In the first half of each year, the HBI Revenue Cycle Academy publishes its annual Thesis in which we set forth our research agenda for the foreseeable future, based on the interactions we have with our valued members. The Thesis also provides members with a summary of the top projects their peers are working on, as well as a brief description of some of the most effective revenue cycle practices HBI has seen being utilized across the country, in organizations large and small.
With that in mind, here are four things you will learn from The 2018 Thesis: Setting Your Revenue Cycle Course.
Revenue Cycle Education Increasingly Focuses on the “Big Picture”
Training new revenue cycle team members has historically focused on specific roles and the IT systems needed to complete daily work. A downside of this type of training is that it does not provide team members with context about how their work fits into the revenue cycle as a whole. As one revenue cycle education leader told HBI, “They understand the whats, but not the whys.” This may explain why a majority of organizations (58%) in our Thesis Survey ranked revenue cycle–wide training as 8 or above on a 10-point scale of 2018 priorities.
Organizations are therefore changing education so team members understand the big picture of the revenue cycle, such as how what happens in registration impacts the organization’s ability to obtain full reimbursement later. When team members see this big picture, they are typically more engaged and can collaborate more effectively with their colleagues.
Others are having success by using cross-training and peer education to break down silos and build knowledge across the revenue cycle.
Implementing new educational approaches can impact teams as well as financial performance. One organization that implemented a series of revenue cycle educational courses observed a 20% increase in staff retention. In another case, an organization that updated its collections education experienced a 60% increase in point-of-service collections within six months!
Organizations Are Reinforcing Revenue Integrity Programs
In the current unpredictable environment, leaders are looking to revenue integrity teams to offset shrinking margins and maximize charge capture across facilities and care settings. Although approaches may differ depending on the organization, HBI has identified successful revenue integrity practices and structures that others may wish to emulate.
In one example structure we have seen, staff specialize by revenue cycle area: a charge capture specialist focuses on missed charges, an HIM specialist addresses coding and billing delays, a registration specialist fine-tunes registration workflows, a billing specialist conducts root cause analysis of downstream errors, and a last specialist works with outpatient sites.
Other organizations are incorporating nontraditional roles, such as nurse reviewers, to conduct charge audits and build charge capture workflows. Although the tactics may differ, better performers are not letting revenue integrity opportunities go unexamined.
Partnerships Outside the Revenue Cycle Lead to Improvements
In addition to breaking down silos within the revenue cycle, organizations have been able to breaking down silos between the revenue cycle and other groups. Some have found new ways to partner with physicians, nurses, or medical assistants to improve patient service and prevent denials. HBI has researched one model where clinicians are placed in the pre-service department to verify order accuracy and medical necessity. In another model, nurses work in the front-end call center to coordinate appointments across specialties, communicate with payers, and respond to clinical questions patients may have.
HBI has also found examples of successful partnerships between revenue cycle and IT. One organization has IT and revenue cycle staff sit in each other’s meetings to encourage collaboration. There is also a natural overlap between revenue cycle and supply chain to determine appropriate charges for new services. For example, revenue cycle and supply chain at another organization jointly participated in initiatives that were expected to have an $18 million impact.
In short, better performers are getting positive results by bringing in revenue cycle “outsiders” and benefiting from their expertise and different perspectives.
New Employee Engagement Tactics Help Connect With a Changing Workforce
Changes in the workforce are highlighting the need for new tactics to engage, develop, and retain talent. To connect with these employees in new ways, some organizations have utilized gamification. One organization utilizes a system where revenue cycle team members can earn points for tasks like posting cash, or lose points for making mistakes, which adds a fun and competitive element to their daily work.
Other organizations are expanding development opportunities. According to our Thesis Survey, 48% of organizations are expanding career ladders to new revenue cycle functions. In one case, an organization constructed a seven-tier career ladder for its revenue integrity team, outlining positions from the entry level to senior director.
HBI’s Revenue Cycle Academy will work throughout the year to uncover innovative solutions in the above areas, as well as respond to our members’ needs.
For more information on the 2018 Revenue Cycle Thesis and to learn how to obtain a copy for yourself, fill out the form below!