Providers Are Still Hitting Snags in Revenue-Cycle Optimization

Timothy Kinney and James McHugh, Modern Healthcare

Providers are still struggling to optimize revenue cycle-related electronic health record functions and manage the increase in self-pay consumers, according to a new survey.

More than half of 107 hospital and health system executives surveyed said they struggle to keep up with EHR upgrades or underuse EHR functions, according to a Guidehouse analysis based on a survey by the Healthcare Financial Management Association. The share of executives who relayed that sentiment increased from 51% in 2017 to 56% in 2018.

The same number of executives reported that EHR adoption challenges have been equal to or outweighed benefits to their organization's revenue-cycle performance. In other words, providers haven't seen a significant enough boost in revenue to justify new EHR functionality.

"The revenue-cycle segment is very expensive," said Timothy Kinney, a managing director at Guidehouse. "It requires the right planning, implementation and training, and if you are not making those moves up front, the average organization comes out similar to where it started."

Streamlining scheduling, payment processing and debt collection has often been one of the first areas hospital executives address as they aim to cut costs and increase revenue. Improving revenue-cycle management can have a quicker return on investment than reducing care variation or limiting unnecessary treatment. 

Within the revenue-cycle space, most executives are focused on improving revenue integrity at 24%, according to the survey. That's followed by boosting EHR optimization at 21%, physician and clinical documentation at 12%, and self-pay management at 11%.

"Providers must take advantage of opportunities to more holistically educate patients on out-of-pocket costs, predict their propensity to pay as early as possible and secure alternative payers or financing when needed," said James McHugh, a managing director at Guidehouse.

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