How to Use Patient Response to Jumpstart RCM Transformation

Derek Stein,
RevSpring

The financial realities of today’s healthcare industry are exposing the inherent workflow gaps and revenue leakage within traditional RCM processes.

But as providers review more integrated revenue cycle solutions and seek consulting firms to strategize upgrades, there are steps that can be taken to jump start desperately needed RCM enhancements.

Start with the data you have

Leveraging existing data within their system, healthcare organizations can identify when and how patients are interacting within their current billing processes.

With this insight, RCM professionals can pinpoint quick-win opportunities to enhance financial performance as they work toward more long-term, comprehensive change.

Patient response analysis helps organizations gauge their performance in key areas such as:

• Self-service. Payment data and trending patient calls can reveal the percentage of patients calling your customer service team to make payment. Depending on the call volume, health systems with limited resources can then benchmark their current performance, and monitor the performance of automated payment investments such as inbound IVR and/or online payment portals. Health systems that currently have these automated payment channels in place should review their current patient communications. Often, the design of a billing statement can be optimized to drive patient adoption of self-service payment channels and reduce call traffic to customer service.

• Communication effectiveness. Merging statement data and payment data can reveal which billing communications are receiving the most payments. In other words, you can determine which statements are working to get you paid and which ones are not. With this insight, health systems look for trends, identify which communications should be redesigned, and have benchmark data to test timing and alternative communication channels such as text, email, and outbound IVR calls.

• A/R. Comparing statement dates to payment dates indicates how quickly patients are responding to your communications and the percentage of accounts that are in the final stages of your billing cycle. Again, this type of benchmark data can guide patient engagement strategy. Depending on the results, this could mean engaging and segmenting patients on the front-end, adjusting engagement strategy on the back end, or considering early-out partnerships.  The key is that you now have the data to aid in the decision process and clear benchmarks with which to measure performance.

Getting started

Although they face similar challenges, finance leaders have to understand what success means for their organization. Health systems that analyze patient response are positioned to take the most cost-effective path to RCM transformation. They have the data to tie qualitative and quantitative returns to their solution investments.

While this type of analysis can be conducted internally, a best-in-breed solution partner can also produce these forms of analytic insights.