Healthcare Business Insights, Part of Decision Resources Group, hosts live events for our members each year. These Member Retreats are included in HBI membership, with no fee to attend. At HBI Member Retreats, we feature presentations by leaders at top-performing healthcare organizations, panels, networking opportunities, and the ability to earn continuing education credits.
HBI data shows that 33% of organizations increased outsourcing from 2017 to 2019, although outsourcing is not for everyone—another 36% of respondents brought previously outsourced functions back in-house during that time. During HBI’s 2019 Fall Member Retreat, four HBI member panelists—two providers and two vendors—gave their perspectives on building and maintaining successful revenue cycle vendor partnerships. The following are some highlights from the panel.
What should drive the decision to outsource or use a vendor?
Provider 1: At [my organization] we’re unique in that I don’t believe we have enough vendors, if you can believe it. It is our culture that we love our people. We love our neighbors. We love our community, and if at all possible, if we can retain that talent in-house and home grow that’s the preference, but that’s not the way to stay competitive. Right now, we’re exploring where our gaps are. What are the internal talents that we have that we don’t need to replace, and then what are the areas in which we could really benefit from supplementing our business with very smart strategic business partners through vendor relationships?
Provider 2: I agree with everything that [Provider 1] said, but in addition, it’s not just bringing the people in-house. There’s a lot more that goes to it. When you’re doing the ROI, the people part is probably the cheapest component. In our particular situation, we don’t have enough space to house the staff to bring some of these service lines in, and we do not have any of the infrastructure from a technology or phone system perspective. So all that has to be taken into consideration when we’re partnering with the vendors.
Vendor 1: In an earlier session here with HBI, there was a lot of conversation about cash being king, and I think a lot of times it goes to really understanding whether a vendor partner would be in a position to maybe help you collect faster, collect more, and do it at a lower cost. Those are areas, when we look to partner with a client, that we talk to them about. Many times, you’ll have vendors that are very focused in this space, and so they’re very innovative and they’re spending a lot of time evaluating how to solve a particular issue, and many times healthcare organizations, simply because of the vast amount of activities that they have to do and support, they simply don’t have the capabilities to do that.
As a hospital or a vendor, how do you evaluate a possible partner and ask the right questions before signing a contract?
Provider 2: We look at our vendors as an extension of our business office, so we want them not only to embrace the rules of engagement and achieve our goals, but we also want them to embrace our mission and our culture, so that to us is very important…We’re a large facility, so one of the questions that we typically will ask is, “Do you have a facility of our size, and are you able to take on this large of a client at this time? And if so, what does that look like?”
Provider 1: How I evaluate vendors is really about the questions that they ask us. I’m not a huge fan of conversations with potential vendors who are there just throwing out numbers and making promises—we haven’t even started doing business. I don’t enjoy those false promises. It’s very much like a first date, right? It’s very awkward and you just kind of navigate through that conversation. I love it when I get asked questions about what’s important to me. I love culture-based questions, because very much again to [Provider 2]’s point, they’re an extension of us…[I]f they’re really wanting to know what our climate looks like, that says to me they’re in it for the long haul and they’re looking to create a strategy that’s unique for what we need in our community.
Vendor 1: Often times you do hear the term “trusted advisor.” I do think that that’s important. I think we want to be in a position that when we work with our clients, that’s how they view us, and simply put, I think there’s a lot of opportunities where we are able to come to our clients and identify places where we can help them improve. But on the flip side of that, we also want to go to our client and identify areas where they’re performing well and celebrate those successes too.
Vendor 2: Really understanding that trusted partner model means that good, bad, or indifferent, whether a decision is made or there is something that impacts, you have to support the vendor and you have to work with that vendor to rectify the situation, because if you don’t, your staff ends up picking up the tones. They pick up the approach that you’ve taken and then all they’re doing at that point is looking for all the mistakes that are being made. That normally drives a wedge between the two, and you really can’t call somebody a trusted partner when that happens, because all you’re doing at that point is trying to figure out who’s going to get the finger-pointing next.
How do you see the vendor landscape evolving in the next two to three years?
Vendor 1: I think just like we’re seeing consolidation of healthcare organizations, you’re seeing it in the vendor landscape as well, and I believe over the next two to five years there’s going to be a press to identify vendors that can offer more services so that you can reduce your administrative costs…I believe that as we go forward, you’re going to look to identify vendors who have a broader set of capabilities that you can really leverage and go forward with somebody in that category. Denials is going to be a significant place where there’s going to be play, obviously, and vendors are looking at opportunities around machine learning.
Provider 2: I think there’s going to be a lot more tools in place to measure quality and also assist us with our risk contracts as we’re moving into that arena. At [my organization], we also think there’s going to be more focus on assistance with front-end issues…[W]e anticipate a stronger presence with eligibility and trying to get things on a front-end perspective corrected, whether it be somebody in a Medicaid program or that eligibility being correct, just assisting on the back end so we don’t have as much of that. Thirdly, we definitely would anticipate there to be a lot more growth with artificial intelligence. We want people to be working on things that they’re going to be smarter with, and let the robots do the things that are a little bit more routine, take the folks out of it.
Provider 1: I think patient access is where it’s at. I’ll expect to see more partnership with vendors to give upfront staff the tools to be successful, reliable tools that they can use, and to support those folks because they’re often the lowest paid in your organization. To put that burden or that blame on them without giving them the resources to be amazing is something that we focus on quite a bit. How do we create positive change that supports them holistically?
Vendor 2: Technology in general is going to change the landscape for both offshore and vendors…Understanding what technology is going to bring to you and what your opportunities are is going to be critical for you to really understand, “Hey, here’s the opportunity I have. Who are the vendors that fit that need? And how do I work with these vendors to fill in those gaps?” So, that’s going to be critical for everybody to analyze their operation and understand that shift, because your vendors, every single one of them, onshore, offshore, is going to change the makeup of what those contracts look like today.
HBI Retreats are free for members to attend, but we welcome non-members as well. To learn more about HBI’s events, including our 2020 Member Retreat in Denver in September, fill out the form below!