November 13, 2018
Value-based care promises a whirlwind of new payment rules, contracts, and metrics; and every corner of healthcare will be impacted. It’s easy to look at this future and focus on new systems and processes; but ultimately, it’s your people who are going to make the biggest difference in value-based care success.
This is even more true for the hospital revenue cycle.
Value-based care represents a shift away from code- and process-oriented approaches and into one where everything should center around your patients. Here are a few suggestions revenue cycle leaders who want to flourish in the era of value-based initiatives should consider to stay people-focused in the coming years.
Self-pay portfolios are growing, and they’re growing fast. The average patient responsibility jumped a full 17 percent in 2017, leaving hospitals (that fail to collect on 65 cents of every dollar billed to patients) in a tenuous position.
What does that have to do with value-based care? If there’s one certainty around the shift away from fee-for-service payment agreements, it’s that hospital margins are going to get tighter, at least during the transition period. This dynamic represents a triple threat for hospital leadership, and one that’s best addressed by turning to their patients.
Getting past those razor-thin margins will require making up ground on the self-pay side to shore up cash flows during complex times.
The ultimate goal of value-based care is to move us away from transactional, episodic care and into a new normal where outcomes matter most. For revenue cycle leaders, this means an opportunity to contribute to the overall care experience.
The impact of financial challenges on care results, or “financial toxicity,” is something the healthcare industry is just beginning to understand. But, as we move forward into value-based care, it’s a concept more revenue cycle professionals will want to grasp.
The patient financial experience is part of the overall care experience, and confusing or frustrating billing and payment interactions shouldn’t ding care outcomes. As value-based care takes hold, a focus on strong, respectful patient communications will only become more important in driving optimal outcomes.
Value-based care models expect providers to keep their patients as healthy as possible for as long as possible and to do that at the lowest cost. At the same time, patients expect more from their healthcare investment and are looking for a more patient-centered experience. Patients want a partner that helps in reaching their healthcare goals — a shift that makes loyalty an even more valuable asset, and one that hospitals and health systems can actively cultivate.
Much of this hinges on patient perception of care outcomes, but when it comes to loyalty, the revenue cycle can be a key contributor. Consider that, according to Accenture, a full 47 percent of patients would be willing to switch providers if they could understand their costs up front. The patient financial experience isn’t just a component of patient loyalty; it’s often the one in the driver’s seat.
Don’t forget about your staff.
Value-based care has thrown a lot of the back-end revenue cycle processes into brand new territory requiring new training and approaches to keep your in-house people prepared for this new world of compensation. Turnover is expensive for any department; and now is the perfect time for revenue cycle leaders to focus on attracting, retaining, and developing the best and brightest team members.
This is a difficult challenge, but new approaches like merchant services implementations that are aligned with consumer-centered perspectives can free up dozens of hours per employee and make space for the reskilling and career development efforts that will be required for effective revenue cycle responses as we walk away from volume-based reimbursement.
Value-based care presents a challenge but also an opportunity for revenue cycle leaders who are ready to take hold of a new position of influence in the future of patient-centered healthcare.
RevSpring Can Help
Integrated payment communication is part of RevSpring’s DNA. We tailor the payment conversation to influence behavior and inspire action. Our segmentation rules and workflows help you become hyper-focused on the patient, understanding their ability to pay and mapping their financial obligations to repayment pathways.
If you’d like to learn more about our comprehensive patient engagement and billing solutions, we’d love to help you. Request a demo to see how we can help your organization meet its goals.