How can Analytics Help Solve Healthcare’s Biggest RCM Issues?

Revenue cycle management (RCM) is a critical part of any healthcare operation and with rising healthcare costs it’s even more difficult to manage. However, to better handle costs and overall revenue, healthcare organizations need to prioritize and develop an RCM strategy. The strategy itself needs to address various revenue pain points, including: cash collections, bad debt, denials, productivity and overall business strategy. We recently connected with Tom Schaal, director of product management at MedeAnalytics, to better understand what’s holding healthcare organizations back from addressing these pain points and what to look for in an analytics partner.

RCM Challenges

  • The Need to Do More with Less – Margins are shrinking across the board and a lot is changing, especially with value-based reimbursement expected to represent 83 percent of provider revenue by 2020. Provider organizations are struggling to meet quality metrics, not to mention, the added reporting required under MACRA and MIPS. With physician burnout and overall healthcare costs at an all-time high, organizations are looking to cut back anywhere they can.
  • Disparate Solutions – According to a recent survey, almost 69 percent of healthcare organizations are using more than one vendor solution for revenue cycle management. This means different numbers, screens, reports, siloed data and inefficiencies.
  • Lack of Actionable Insights – Many solutions aim to consolidate data, but significant challenges still exist when it comes to sharing that data. Some providers are leveraging data visualization tools to bring information together, but issues arise when it comes time to draw actionable and timely insights from it and hinders organizations from understanding how to adjust their RCM operations.

What to Look for in an Analytics Partner

  • Strong Industry Knowledge – The most important step when finding an analytics partner is to select an organization that has a strong background in healthcare. A vendor who knows the industry top to bottom that can help your organization stay up to date on the latest trends, policies and technology. You want to also ensure you are selecting a partner that allows for unification and normalization across the board so there is complete transparency and a single source of truth.
  • Action, Action, Action – Having the right RCM data is one thing, but what good is data if you can’t do anything with it? An analytics partner can use your data to draw actionable insights that will not only make a difference in your organization’s bottom line, but also in its overall success.
  • More Time to Focus on What’s Most Important – At the end of the day, healthcare organizations have one overarching goal: provide patients with quality care. With a strong analytics partner, providers can spend less time worrying about issues or processes and spend more time focusing on quality care.

MedeAnalytics offers a suite of analytics solutions, including a business office platform that can help you get big-picture insight into your revenue cycle. With a background cemented in the healthcare industry, our team understands all the critical nuances that come with it. Our analytics tools and offerings draw critical and timely insights that can help your organization make even smarter decisions. To learn how we can help support your organization in addressing its RCM, check out more here. Contact us here.

MedeAnalytics

MedeAnalytics is a leader in healthcare analytics, providing innovative solutions that enable measurable impact for healthcare payers and providers. With the most advanced data orchestration in healthcare, payers and providers count on us to deliver actionable insights that improve financial, operational, and clinical outcomes. To date, we’ve helped uncover millions of dollars in savings annually.

Leave a Comment





Get our take on industry trends

Why It’s Time for Healthcare to Move Toward AI Reporting

November 5, 2019

Business intelligence (BI) was a dramatic and significant step forward in healthcare industry reporting and a natural transition to artificial intelligence (AI) enabled real-time insights.

Read on...

Why Healthcare Should “Double-Down” on Exploring AI-powered BI for Reporting

October 29, 2019

Many areas in healthcare rely not only on the collection of data but, importantly, the ability to decipher and act upon it. In that intersection, reporting was born.

Read on...

Why Health Plans and Employers Need Stop Loss Reporting

September 10, 2019

Due to rising healthcare costs and the Affordable Care Act removing the ban on capitated benefits coverage, numerous employers with self-insured health plans often purchase stop loss coverage. This coverage is not medical insurance; but rather, it’s a financial and risk management tool that protects the employer from excessive claims.

Read on...

Bridge the Payer/Provider Data Gap

August 23, 2019

Every patient has a plethora of data associated with their health record, which can include decades of enrollments, claims, accounts and charges. Much of this data is not housed within the same institutional, facility or provider database…

Read on...