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From the Consultant’s Corner 9/12/14

September 12, 2014 News No Comments

Onboarding Financial Systems: Three Strategies for Mitigating Risk to Revenue

For the past several years, healthcare organizations have invested significantly in EHRs given the Meaningful Use incentive opportunities. Another driver for EHR implementations and upgrades has been expanding clinical integration and alignment activities, which often involve deploying a common EHR to coordinate care and share clinical information across the continuum of patient care.

Although organizations are still focusing on EHR optimization and other clinical informatics initiatives, including MU Stage 2 and ICD-10, they are also starting to replace revenue cycle applications as part of a broader IT strategy that involves using a core vendor to support patient access, clinical, and revenue cycle requirements.

A single platform capable of reporting clinical and financial information provides efficiencies for managing patient populations and competing in value-based reimbursement arrangements. A core vendor platform also allows organizations to reduce their dependence on interfaces, providing cost efficiencies and limiting potential workflow bottlenecks. Moreover, these integrated systems can reduce the likelihood of lost charges and improve overall claim lag.

Beyond a Software Upgrade
Replacing revenue cycle technology – such as patient financial accounting and practice management software- is not just an IT exercise. In fact, I recommend taking the opportunity to redesign business processes to gain efficiencies, improve effectiveness, and also enhance the patient experience. New systems should not merely replicate manual or other outdated processes, but also reflect redesigned workflow and optimized staffing levels and structure.

In my experience, an effective implementation requires robust change management to help people understand and adapt to both the new system and the new way of doing business. For instance, some organizations choose to create a single business office that marries hospital billing and professional billing, resulting in one statement and one point of contact for customer service. To be successful with this model, organizations must appreciate and respond to the risks involved, as people are being asked to do things they have never done before. Whether implementing a system change or a broader organizational redesign, these organizations must proceed in a manner that minimizes the impact on revenue cycle productivity and limits cash flow disruption.

Three Strategies to Minimize the Risk to Revenue
As healthcare organizations consider replacing their revenue cycle applications, executives must pay careful attention and develop ways to mitigate risk to revenue. Here are three strategies to keep in mind.

1. Build a business intelligence model that parallels the change.
I strongly recommend collecting, monitoring, and responding to key metrics before, during, and after implementation to quickly catch problems and head off potential cash flow implications. When identifying critical performance indicators, think about comparing current metrics to future needs and determine which measures will fully demonstrate organizational performance. During this process, be sure to understand how the new system’s measurements compare with previous indicators to ensure apples-to-apples comparisons. It may be helpful to create a baseline measure of the new metrics using the old system to accurately measure change and monitor future performance.

Once you begin collecting data, be sure to report metrics to the right people at the right time, establishing who needs to receive reports and checking they understand the data’s meaning. I find it helpful when determining reporting frequency to look at the data recipient’s role in the organization – i.e., executive, manager, supervisor. For instance, patient access managers should have daily access to claim denial information to quickly identify and resolve issues, and lessen any negative effects to the revenue cycle. If these individuals do not receive reports until month end, it could have a major impact on revenue and workflow.

2. Create a comprehensive training plan.
When training staff on a new system, be sure to focus on operational and workflow changes, not simply new IT screens or functions. Training should cover the concepts behind a switch, the individual’s changing role in the department, and revised workflows as well as the system’s various nuances. Note that when designing a training plan, it can be helpful to evaluate vendor-suggested models against operational changes to support a more organization-specific approach.

3. Make sure the vendor’s implementation strategy can be tailored to meet the organization’s specific needs.
Most revenue cycle vendors have an established implementation plan that is based on best practices from current clients. While these plans have merit, you should not accept them at face value. Make sure you fully understand the impact of the vendor’s pre-configured strategy and system design. In most cases, organizations will have to balance an efficient implementation with risk to revenue, personalizing the vendor’s approach with organization-specific requirements.

One Part of a Greater Goal
Implementing new financial accounting and PM software inherently involves added risk to revenue across your organization. Combined with an EHR strategy, this investment can yield a broad, transformational change, which helps organizations report on clinical and financial information to manage population health and sustain financial viability. Organizations that pursue a well-considered implementation approach can reduce risk and optimize revenue, ensuring they remain nimble during these changing times.

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Brad Boyd is vice president of sales and marketing for Culbert Healthcare Solutions.


Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Dr. Gregg, Lt. Dan, Dr. Travis

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