A 2019 HBI survey shows considerable churn in revenue cycle vendor partnerships over the past two years, with 33% of organizations expanding their outsourcing and 36% increasing insourcing.
Some functions were about equally likely to be outsourced or insourced from 2017 through 2018: 38% of organizations outsourcing did so for denials and underpayments, but 33% of organizations insourcing brought them back in-house. For other tasks, such as billing, the trend has swung more toward outsourcing: 29% of organizations outsourcing did so for billing, but only 4% of organizations insourcing brought it back in-house.
The same survey showed that many revenue cycle leaders are investing in patient-facing technology (such as the 27% of organizations that offer mobile scheduling) or attempting to automate processes (like the 67% focusing on insurance verification).
With so much recent activity surrounding revenue cycle vendors, many HBI members have come to us for help with benchmarking performance, setting expectations, and monitoring quality.
While HBI has talked with many revenue cycle staff about those topics, the team historically has not posed the same questions to vendors themselves.
To gain insight into successful vendor management from their perspective, HBI spoke with executives from three revenue cycle services firms: David Hitzel, vice president of revenue cycle at Ensemble Health Partners; Bret O’Connor, partner at Cross America Financial; and Mark McVeety, vice president insurance discovery and revenue recovery solutions at TransUnion Healthcare.
They shared this advice on four frequent vendor management questions:
- How to Choose the Right Partner
Identify mutual values with your vendor candidates to better align your efforts. Consider selecting multiple vendors and using competition to improve outcomes. Choose a vendor the way you would hire an internal staff member, based on aptitude and skill rather than solely cost.
- How to Maintain a Relationship
Formalize your metrics early in the relationship and communicate frequently about performance. Ensure expectations are documented in writing and revised as needed. Designate groups of stakeholders to meet regularly to maintain accountability, monitor service level performance, and manage the day-to-day aspects of the job.
- How to Define and Monitor Success
Vendors should be able to provide a standard list of metrics to assess your return on investment. If your organization wants to monitor a unique metric, be prepared to explain how the data should be gathered and how analysis will be used. Always question what’s driving a change in metric performance; understanding those root causes will be more useful than limiting conversation to numbers.
- How to Stand Out From Your Peers
Don’t forget your vendors during strategic planning; they often offer services and expertise beyond what you are receiving. Solicit feedback from your vendors to guide internal process improvements and then look for new directions to take your partnership.
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HBI does not endorse any particular vendor or product. The vendors featured here were selected based on prior participation in HBI research projects, their expertise in the given subject matter, and their willingness to respond and contribute to this study.