The future of healthcare revenue cycle management and tips to help medical practices prepare
Just like everything else in healthcare, revenue cycle management is always evolving. What will that revenue cycle look like in the next few years and beyond? The honest answer is that nobody knows for sure. However, edgeMED continues to gather feedback and input from customers, and we also frequently monitor larger industry trends. We’re constantly striving to improve our technology to support today’s dynamic healthcare revenue cycle. In the meantime, we offer these five short-term predictions for medical practices to consider:
1. Continued focus on a patient-centric experience. Consumers are looking for retail-like experiences in every aspect of healthcare and particularly on the financial side. What does this mean for providers? A strategy to strengthen patient financial engagement. The goal? Make it easy for patients to pay their bills online.
How to prepare: Give patients the tools they need to take control of their finances. While you’re at it, explore other ways to engage and empower patients such as secure electronic appointment reminders, online scheduling, educational resources, and an interactive patient portal.
2. Greater reliance on data analytics. Data is the new currency, and medical practices will increasingly rely on it to mitigate compliance risk. Now and in the coming years, providers will need a strategy to leverage real-time data to improve financial performance. At its core is a user-friendly dashboard that surfaces critical insights, key performance indicators, and other actionable information.
How to prepare: Evaluate your practice management system. Does it offer medical coders and billers the type of data they need to drive operational improvements? How easy is it to access and customize that data? How willing is the vendor to partner with your medical practice on this journey?
3. Increased financial transparency. In the wake of the No Surprises Act, healthcare price transparency will continue to play an important role in revenue cycle management. Providers must strive to provide accurate price estimates and help patients make informed financial decisions.
How to prepare: Invest in real-time eligibility. Also become patient financial advocates. For example, you might need to employe revenue cycle staff to help patients navigate their insurance coverage or work with banks or other funding entities to finance loans directly to patients. The goal is to help patients better manage their out-of-pocket expenses.
4. Reduced cost to collect. As certain back-end revenue cycle management processes become more automated, medical providers gain operational efficiencies that ultimately reduce the cost to collect. Fewer manual touches also drive down these costs.
How to prepare: Ensure you have the right practice management technology in place to streamline operations and promote the most efficient revenue cycle possible. If your medical practice management technology doesn’t enhance efficiency and reduce costs, chances are likely you’re not working with the right vendor.
5. More expansive vendor partnerships. Even in a post-COVID world, medical practices continue to struggle to hire and retain qualified medical coding and billing staff. That’s where vendor partnerships can—and do—help.
For example, some electronic health record and practice management vendors also provide revenue cycle support and outsourcing. This means highly trained and specialized experts review, post, and automatically compare payments against fee schedule amounts. Specialists also analyze, correct, reprocess, and appeal any denials at the time of payment posting as well as analyze past denied claims to identify patterns of workflow problems. This combination of technology and services will be increasingly important as healthcare providers try to stay focused on what matters most: Providing high quality patient care.
How to prepare: Vet your partners carefully. Make sure you understand what you’re getting, how much it will cost, and how this vendor will support you in the short- and long-term.
Conclusion
The next few years will be interesting as patients continue to demand a seamless financial experience, and providers continue to leverage data to drive performance improvement. Although we don’t know exactly what’s in store in the years ahead, we do know one thing: The healthcare revenue cycle plays a critical role in a medical practice operations. Its future is one of opportunity and innovation. Learn how edgeMED is leading the way and be sure to check the Healthy Snacks blog for more expert insights, best practices and industry trends.
