RCM requires a strategic approach across silos for the best results.
Revenue cycle management is a process, not a product, so it can often be tough to convince practice managers or hospital administrators to fund improvements to it the same way one might find new technology or equipment, says Brian Paradis, Senior Partner at CSuite Solutions, a healthcare advisory firm in Tamp, Fla.
“When you talk about enhancement to the revenue cycle, the financial people tend to migrate back to a controlling cost mindset,” Paradis says.
However, Paradis considers this a mistake.
“You should be looking at it as a strategic investment as opposed to overhead costs that you’re trying to constrain,” he says. “If it’s seen as something strategic for the entire organization, it opens the door to engage the entire organization in that process, instead of just relegating it to the billing office or the business manager.”
Removing the silos
The challenge in many healthcare organizations is to make RCM a strategic process.
“You have the people sitting at the front desk who often have a disconnect from the people in the billing office,” Paradis says. He suggests that “you need to manage that silo,” which means bringing those people together in the same room on a regular basis to share goals and objectives and learn what affects the other.
This includes physicians. The financial people need to understand the clinical implications that stand in the way of managing the revenue cycle, and the physicians can help bridge that gap.
Merging silos isn’t as simple as just imposing a set of goals. It’s about “having very clear, mutually agreed upon goals and outcomes, and a clarity of how that benefits patients as well as providers,” Paradis says.
A four-pronged approach
Paradis believes the four most important steps of making RCM more strategic are:
Advocate for the patient
Additionally, Paradis believes that RCM processes can be improved by thinking about the patient more up front. “Whenever I hear discussions take place within medical groups or systems, it’s amazing how often the conversation doesn’t revolve around the patient.”
If all a patient knows is that their co-pays increased by 30%, he says, that’s not adding new value for the patient’s experience, and you run the risk of losing that patient. “I think physicians can be more of an advocate for the patient from a revenue cycle standpoint.”
He says physicians could be the ones to help ask such question: “What aren’t we delivering to patients? What services could we be providing? How can we find revenues?”
If RCM is seen as something strategic for the organization, Paradis says it provides everyone in the organization with a shared vision.