Importance of Revenue Cycle Management in Value-Based Care

Episode Overview

Revenue cycle performance is a hot topic across the country as organizations work to rebound from the difficult past couple of years caused by COVID. There are many things that impact and contribute to the complexity of the revenue cycle, but they boil down to three categories: people, process, and technology.

On this episode of Value-Based Care insights, host Daniel J. Marino discusses ways to identify areas of opportunity and increase the revenue cycle performance with revenue cycle leaders, Cecilia Gonzalez and Rachel Greenspan.

 
Key takeaways:
  • When aiming to increase revenue and create efficiencies, leaders must educate and properly train front-end staff so that they understand the entire revenue cycle and how to avoid costly denials.

  • Key performance indicators support operational effectiveness as they drive outcomes and improve the overall financial performance of the group.

  • Centralized pre-certification processes can reduce inefficiencies as staff members become subject matter experts who are focused on the requirements of the payers to ensure timely and proper payment for services.

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Operational Effectiveness in Surgical Services

Episode Overview

Many challenges can arise when trying to implement standardized processes in complex surgical settings. Reviewing the data and performing prioritization exercises will help leaders identify inefficiencies and assist them with understanding where to begin to operate effectively. By utilizing data and engaging surgical staff, hospitals and ASCs will see tangible benefits to the financial bottom line and to staff and patients.

On this episode of Value-Based Care insights, host Daniel J. Marino has an informative discussion with Kate Geick on the benefits of implementing operational effectiveness tools in surgical services. 

 
Key takeaways:
  • One of the biggest mistakes that hospitals make is collecting data without taking the next step to understand and interpret it. After gaining analytic insights into the problems you are facing, you can move forward with an exercise like value stream mapping and identify opportunities for improvement right away.
  • It's really important to not only measure certain KPIs on a regular basis, but also share the analytic insights with the right people on a regular basis. If you aren’t informing the staff who are affected by the inefficiencies and are instrumental in enacting the changes needed, then it will be very difficult to make improvements in processes.

  • Making changes to processes that surgeons and staff have become accustomed to for years can be stressful. Necessary changes may involve more paperwork or more steps and this can create frustration. Bringing the focus back to the purpose and why you’re doing it will help maintain the level of commitment needed to implement meaningful changes for improved operational effectiveness.
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