The PFX Voice

Mike Sowinski

With the recent shift in the White House, the entire healthcare industry is bracing for changes over the next year or more. Many of the changes will directly impact the revenue cycle for hospitals and health systems. Revenue cycle leaders though, should take this shakeup as an opportunity to focus on their most essential skills and applying them in ways that guide their organizations in the near future.

As Becker’s Hospital Review relates, the role of revenue cycle leadership has expanded well beyond simple billing and collections. We’re seeing an increase in positions such as the VP of revenue cycle and even chief revenue cycle officer (a healthcare spinoff from the CRO position you see in other industries). These positions, according to David Boggs, head of WK Advisors, will require three, essential skills for success.

 

An Understanding of Technology

More than ever, technology plays a crucial role in the hospital revenue cycle.

According to Mr. Boggs, today’s RCM executives will need a thorough understanding of not only how their organization codes and admits patients, but also how technology such as EHRs and EMRs can be used to streamline the process. As it becomes more clear that we’re walking into a world of high deductibles, revenue cycle leaders will be increasingly responsible for ensuring that patients have solid expectations of their balances and that their organization is addressing coverage and reimbursement issues on the front end.

 

Tech to Watch: Data Analytics, the cloud

 

A Broad Perspective

The revenue cycle now intersects with hospital operations at multiple levels. Leaders will need to push beyond billing and collections, and understand innovation in patient registration, as well as coding challenges that have becoming increasingly complex since ICD-10’s release. RCM leaders will also need to understand integration with managed care/insurance contracting, as well as how IT innovation impacts all these areas at both a strategic and tactical level.

According to Mr. Boggs,

"Having a strategic understanding and a broader understanding of the areas outside of billing and collections is important. Getting the bill out and collecting it are critical, but so are having the analytics in place to ensure you are collecting what you're supposed to collect, making sure contracts are paid at the level they're supposed to be paid, and ensuring that coding is accurate so it won't be denied later. It's a big-picture role."

 

 

Connection with Key Leaders and Staff

Revenue cycle executives, according to Mr. Boggs, need to be able to connect and collaborate even in areas where they don’t have direct authority, but still have the ability to leverage influence. These areas include

  • Working with physicians and nurses
  • Working with registration staff in multiple locations
  • Working with individual facilities as well as across systems

Revenue cycle executives also need strong training and mentoring skills, as a large part of their job frequently involves educating and guiding other employees, especially as regulations and standard practices continue to evolve.

Ultimately, all of this means revenue cycle leaders require a balanced mix of people and technical skills, a knowledge of government and managed care reimbursement, as well as strong communications skills.

Topics: Revenue Cycle Management

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