Hospital revenue cycle data management tools are top of mind these days for CFOs and revenue cycle teams. Driving this is the proverbial carrot and the stick, with pressure both from recent rules requiring new measures in healthcare (the stick) and the promise analytics brings to streamline the business (the carrot). The IT tools you choose will help shape the healthcare you deliver.
An article in RevCycleIntelligence details how hospital management is looking to new systems and system optimization. “The respondents in the 2016 BlackBook survey stated that revenue cycle management system optimization was a growing priority as their organizations engaged in value-based care. New or updated systems would result in better financial health and increased efficiency, 94 percent of healthcare CFOs said.”
“Federal and industry regulations are forcing healthcare organizations of all sizes to review and upgrade many business and operational processes. And with mandates now requiring companies in the healthcare industry to measure and report on practically all aspects of their business, in combination with the digitization of health and financial records, one area that they would significantly benefit from improving is their data access and preparation strategy.” — from “HIT Think How new data tools can improve revenue cycle management“, in Health Data Managment
Leaders are continually challenged to find the right quality measures and meaningful analytics. Deanne Kasim, Research Director of Payer Health IT at IDC Health Insights observes in RevCycleIntelligence, “the biggest challenge that I’m hearing for pay-for-performance is, ‘what quality measures do we use, and why?’” Kasim recommends a focus on analytics that demands actionable results. “What providers absolutely must have are really powerful analytics that are able to take clinical and outcomes data, a lot of which resides in clinical systems, and combine it with financial data to accurately measure where we improve quality based on outcomes results,” explains Kasim, in reference to IBM Watson’s recent initiatives to boost patient outcomes via electronic health records (EHR) data collection.
There’s a lot to track in a hospital system, but another article in RevCycleIntelligence sums it up like this, “In simple terms, value-based care hinges on care quality improvement. Providers should invest in data analytics infrastructure or vendor-sponsored systems to help analyze quality metrics and monitor an organization’s progress with improvements.”
Where can hospital revenue cycle teams look for gains in the system? Becker’s Hospital Review ran a recent article where one expert recommends that you look across the board. “From check-in to the insurance verification to billing, data analytics can help you identify where the biggest opportunity for improvement lies. Are patient no-shows causing you to lose money? Data analytics spots these trends and help you course correct the problem (i.e. set up appointment reminders for patients),” explains Tom Schaal, director of product management at MedeAnalytics”
Sometimes the answers you need are found in reporting tools you may not have used yet from deep within your existing system. Study the data you already have is a message from another article in Becker’s: “The right analytics solutions must be easy to deploy and use, integrate with existing systems without a lot of IT lift, provide full data transparency and, to the extent possible, offer accurate, prescriptive insights and recommendations. Hospitals and their staff are drowning in data, while administrators and clinicians are caught up in the day-to-day activities of running their organizations and caring for patients. Hospitals also face increasing cost constraints that prevent them from hiring massive data teams. So our role isn’t to offer another system that adds to the technology exhaustion, but to enable hospitals to use the data they already have to make real, meaningful change that will improve operating margins and patient experience.”
Reviewing hospital revenue cycle data management tools can be daunting, so it’s important to keep the big picture in mind. As an article in RevCycleIntelligence on preparing for value-based care puts it, “In simple terms, value-based care hinges on care quality improvement. Providers should invest in data analytics infrastructure or vendor-sponsored systems to help analyze quality metrics and monitor an organization’s progress with improvements.”