As an aftermath of the drastic regulatory changes the healthcare industry has undergone in the past couple of years, a large number of physicians and healthcare providers are still trying to find ways to improve their revenue model. Having seen steep downward slopes in their annual revenue lately, many practitioners have been driven into desperation and are seeking expert advice on these matters.
Some experienced practitioners maintain that effective revenue cycle management calls for innovative and thoughtful strategies pertaining to data analytics, in order to effectively track some of the most critical revenue defining parameters, including:
- Efficiency of administration
- Operational cost tracking and management
- Service utilization
- Billing cycle management
Few healthcare providers claim to have lowered their operating costs by over 15%, by resorting to innovative and improvisational strategies. Whereas, others were observed to have resorted to revenue cycle management software and other benchmarking performance assessing tools to help better their revenue model. However, obtaining the licenses for these software based solutions also adds to the operational costs. Add to that the ancillary costs involved in training your in-house administrative teams to understand the operation of these tools.
In the meanwhile, some practitioners have managed to conquer their challenges by outsourcing their revenue cycle management to dedicated service providers, who are known experts in the field of data analytics and can pull up center-specific customized reports that help plan effective business strategies.
Another hot topic in discussion is the need for transition from fee-for-service models to value based reimbursement or VBR models, in order to change the way healthcare providers deliver their care procedures. Providers operating on the basis of VBR report lowered costs to company and improved quality of care. Rather than charging the patients on the basis of their number of clinical visits, providers are charging their patients based on the value of care they deliver.
VBR models are designed to help healthcare providers reduce the costs incurred by ineffective care, stay ahead of authoritative mandates and regulations, enhance their collaboration with the payers, and automate their administrative functions to a great extent. However, some practitioners, who fail to achieve the adequate scores, are challenged by lower reimbursements and penalties that take a toll on their revenue models.
And lastly, speaking of the repercussions of ICD-10 implementation, a large portion of the healthcare industry is affected by the drastic increase in the number of codes from 17,000 to near about 140,000 codes. Undoubtedly, practitioners are forced to spend exorbitant amounts of money on training their in-house billing teams to identify, understand, and keep up with the new coding standards. Majority of the healthcare providers are tied up increasing their understanding of the human anatomy and acquiring more intricate knowledge pertaining to clinical practices. Now is the time the healthcare industry is seeing a need for a revenue cycle management partner, more than ever, to help practitioners modify their care delivery, cost management, and data analysis and reporting strategies to match the ICD-10 coding standards.