Changing revenue cycle landscape requires adaptability, University of Virginia Health administrator says

Leigh Williams has been the administrator for business systems at the University of Virginia Health system for about a year and a half now, and in that time, the shift from volume to value has accelerated. That requires some adaptability when it comes to managing a system's revenue cycle, and Williams believes she has identified some of the key strategies for achieving financial stability in this new landscape.

The number one place to focus, she said, is on capturing accurate and complete clinical documentation in order to support accurate coding -- information that's sent out to payers and used to assess the work being done in the health system.

"As we shift to a pay-for-performance system, it's increasingly important to demonstrate how you're faring, and understand where you're scoring in MACRA or MIPS," said Williams. "They're all looking at how well your system is doing around those quality metrics."

UVA, for its part, has placed emphasis on effectively leveraging its electronic health records. Of prime importance is what Williams calls a "clean data capture" at the front of the revenue cycle. That means no duplicates, accurate information on all new patients, and the ability to follow their progress over time, not just over the course of a single visit. As the system looks toward bundled payments, it needs information on the full evolution of a patient's care.

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The patient experience, in fact, has been a hot topic of discussion at UVA. That experience has been boosted using technology, which allows the patients to schedule appointments, identify physicians that meet their needs, set up payments plans and understand the costs associated with their visit.

"A lot of that is enabling the patient to have good information about what the costs are … and what their responsibility is going to be," said Williams. "There are things we're used to in other industries where we have a lot more control as consumers. Hospital care has just been a big black box for people. In order to have patients understand what's going on with their treatments, they need to be actively informed and engaged about their care so they make the right decisions for themselves."

That inspires loyalty in a patient. And in an industry that's increasingly consumer-centric -- with the public having a greater choice than ever before -- loyalty can be everything.

In order to implement some of these practices, Williams said it's necessary to get on board with some type of integrated revenue cycle platform.

"Some of the health systems I've worked with recently are ones that still have very disparate systems where you're siloed; all of the systems are different. You need to look at how you're really going to integrate those. You've got to allow that complete revenue cycle experience to e a chain of data, not just pockets where it's not tied together."

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With everything so interwoven these days, sometimes the lines become blurred. The revenue cycle kicks off whenever someone makes contact with a healthcare organization, and that kicks off their care, as well. They go a long way together, and feed into post-care. Data flows between the revenue cycle and clinical operations, and Williams said a system can't operate like they're completely separate things. That requires leaders to think comprehensively about their workflows.

Population health is another paradigm shift that hospitals executives and clinicians need to stay abreast of, said Williams.

"The revenue comes from keeping the beds full," she said. "But we're shifting now to where revenue is better served by having a healthier community. Population health initiatives are keeping people out of facilities. That's a big shift. There are lot of wellness initiatives, investments in the things that are keeping people healthier.

"Nothing stays the same for very long," she said.

Williams will be covering the topic in depth during her presentation on Dec. 6 at the Revenue Cycle Solutions Summit in Boston.

Twitter: @JELagasse