By Rick Stevens, Chief Technology Officer, VISPA
Twitter: @VispaFlow
2020 threw its share of curveballs at healthcare revenue cycle leaders. From drops in patient volumes to rises in self-pay receivables, new tactics and strategies were essential to stay in the game.
Now that we’re in 2021, many of last year’s survival strategies have moved from stopgap measures to long-term operational changes in the healthcare revenue cycle. The biggest of these is the solidification of a remote or hybrid revenue cycle workforce as a permanent part of the healthcare landscape. This topic, along with other important revenue cycle IT challenges for 2021, was discussed during my recent HealthcareNOW Radio interview with Jim Tate on The Tate Chronicles.
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Wisdom for the new now
Health systems that rapidly set up remote revenue cycle teams reported higher levels of staff efficiency, cash receivables and operational effectiveness during the first six months of COVID-19. In fact, one of the health systems experienced the fourth highest month of cash collections in their organization’s history during June 2020.
Lessons learned at these health systems are harbingers for successfully building a long-term remote or hybrid revenue cycle workforce. Here are three insights for revenue cycle and IT leaders to consider.
Build opportunities to improve efficiency
Remote revenue cycle teams drove positive improvements in productivity, effectiveness, recruitment, satisfaction and retention in 2020. When properly supported by technology, these remote teams expedited account decision-making and took more proactive steps to collect cash.
The secret is to simplify. Revisit existing processes, procedures and workflows to remove unnecessary steps and automate as much of the process as you can. Here are three examples.
- Change system workflows for account follow-up staff: Instead of bouncing between worklists to choose an account, present staff with the next most valuable account. This simplifies work for staff and relieves managers from the onerous task of telling teams which accounts to work in a remote environment.
- Work by exception in patient access: Check eligibility (pre-certification) across payers using technology and route cases to registration representatives by exception—only those that fail checks. Working by exception reduces patient access workload by up to 50 percent.
- Implement stronger productivity monitoring tools: Remote revenue cycle teams require leaders’ ability to view what staff are doing at home and make necessary adjustments. EHRs are often lacking in this area. For example, Epic displays that a specific staff member was following up on a claim, but lacks detailed insight regarding time spent on the claim, actions taken on the claim, resolution action, etc. Every step should be recorded and available for managerial oversight to truly manage and compare staff performance.
Maximize use of system analytics
During the pandemic and its subsequent plummet in patient volumes, all eyes turned to keeping patients loyal and staff satisfied. These priorities remain today, and revenue cycle leaders must make extra efforts to ensure staff satisfaction and a positive patient financial experience when teams are remote. Analytics help.
- Analyze front-end process data to minimize risk of back-end problems such as denials and recoupments.
- Use analytics to make data-informed tweaks and adjustments in the process versus putting out individual fires every day.
- Consider using broader analytics to see a holistic view of performance. When you have the total swath of the revenue cycle, you can see performance at a high level and across all departments, which provides greater leadership insights. It also saves having to dig into each function’s system or dashboard.
- Develop strategies and tactics to manage revenue cycle tasks by categories of patients, payers and situations versus individual cases. Use intelligence gleaned from analytics to build best practices and workflows.
If you’re short sighted in your problem solving, you will miss opportunities, place blame in the wrong place, create staff dissatisfaction and never get the best results from a remote workforce.
Keep measuring
Success must be measured in order to be achieved. While we’ve always established and monitored KPIs in the healthcare revenue cycle, new benchmarks based on 2020’s impact should be considered. Knowing the plumbline of 2020 as we set new goals for 2021 is an important step. And when remote or hybrid teams can’t keep up with volume spikes that may occur during tumultuous times, establishing outsourcing partnerships that can quickly scale is essential. These partners should also be held to metrics and remain accountable for the services they provide.
Go forward with confidence
Keeping your revenue cycle staff home for good? If so, now is an ideal time to set new goals, reinvent processes and use technology to enable workflows in the healthcare revenue cycle. Avoid letting perfection become the enemy of progress. Instead, keep improving as you go.
Remote or hybrid revenue cycle teams thrive when they focus on doing the most valuable work at the right time. Track everything staff is doing and implement the necessary IT tools to accomplish efficient managerial oversight. This approach provides the ability to make decisions based on your data versus standing over someone’s shoulder.
By tasking and tracking remote teams, revenue cycle leaders set themselves up for long-term efficiency, operational flexibility and a happier workforce. Listen to the full podcast regarding the revenue cycle IT checklist for 2021.