Running list: Top revenue cycle news, solutions from 2015

Healthcare finance is going through a rapid transformation due to pressure from the Affordable Care Act, payer demands and patient needs, and that extends right down to the revenue cycle. To help you stay on top of the latest news, follow this running list of revenue cycle insights from industry leaders.

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While every financial metric carries importance in running a healthcare business, tighter margins means managing days in accounts receivable is becoming more important than ever. Days in accounts receivable measures the amount of time between patient discharge and when payment is made. This directly impacts cash flows for the facility. Full story.

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If revenue cycle professionals have any doubt that they are expected to drive business strategy today, they need only read the job description for Emerson Hospital's desired new senior director of revenue cycle. Words such as "oversight", "execution", "leadership", "mediating", "best practice", "core values", and "communicates" all leap off the page as must-have skills and qualities for anyone likely to be considered for the role in this Concord, Massachusetts healthcare center. Full story.

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The revenue cycle management process might be the hottest topic in healthcare as consumerism and changes to payment models bring big shifts in how systems get paid. "The increase in consumer financial responsibility is the number one issue," said Stuart Hanson, chair of the HIMSS Revenue Cycle Improvement Task Force. "We've seen this flood of consumers with high-deductible health plans, whether they came from a public or private exchange, or their employer," he said. "Providers are now, in earnest, starting to grasp how quickly this paradigm shift is occurring. Full story.

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With revenue cycle staff in big demand, healthcare providers are scrambling to find candidates with this specialized type of experience before initiatives like ICD-10 and value-based payments put too much pressure on cash flow. "Absolutely there is a shortage," said Ann Trotter, a healthcare finance recruiter with Kaye/Bassman International Corp. "It doesn't look like ICD-10 will be delayed, so it is putting hospitals in hyperdrive because they know their dollars are going to plummet." Full story.

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As the October 1 deadline for ICD-10 nears, healthcare organizations are under pressure to improve operational efficiency so that the transition to the new medical and diagnostic coding system is relatively smooth. While expecting a seamless conversion to ICD-10 is unrealistic, healthcare providers can minimize the impact of claims errors and denials on the revenue cycle by anticipating the most likely mistakes and working to optimize internal processes or workflows. Full story.

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Most U.S. healthcare providers are simply unprepared to convert to new payment models, according to a recent survey by KPMG's Healthcare & Life Sciences Practice, which found only 15 percent of the 164 healthcare professionals surveyed said their finance departments can support capitation, bundled payments and quality-based payments. Another 61 percent reported that their finance departments are "gathering tools and conducting analysis about getting their finance function ready for this move," KPMG said. Full story.

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While others were out vacationing, Florida Hospital finance vice president Jeffrey Hurst worked overtime to launch one of the biggest technological changeovers the hospital has seen -- all of its revenue cycle management tools are being moved to one unified system. The changeover of its back-office management to a new Cerner system will be a two- to three-year process for Florida Hospital. Hurst said a combination of things led to the initiative, but a major reason is integration and alignment of the clinical and revenue sides of the organization. Full story.

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It’s a safe bet that the state you live in is failing when it comes to price transparency for medical procedures, according to a new report by the The Catalyst for Payment Reform and the Health Care Incentives Improvement Institute. In fact, 45 states earned a ‘F’ in this year’s report, highlighting just how far most regions need to come to provide price transparency. Full story.

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According to Yvonne Chase of the Mayo Clinic Arizona, solid revenue cycle strategies can improve the patient experience from the point of access to post-discharge. "Pre-service and communications set the tone for the entire encounter," Chase said during the Healthcare Financial Management Association 2015 National Institute conference Tuesday. Full story.

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Though Steven Brill’s essay “The Bitter Pill” has spurred demand for healthcare price transparency, competition and the complexities of value-based payment has made that a much harder goal than thought. “In a world where pricing should become less important, it’s actually becoming more important,” said Scott A. Schwab, senior manager at Ernst & Young, speaking at the Healthcare Financial Management Association’s 2015 Annual Institute. While value-based payments by nature make it harder to pin down fees for services, patients carrying a greater degree of the cost demand price transparency. Full story.

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More than 30 percent of the estimated $5 trillion a year in healthcare payments in the United States is wasted due to inefficient payment processing and costs associated with paper-based billing and administrative tasks, according to a new trends report by InstaMed, a vendor offering a healthcare payment platform. The survey results from over 100,000 healthcare organizations shows healthcare providers must give consumers more online and mobile choices for paying their bills while protecting patient data. Full story.

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When viewing healthcare’s transition to a value-based purchasing model, providers that haven’t taken the critical steps forward may be intimidated and paralyzed with indecision because of all the moving parts involved. But those frozen in their footsteps are not alone – in fact, they are in the majority, said Rob Schreiner, MD, managing director of population health for Chicago-based Huron Healthcare. Full story.

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Lean Six Sigma is thriving in healthcare, a distinct change from two decades ago, when the performance improvement methodologies were first introduced to the industry. When Marti Beltz, a healthcare instructor with the American Society for Quality in Milwaukee, started applying Lean Six Sigma to healthcare fifteen years years ago, she says there were no books, no conferences and even no curriculum dedicated to the field. Now, there are dozens. Full story.

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The U.S. healthcare system has taken a dramatic turn in recent years, as patients increasingly bear more costs in the form of higher-deductible plans and bigger co-payments. As a result, hospitals and health systems are evolving their approaches to collecting self-payments from patients who, given the costs they are bearing, increasingly view themselves as consumers and have greater expectations of the customer experience. Healthcare administrators must start to think of their patients in this light, said Austin Kirkland, principle and founder of healthcare consultancy Outperform, LLC, and a member of the National Society of Certified Healthcare Business Consultants. That means going beyond just verifying eligibility to making sure that cost information and financial counseling is part of the upfront process for non-emergency care, he said. Full story.

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Health systems entering the world of predictive analytics should start small before leaning so heavily on big data, said Katrina Belt, chief financial officer of Baptist Health in Alabama. “For us, we needed to ease in,” Belt said. They started with looking at claims, she said. After that, they started analyzing clinical data to help them reduce catheter-associated infections. Full story.

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Amid reimbursement upheaval, a sick and uninsured population, Our Lady of the Lake Regional Medical Center in Baton Rouge, Louisiana is pushing ahead with a number of ambitious plans to align its payment structure more with value than traditional fee-for-service. The facility recently became the state’s first hospital to offer a guarantee to patients receiving hip and knee replacements and their insurers. Our Lady Regional does not charge for any additional care within 30 days of a hip or knee replacement, covering readmissions, infections, rehab and postoperative care — everything except deficiencies in the joint devices. Full story.

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