Performance measurement under MACRA has started in 2017, but only one-third (33 percent) of hospital-affiliated physicians have reported feeling prepared for its implementation, according to a recent Black Book Research survey. With several payment pathways to choose from, providers and their physicians have an added layer of complexity around clinical documentation, which increases their reimbursement risk. Though many providers feel strapped for time as more of their attention needs to be spent on properly categorizing claims data, analytics can help those organizations have a better grasp of their revenue cycle, especially as it ties back to value-based care goals.
Our very own Tom Schaal, director of product management, recently spoke with Jeff Lagasse at Healthcare Finance News to discuss the common revenue cycle management (RCM) challenges and opportunities as they relate to preparing for MACRA. One such challenge is the lack of time to consider revenue cycle leaks. Schaal shares three key takeaways that can help healthcare organizations have a better grasp of their revenue cycle and measurement:
- RCM shouldn’t be a second job – However, many times it feels like it. Physicians want to focus on providing the best quality care to their patients. Focusing on the minutia of RCM draws their attention away from their primary job. Technology and data can turn the RCM job into a seamless task that can be incorporated into their everyday workflow.
- Revenue leakage can happen at any stage of the care continuum – From registration to insurance verification to billing. Data analytics can help you identify where the biggest opportunity for improvement lies. Are patient no-shows causing you to lose money? Data analytics spots these trends and help you course correct the problem (i.e. set up appointment reminders for patients).
- Physician quality is the biggest opportunity for RCM – As Schaal noted in his interview, “as we look toward patient satisfaction and payment structures around things like lack of readmissions, physician quality really becomes a focal point in terms of maximizing revenue.” Ultimately, physician quality measures are going to be a “cornerstone when it comes to any enterprise's [financial] health,” and data analytics helps physicians make meaningful decisions that will impact their bottom line and future.
As MACRA moves full steam ahead, providers will need to have a good understanding of their clinical, financial and operational data to succeed. Implementing revenue cycle data analytics helps providers track towards value-based goals, while minimizing their reimbursement risk.