folks who play the most important role of starting the cycle. They enter registration information, verify insurances and carry out the important detail work that eliminates the need to do clean up on the back end.
Incentive ideas for the front end staff could include offering bonuses for up front collections and effective information verification measured by the number of denials, rejections and edits on the back end.
Train and develop to retain
Compensation packages are no doubt an important part of a person’s decision to elect to work in and stay with your organization. However, healthcare professionals also have long term interests and goals that are often tied to a clearly defined career path. They want to be working for an organization where they see opportunities for growth and greater responsibilities.
To meet that need, it pays to invest in a skills training and development program for your RCM staff. This will not only give employees a long-term view of their future, but provides the benefit of adding “bench strength” for your organization as more employees develop their skillsets.
Many organizations lack a deep, skilled resource pipeline to fill vacancies that will inevitably occur. This is especially true for hospitals in rural settings where there is a limited market for skilled candidates when compared to organizations in more settled, urban areas.
If you find yourself in such a situation and are having difficulty finding potential hires, it’s a good idea to focus on soft skills such as good communication. People with solid technology skills or experience in customer facing positions in the healthcare industry can also be good hiring candidates. A strong training and development program can take individuals with these skills and bring them to the level you require to fill RCM roles.
One point to keep in mind when developing your training program is that it’s important to go beyond the basics. You can fall into the trap of focusing on systems or technical training like how to register a patient or log into a particular application. This approach often neglects the more specific knowledge that explains the full revenue cycle, why it’s important and how each individual contribution is crucial. Not explaining that side of the position means they won’t understand how something falling through the cracks can negatively impact the revenue cycle, cause inefficiencies, loss of revenue, and delay revenue recognition.
Get help
It’s often difficult and expensive to institute a recruiting, training, and retention program given the constraints on in-house staff. A qualified third party resource can not only help with RCM position analysis and training, but they can also offer another way to overcome temporary or permanent staffing gaps. Such resources include temporary agencies, accounts receivable outsourcing companies and consulting firms.
Third party consultants can also help optimize your revenue cycle in the face of the growing challenges of healthcare reform, the need to upgrade IT systems, and the shift to new value-based reimbursement models.
People are one of the most valuable assets in a healthcare organization. It pays to invest to ensure they are trained properly, are committed to your organization, and understand the important roles they play in the success of your revenue cycle.
¹ Black Box Marketing Research, September 23, 2013
This article was originally published on Hayes Management Consulting and is republished here with permission.