Strengthening revenue cycle performance

As practices face the daunting task of implementing the infrastructure needed to meet new value-based care objectives while simultaneously juggling business-as-usual, every minute and each investment matters. Focusing on the following key practice assessment areas can strengthen your revenue cycle performance under fee-for-service today while preparing your practice for success in the value-care world ahead.

Current-state practice assessment helps you determine how your performance stacks up now, where you’re doing well and where you can do even better to gain a competitive, sustainable advantage. A thorough assessment can uncover underlying problems holding your practice back. 

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A current-state assessment has three parts:

Financial foundation assessment. Like any business, a healthy medical practice needs a healthy revenue stream. Analysis of your current finances can illuminate points of revenue leakage.

Financials that should be monitored include total charges and collections by provider, gross and net collection percentages, charges and collections per visit and the number of days that bills sit in short- and long-term accounts receivable. These metrics help identify and eliminate error patterns in your billing department, or between your internal billing staff and external billing service. 

The reimbursement schedule for your top codes from your top payers should be revisited quarterly to ensure payments are accurate and received in a timely manner, all in alignment with your competition and industry benchmarks.

Next: The final two assessments

Competitive intelligence assessment. Benchmarking is an important tool for understanding how your practice’s performance compares to others in your defined service area, region and even nationally.

Use patient origin data to define the current service area. Map out your practice and service area along with those of your competition. Data on patients in your area by disease state, hospital length of stay and other factors can be helpful when considering how future changes in demographics may impact your practice.

Calculate the ratio of staff members and their salaries to providers and compare this against appropriate peer benchmarks. The results may identify areas where the practice may be overspending or over-staffing as compared to similar practices.

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Process and workflow assessment. Have key employees complete a strength, weakness, opportunity and threat analysis to provide insight into office roles. Feedback from those on the front line of care can prove invaluable, especially regarding tasks that a provider may not see, such as scheduling efficiency.

Document processes for each functional area within your practice. What are the responsibilities of the front-desk staff, for example? Are they up to learning new tasks such as electronic check-in, pre-authorization and collecting the patient’s expected copay and deductibles up front to improve collections and lower days in accounts receivable? This growing movement of many back-office functions to the front-end can dramatically improve your practice’s flow of both cash and patients, and actually increase patient satisfaction.