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Five CFO RCM & Cash Flow Challenges & Solutions 2016

CFO RCM Cash Flow Challenges 2016

How to raise patient satisfaction, reduce overhead operating costs and integrating patient-centered technology are just some of the challenges impacting cash flow and revenue cycle management in 2016. Of the five mentioned here, Patient Satisfaction accounts for 3 of the challenges.

Three Patient Satisfaction Challenges

The hospital CFO has a new driver in the cash flow driver’s seat: the consumer patient.  How did that happen?

  • Higher patient deductibles leading to higher patient payments
  • Decreasing reimbursements
  • Erosion to the payor mix

All that has led to the growing impact of patient payments on cash flow and profits.

Like any modern consumer, the patient as consumer expects cutting-edge quality care, more information on all aspects of care and billing, more interaction and access. These are challenges the CFO must address for his hospital’s success.

Challenge 1: Provide Robust Patient Financial Services

 “Many studies have demonstrated that a patient’s payment experience colors their overall feelings about a hospital stay. They have discovered that a positive billing and payment experience can impact patient satisfaction and loyalty as well as reduce costs and raise revenue.”

A positive billing experience is one that has no expensive surprises at the end. To do this billing and AR must be engaged at the front end of the patient experience (Patient Access stage) with Patient Financial Services (PFS) professionals. Together they work to educate the patient on billing-payment choices and what lies on the path ahead, describing what options are available at each step of the way.

At the end of the journey, patients expect a simple, easy-to-read medical bill that they can pay as easily as they do other bills.

How Nearterm Can Help:

  • RCM Consulting Services: Patient access, PFS and billing integration – analysis, strategy, planning and implementation assistance.
  • Interim Management Services: To fill the gap during Patient Access, PFS and billing implementation transition and process optimization.

Challenge 2: Eliminate Coding Errors before They End Up on the Patient Bill

Needless to say, coding errors along the clinical path can negatively impact the billing experience for patient.

Also, coding backlogs, system upgrades or a sudden loss of leadership are all breeding grounds for coding errors.

How Nearterm Can Help:

  • RCM Consulting Services:
    • Coding and billing process analysis, strategy, planning and implementation assistance.
  • Interim Management Services: 
    • Coding Manager
    • HIM Director
  • Interim Medical Coding Services
    • Interim HIM/Medical Coding Specialists to help with backlogs and system upgrade: I inpatient/Outpatient, Emergency
    • Production Coding Staffing to help with major backlogs and system upgrades
    • Clinical Specialty Coding
    • Medical Coding Auditors to determine the root causes of errors and fix them upstream.

 Challenge 3: Quality Care & Financial Experience Synchronized

 Technology can be one of the best tools to improve revenue cycle performance and improve the overall patient experience, both clinically and financially.

Patient-Centered Technology can integrate your EMR with the needs of the consumer patient clinical and financial experience, creating one seamless billing, payment and care experience across all patient physician and hospital visits. This means going beyond health information management and building stronger patient relationships

Such technologies provide access to complete patient information, current conditions, care management, medications, appointment history and communications preferences.

A connected environment can be created to provide all involved (admin, patients, specialists, etc.) with access to the actionable information they need at any time and on any device, at home, in hospital, and on the go. This can improve workflow and clinical outcomes.

Cost saving can come from reducing:

  • Readmissions
  • Unnecessary and duplication of tests and other services
  • High-cost prescribing behaviors

And technology can improve patient loyalty and offer a competitive advantage.

How Nearterm Can Help:

  • RCM Consulting Services: Technology transition analysis, strategy, planning and implementation support assistance.
  • Interim Management ServicesInterim HIM Managers and Leaders to fill in while hospital management staff focuses on implementation of the system upgrade.

The Challenge That Never Goes Away

 Challenge 4: Reduce Overhead Costs

Keeping non-medical spending down is always a big challenge for hospitals. However, there are ways such as:

  • Paying close attention to administrative costs, such a sales and marketing
  • Eliminating redundancy of managers doing the same function and consolidating management layers
  • Outsourcing IT, finance, human resources, labs and pharmacies

 How Nearterm Can Help:

  • Financial Management Consulting Services: Determine ways to reduce costs without compromising efficiency or patient satisfaction.  Analysis, strategy, planning and implementation assistance.

 KPIs – Friends the CFO Likes to Follow

 Challenge 5: Identifying KPIs that Can Reduce Costs & Increase Efficiency

Timely access to different types of data from in-house financial systems and Key Performance Indicators (KPIs) help managers to monitor efficiency and performance. KPIs are especially useful in monitoring work hours, overtime, patient census and employees per occupied bed, among other metrics.

How Nearterm Can Help:

  • Financial Management Consulting Services:
    • Assistance in developing your KPIs and sources of data.
    • Help in determining  which KPIs impact revenue the most and and serve as good indicators of good or poor performance.
    • Assistance with  the transition care process and spotting readmission issues.

Whether you need to improve financial performance in general or if you need help dealing with change or transition, Nearterm can rapidly deploy resources to improve your revenue cycle management and financial processes.

All services are offered separately or as part of a 360° RCM solution.

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