HBI’s Revenue Cycle Academy received more than 1,300 research requests from the membership community in 2018, allowing us to identify major trends in the issues commanding the attention of leaders throughout the industry.
The Top 5
- Staff Management:
More than a third of the research requests the team received were related to staff management. Revenue cycle leaders want to understand how their FTE levels and productivity expectations align with industry averages, as well as how their turnover levels compare. Also included in this category were requests related to training staff, attracting and assessing candidates for open positions, setting up reporting structures, and more. This indicates that many revenue cycle leaders, despite having subject matter expertise, could be unsure of how to handle the administrative tasks that come with a managerial position. HBI data on reporting structures and right-size staffing provide context for current performance, and case studies on training staff and monitoring performance offer behind-the-scenes details on how high-performers set themselves up for success.
- Patient Out-of-Pocket Costs
This category included self-pay collections (both uninsured and balance-after-insurance), upfront estimates, patient statement design and processes, and financing options (both in-house and contracted). Many revenue cycle leaders were seeking benchmarks for performance in these areas, but case studies of what their peers were doing were also in high demand. HBI research on patient out-of-pocket costs in 2018 revealed that the majority of organizations have a team dedicated to collecting self-pay balances, adoption of mobile and interactive voice response payment options remains low, and the definition of “estimate accuracy” varies widely.
Revenue cycle leaders placed significant emphasis on better understanding how their peers were structuring data analysis teams and dashboards, as well as how they are defining key metrics. Nearly a third of survey respondents indicated it was extremely challenging to collect revenue cycle data at their organizations, and the majority also reported that revenue cycle analytics efforts were only moderately integrated. This category also reflects high interest in how the revenue cycle is embracing automation and predictive analytics and how innovators are preparing to incorporate artificial intelligence into revenue cycle processes. While many are theorizing about AI’s potential in the revenue cycle, robotic process automation remains much more common.
Of all functional areas, billing received the most attention in 2018, winning out over financial assistance, pre-service processes, registration, coding, insurance follow-up, and more. Billing-specific questions covered best practice workflows, strategies for ensuring clean claims, and inquiries on whether peers have also encountered certain challenging scenarios. In this realm, HBI’s research team and other experts are uniquely positioned to connect members with each other to compare notes on trends they are identifying in the industry, as well as to develop training and resources for staff to adapt to changing requirements.
- HBI’s Revenue Cycle Scorecard
Finally, a large portion of research requests were either directly related to or resolved using data from HBI’s Revenue Cycle Scorecard. This tool is included in the Revenue Cycle Academy membership and allows users to upload data to directly compare to the national average and top quartile on a monthly, quarterly, or annual basis. Users can tailor the Scorecard to show custom KPIs if they want to monitor metrics beyond the standard options (including uncompensated care and denial write-offs, A/R days and aging, point-of-service collections, and more) and also have the option of inputting historical data to compare to prior trends and gain context for current performance.
Additional Trends in Revenue Cycle Leaders’ Areas of Focus
- Also ranking high on the list were denials, registration, and pre-service best practices. Additionally, tips for communicating with patients and guarantors to promote high levels of satisfaction and requests for insights on upcoming regulatory changes were of interest.
- Many requests asked for “like me” comparisons, meaning revenue cycle leaders were provided with networking contacts or customized data sets based on their region, bed size, net patient revenue, EHR system, or other factors.
- The past year revealed a growing emphasis on outpatient settings, including ambulatory clinics, physician practices, and hospital outpatient services (but excluding observation and the ED), suggesting a continuance to the recent trend of acute revenue cycle leaders gaining oversight of physician processes.
- The majority of requests could be answered from HBI’s library of case studies, survey results, training tools, and more, enabling members to receive quick and targeted insights to resolve their challenges. When a request requires new research, the team conducts interviews and analysis to identify high-performing organizations and understand what lies behind their success.
- Requests for case studies topped the list, with benchmarks a close second, indicating revenue cycle leaders remain focused on learning from their peers while seeing how they stack up against them. Also high on the list were requests for policy templates and technology-based peer networking requests.
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