"End-to-End" System is Key to Value-Based Care Success

Many healthcare trends make it harder for healthcare providers to get paid.

That is, unless healthcare organizations embrace end-to-end revenue cycle management practices and technology. Don’t take my word for it – – see what industry pundits have to say.

With the fee-for-service business model changing to prospective payment and value-based care, healthcare organizations are undergoing a cultural shift that dramatically alters their approaches to patient intake, eligibility verification and claims processing. These are issues that providers will have to understand and adjust to accordingly, says Jose Rivera, vice president of physician solutions development at Santa Rosa, Calif.-based Visiquate.

The article goes on to predict that the fee-for-service model is going away, and it’s time to prepare for  more bundled payments – – and more risk on the backs of providers.

The solution? Evaluate inefficiencies within the revenue cycle workflow and replace out-of-date, paper-based processes such as explanation of benefit forms and correspondence letters. $1 – $2 per claim unit costs can be reduced by as much as $1 per claim. With a lower unit cost per claim, greater flexibility can be employed with pricing models for patients and reimbursements.

It’s either make changes, or put your full trust in the new models. Which would you prefer?