December 13, 2018
New cars can do amazing things. Not only do they look good, they can boost your ego, and even change peoples’ perceptions of you. In certain situations though, their benefits run deeper. “Extras” quickly turn into “must-haves” when emissions standards shift, commutes get longer, fuel costs rise, and drivers become even more distracted.
The same thing is true for the hospital revenue cycle, and right now, we’re facing a whirlwind of paradigm-shifting conditions that should have all leaders reevaluating the effectiveness of their EMRs.
Here are three signs that changes in the revenue cycle ecosystem have turned a previously “ok” EMR into a liability.
Value-based care is winding up to deal a blow to the revenue cycle that remains to be seen. Many hospitals are essentially sitting ducks, floating happily along with EMRs that were built for a fee-for-service, pre-interoperability world. Even some of the most recent EMRs aren’t ready for the introduction of bundled payments and alternative payment models.
With reimbursement being more closely tied to quality measures, issues like the inability to capture required data elements in structured formats, coordinate care across the continuum, or stratify patients based on risk quickly transform from minor inconveniences to massive liabilities.
Effective EMRs incorporate value-based care considerations into the core of their design. They’re built for speed and performance, and support revenue cycle adaptation to programs like MIPS and new payment models from the beginning.
Revenue cycle is turning a corner on big data and analytics, and many EMRs just aren’t prepared.
Successful navigation of value-based care, population health, and efficiency demands requires sophisticated use of existing data in addition to inputs from new sources. Unfortunately, many existing EMR analytics functionalities can be described as “incomplete.”
Value-based care requires providers to benchmark, measure, and manage patient populations in terms of quality and cost. Quality reporting will demand new levels of functionality, and while new solutions are improving by leaps and bounds, many of today’s solutions will trip over the sheer volume of uncaptured and unstructured payment data.
Another factor is the ease of use in analytics options, a challenge that’s being examined on the clinical side. While many EMR solutions do have advanced analytics capabilities, they are sometimes so complex (requiring the user to work with multiple systems and steps) that full engagement is discouraged.
Consumerization is a reality of the future of the revenue cycle, but unfortunately, many EMRs haven’t yet caught up.
An increased focus on the patient means a need to understand and impact individual patient experiences. This will also mean an experience that is more “retail-like” — a challenge that even on its own is a moving target. With formerly external players like Amazon, Uber, and even Walmart exerting pressure to change the way consumers engage with healthcare, some EMRs have been backed into a consumerization corner.
While some systems have held their ground through the successful use of APIs, many EMRs have struggled to keep up with the complex integration and communication needs that are inevitable in a fast-changing, consumer-centered environment.
Revenue cycle leaders can expect to see significant evolution of the EMR in the near future. As the technology adapts to meet disruption across the revenue cycle space, leadership should stay aware of how well their current solution is or is not meeting their needs, and be willing to consider necessary upgrades if significant gaps appear.
RevSpring is a leader in patient communication and payment systems that tailor engagement touch points to maximize revenue opportunities in acute and ambulatory settings. Since 1981, RevSpring has built the industry’s most comprehensive and impactful suite of patient engagement, communications and payment pathways backed by behavior analysis, propensity-to-pay scoring, intelligent design and user experience best practices.
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