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Healthcare Revenue Cycle Solutions

Significance of Healthcare Revenue Cycle Solutions in the Post-Covid Scenario

Health care providers across the nation is under significant amount of stress since the outbreak of Covid-19 pandemic; everybody is on a lookout for better healthcare revenue cycle solutions. Covid acted as a major catalyst causing lasting and unexpected changes in healthcare industry and society at large. Some of these effects are permanent, very significant and totally unwanted. But at this point we don’t have a choice but to move forward and ensure that we are all well positioned to deal with what is going on. One has no other option but to accept the reality, that it is here to stay and we should learn to deal with it somehow.

As far as revenue cycle operations are concerned, Covid-19 has brought in billions of dollars business losses from a healthcare perspective and provider perspective alone. It has touched the every-day lives of many. Healthcare market alone has about three million dollars’ worth transactions going on every day. But it has come down drastically in the recent past. Its time to bring about a facelift to the current situation with healthcare revenue cycle solutions.

Let’s review how the pandemic has affected the healthcare industry in detail;

Aftermaths of Covid 19 pandemic on today’s healthcare scenario

In the revenue cycle operation space, we deal with huge losses at an individual level; with unexpected losses close to 300 billion this year. Which definitely marks a tremendous loss and cannot be recouped in the near future. But even now the situation is not normal, its beyond abnormal. Looking at the financial implications, the services are curtailed, opportunities are curtailed, reimbursement is a problem. The payers are having difficulty accommodating the providers, providers are not able to pay their staff and employees are losing their job and cannot pay for their insurance. A really complicated and convoluted financial scenario which has to be dealt with care.

Specific areas affected by the pandemic

Due to pandemic, providers experienced various operational setbacks along with revenue loss, delayed patient payments, virtual care issues, staffing challenges and more like the following;

  1. Revenue loss due to reduction in elective care
  2. Reduced cashflow due to delayed billing
  3. Higher cost of supplies leading to margin pressures
  4. Declining patient collections due to federal mandates
  5. Higher default rates on out of the pocket collections
  6. Increased infrastructure costs to support remote work

This revokes the significance of adopting smart healthcare revenue cycle solutions. An established level of operations is the need of the hour which can be sustained in the coming years to bring the system back to its feet.

Recommendations for overcoming the covid-19 RCM challenges

There are several problems existing with the revenue cycle, starting from front office scheduling all the way to the finance management. Healthcare revenue cycle solutions mainly focuses on the business part of the cycle. The typical areas of concerns vary depending on the maturity of the organization. On its journey forward, operational optimization within RCM may be different for each organization. In spite of where one is or how one is doing business today, all providers are equally impacted with the pandemic.

Following are the key areas of focus;

  • Digital enablement- Secure backups for impending disasters in the cloud with remote recovery options, Artifice intelligence -based workflow to derive operations based on business prioritization
  • RCM diagnostics- Assess RCM operations and its impacts on RCM functions post covid-19, quantify one’s performance against RCM operational benchmarks
  • Enabling virtual care – Transform RCM services to be delivered in a ‘work from anywhere model’. Enable infrastructure to support demands of virtual RCM operations
  • Managed services- Adopt global delivery of RCM operations for front, mid and back-office functions. Flexible staffing to support dynamic changes in RCM operations.

Key benefits from implementing healthcare revenue cycle solutions

Virtual care solutions like tele-health and remote monitoring can be brought in. Also helps you acquire better interoperability options with data sharing and regulatory requirements. Holding financial performance assays is good for improving revenue and reducing practice running costs. Making a shift to government healthcare programs like Medicare and Medicaid managed care can ensure maximum potential growth at practice. Implementing digital healthcare revenue cycle solutions for business operations optimization improves financial outcomes tenfold.

Health data analytics are possible for quality performance and measuring outcomes. Population health for improved care outcomes and reducing cost for communities is an added benefit. IT modernization and secure digital -ready backbone aids in building advanced infrastructure and addressing growing threats in the industry. However, Value based care is the moto, which shifts from volume to value along with innovative payment models and advanced clinical integration. Also, There is enhanced patient experience and unification across continuum of care with personalized consumer experiences resulting from it.

With smart healthcare revenue cycle solutions, considerable reduction was achieved in account receivable days along with improved collection from patient as well as insurance payers. Furthermore, there was increase in percentile growth of virtual care revenue capture, enhanced staff productivity, improved uptime and rapid disaster recovery. Also, there are high rates of clean claims and significant increase in the cost to collect, a win-win for both the patients and providers.

Practolytics is a 20+ year old healthcare technology and management company. We partner with healthcare practices to provide end-to- end solutions including medical billing, healthcare consulting and practice analytics, allowing practices to eliminate revenue cycle management inefficiencies. Our diverse background in every aspect of healthcare allows us to maximize revenue and consistently deliver optimum results.