In recent years, the US healthcare industry has experienced significant changes in regulations which have led to changes in the way healthcare services are organized, delivered, and financed. Recent changes in laws and regulations, particularly the introduction of the Affordable Care Act (Obama Care), a transitioning coding system, and increasing pressure on healthcare providers to adopt cost-containment strategies while ensuring and improving the quality of healthcare services have revolutionized the way healthcare organizations operate today.
The transition from fee-for-service to value-based payment models, declining hospital admission rates, PQRS penalties, and escalating healthcare costs, all have contributed to the shrinking revenue figures of healthcare providers. With more than 20 percent of hospitals operating in the red , it’s high time healthcare providers look for ways that can help them improve their organization’s revenue for transaction figure and drive it towards sustainability.
Today, to compete in a healthcare environment that demands clinical and operational efficiency, healthcare providers need to ensure that their financial operations are running efficiently. In an environment where financial pressures are escalating to record levels and reimbursement rates are declining, only a well-managed revenue cycle can help healthcare providers minimize the time spent on administrative duties, ensure them maximum revenue and unobstructed cash flow, and provide them time to focus on their core function – provision of healthcare services.
This whitepaper provides an overview of the recent healthcare industry trends that are affecting practices’ bottom-lines as well as statistics that reflect how escalating financial pressures have shifted the focus of healthcare providers from clinical activities to administrative tasks. It also contains a quick revenue cycle self-assessment to help physicians determine whether their practice is in need of effective revenue cycle management.
A majority of this whitepaper is comprised of 7 tips which healthcare providers can use to improve the revenue generating capacity of their practices. From workflow analysis, evaluation of payer contract, and denial resolution to improving patient engagement level and measuring practice’s financial health, this whitepaper provides comprehensive guidelines on optimizing the entire revenue cycle.
The document explains how the changing healthcare industry landscape has led to a generation of newer business opportunities. It explains the reasons behind the increasing trend of outsourcing the revenue cycle management (RCM) function among healthcare organizations. This whitepaper highlights the benefits of outsourcing RCM with concrete statistics reflecting improvement in the performance of healthcare firms that have outsourced their RCM function.