It’s Time for Patient Care Leaders to Rethink Revenue Cycle

Last month, Kevin Ormand, Thomas Kiseau, Todd M. Bankhead, and Catharine Wilder of The Chartis Group published a white paper entitled “The Next Strategic Imperative: Rethinking Revenue Cycle Transformation.” It looks at the dramatic changes taking place around payment and operations in U.S. healthcare, and how those changes are impacting revenue cycle management.

The Chartis Group.

The white paper’s authors focus on three areas that they believe will be critical for the leaders of patient care organizations:

• Innovation: “Health systems must embrace a necessary (and potentially disruptive) overarching evolutional paradigm shift in conventional revenue cycle practices. Such innovation helps to avoid becoming obsolete and creates the ability to nimbly scale to known and unknown headwinds.”
• Investment: “Strategic investments must be made in automation, technological advancements and a robust recruitment and retention program for highly motivated, team-centric and ‘Lean-savvy’ talent. Such investments run counter to short-sighted cost containment exercises by demonstration ROI and recognizing more significant longer-term sustainable reduction in the cost to collect. This ultimately increases net patient services revenue and drives efficiencies.”
• Integration: “Health systems must move beyond their current view of revenue cycle as a cost center. It is essential to create a holistic governance model that oversees the full integration of revenue cycle, clinical and operational workflows that are truly aligned with patient-centric processes and go above and beyond expected standardization and centralization programs and efforts. The structure,” they assert, “is necessary to avoid being ‘out-gamed,’ outnumbered and at the mercy of payers’ adjudication bureaucracies and denial algorithms.”

Two of the white paper’s authors, Kevin Ormand, who is director and leader of the revenue cycle group at Chartis, and Todd Bankhead, who is a principal at Chartis, spoke with Healthcare Informatics regarding the white paper’s conclusions and their perspectives on where revenue cycle is headed within the U.S. healthcare system.

We think there are some great observations made in the paper and the interview, the bulk of which align with OrboGraph’s vision and mission regarding intelligent payment automation and leveraging transaction data for further efficiency. As Mr. Ormond points out when referencing the Healthcare Provider Revenue Ecosystem (see above), 75 percent of the success of the fourth group — Revenue Cycle Operations  — is dependent on having a “data handle” on the previous three areas, all of which impact your ability to bill and collect for delivered care.