EPM Series: Providers, Follow these Best Practices to Optimize your Revenue
With the healthcare industry continuing to shift away from fee-for-service, healthcare organizations still face the challenge of properly tracking all their efforts and ensuring they are being appropriately reimbursed. A recent Healthcare Informatics report noted that:
“Ongoing changes in both public and private payment are shifting the landscape around revenue cycle management these days, and U.S. physicians and hospitals are facing considerable impacts on their healthcare reimbursement.”
The report also notes, that healthcare organizations are conducting procedures that are “more complex,” and so are the payments. Now more than ever, organizations need to be laser focused on their billing processes and revenue cycle. The ability to access data is obviously a key factor for success but transforming that data into a strategic plan to tackle revenue remains difficult.
The challenges around creating plans can come from a lack of leadership accountability, insight into performance metrics, transparency and progress tracking. These factors all play a role in losing sight of tactical actions that drive results. Critical data gets lost in various outlets within the organization which creates a gap between setting goals and achieving them.
Enter, Enterprise Performance Management, which offers a “closed-loop” system that organizations can use to combine robust data analytics with real-time action planning and progress tracking. Enterprise Performance Management enables organizations to clearly define, track and execute on strategic and operational objectives by empowering employees to track their day-to-day activities with the big-picture strategic plan in mind. For revenue, there are three potential goals to keep in mind:
- Increase point-of-service collections - Verify eligibility, confirm demographics and fully understand patient portions after insurance, so your registrars can collect payment prior to service.
- Understand denial root causes - Denials come from all parts of the revenue lifecycle. By linking denial trends to their origins, you can resolve errors and oversights that lead to payer rejections and denial write-offs.
- Monitor audit risk and reduce take-backs - Improving your financial health isn’t about finding maximum revenue. It’s about finding accurate revenue. By proactively identifying compliance risk areas, you can avoid revenue take-backs and track the audit appeal process.
CHIME Series: Are You Making the Most of Your Analytics Investment?
This week we are continuing to share our College of Healthcare Information Management Executives (CHIME) survey results with you. The focus is specifically around the question: Do you feel that you have realized the full ROI of your data warehouse and analytics investments? The results were telling – with close to 100 percent responding “no.” The healthcare industry continues to view data and analytics as top priorities to driving change. We have outlined best practices and strategies to ensure healthcare organizations receive the full potential of their IT investments while making strides to maximize value through the improvement of quality care and reduction in costs.
In partnering with our clients, MedeAnalytics works to ensure that the large hospital investment – both from a cost and organizational perspective – is realized. The key to achieving an overall best-practice strategy is to not only take data to insight but also into action. Below are five steps healthcare organizations can do to get their analytics investment on track:
- Identify enterprise champions – They will be the point-people to turn data into change as they will lead the entire organization’s attitude on data governance. Establishing authority will create a trickledown effect ensuring value is tracked and achieved.
- Find value in existing data – Organizations should leverage their core data set and claims data, but also pull in existing ancillary data to have a better understanding of their organization.
- Create a data-driven culture – An analytics department ensures that the entire business is standardizing and handling data consistently, but also encourages the new analytics department to champion a holistic approach towards data management.
- Outline and develop manageable goals – Instead of tackling all problems at once, start small. By setting a goal with real, manageable next steps, the organization can quickly perceive value in an enterprise initiative.
- Train, train, train – Repeated trainings and regular communications ensure long-term success. By holding teams accountable, while empowering them with resources to succeed, data sharing efforts across the enterprise are bound to improve.
An investment in analytics is the first step toward becoming a data-driven healthcare organization; however, the real change comes from leadership and education. To learn more about analytics best practices, download our whitepaper here. For success stories, access our case studies here. If you’re looking for guidance on how to make the most of your analytics investment – make sure to contact us: http://medeanalytics.com/company/contact
10 Ways to Stop Revenue Leaks Before They Start
Today’s healthcare financial landscape is complex. Value-based reimbursements, bundled payments, and ICD-10 are changing the revenue lifecycle. As if that weren’t enough, revenue is managed by multiple departments, all of which operate in silos. From patient access to the business office and everything in between, revenue is touched by multiple systems that typically don’t talk to each other.
It’s no wonder healthcare CEOs say they worry most about financial challenges.
Gaining insight into revenue across the enterprise is no easy task. Revenue could be leaking out of the organization and you wouldn’t even know it. The key to identifying those leaks—and stopping them before they start—is having a complete, unified view of your revenue.
3 Ways Healthcare Organizations Can Foster More Mindful Documentation
There has been extensive conversation around Meaningful Use (MU) and the passage of Medicare Access and CHIP Reauthorization Act (MACRA). CMS announced earlier in the year a shift from MU to MACRA which streamlines the transition from fee-for-service to value. MACRA highlights three changes in how to pay those who treat Medicare beneficiaries, including:
- Ending the Sustainable Growth Rate (SGR) formula for determining Medicare payments for healthcare provider services
- Making a new framework for rewarding health care providers for giving better care not just more care
- Combining existing quality reporting programs into one new system
MedeAnalytics Clients to Speak at the 7th Annual Becker’s Hospital Review
On Friday, April 29, our clients will be presenting at this year’s 7th Annual Becker’s Hospital Review Meeting at the Hyatt Regency in Chicago, Illinois. Here’s a breakdown: Dr. Joseph Scott, FACHE, President and CEO of Jersey City Medical Center (JCMC) will present on our closed-loop performance management solution. Dr. Richard Boehler, MD, MBA, FACPE, President and Chief Executive Officer of St. Joseph Hospital/Covenant Health will discuss the implementation of our employee-based population health management solution.
The first session taking place from 2:30-3:10 pm CT will be hosted by Joseph Scott who will cover how JCMC was able to rise to the top 10 percent nationally in care metrics using a closed-loop performance management solution. Utilizing this solution enabled them to do the following: