With shifting paradigm in the regulatory environment, valued-based reimbursement, healthcare consumerism, and long term sustainability is on the minds of healthcare executives. In planning strategic initiatives, there are key improvement opportunities for providers to address.
Key Improvement Opportunities:
- Optimize revenue cycle technology – finding a middleware vendor that can integrate with all HIS systems and can reduce the many disparate vendors to one enterprise-wide platform. This significantly will cut costs by reducing the many bolt-on vendors, less staff managing all those vendors, and will increase efficiencies by one view platform of the patient encounter and not having to log into many different systems.
- Enhance revenue integrity efforts – ensuring revenue is accurate in coding and charge capture, 100% confident that your expected reimbursement is accurate on all payer contracts, modeling and negotiating payer contracts that provides your organization the highest yield, making sure your hospital is up to date with all regulatory compliance, and addressing revenue leakage is paramount to your initiative.
- Patient Consumerism – more engagement with patients on their financial obligation. With high deductible plans, self-pay patients on the rise, less reimbursement from all payers – having a solid strategy on patient engagement can increase upfront collections, thus reducing bad debt write off on the back end, increases patient satisfaction, and ultimately increases net patient revenues.
- Predictive analytics – transferring big data to predict trends and opportunities to improve patient care and revenue cycle trends is the latest buzz in healthcare.
Healthcare providers are in a continual struggle to balance the conflicting goals of how to enhance the quality of care, while maintaining profitability and/or sustainability. They must deliver superior care to ensure the best possible patient results while minimizing administrative and clinical expenses. Having a solid strategy and plan is vital to the success of all entities and sharing best practices across the healthcare continuum will help all of us succeed for the betterment of our patients.
