Who’s Winning in this New Era of Healthcare Revenue Cycle Management? Consultants…
According to a new survey by Black Book, the consulting business is booming in healthcare revenue cycle management; and rightly so! Challenges that executives cited for updating RCM projects include:
- 77 percent have not begun a strategic plan for transforming RCM solutions for known deadlines because of lack of internal experts to do so.
- 80 percent of CIOs said they do not have the IT staff in-house to transform RCM end-to-end.
For these reasons, consulting companies will be utilized heavily over the next several years:
- 90 percent of those who use RCM consulting services expect their expenses to double for add-on RCM projects in 2014. Thirty-six percent of “light users” of consulting services said their expenses could quadruple.
- 86 percent of hospital C-level executives expect new RCM consulting engagements to be under way through the end of 2014. Fifty-seven percent expect new projects to begin by June 2014.
- 66 percent of RCM-centric consulting firms and 92 percent of general management consulting firms expect to be hiring additional RCM financial and technology experts in this high-growth area.
It’s hard to imagine all of the initiatives which could impact the profitability of a healthcare provider. Let’s see… there’s billing changes (ICD-10), a whole new wave of new patients which may not be profitable (ACA), new regulations and technologies (ERA Standard and EFT & ERA Operating Rules, HIT), new accountability (ACOs), industry consolidation, new integration (HIE)… and don’t forget about HIPAA and about 10 others which we won’t go into right now. Try to assemble a model with variables which incorporate patient profiles, adoption rates of Obamacare and technology investments. Now there is a complex decision process which consultants can help with!
However, if an organization has the right expertise in-house, then implementing new technologies which reengineer existing workflows can dramatically reduce costs of certain dedicated processes. We know that to be the case in healthcare payments. Paper processing still exists, i.e. EOBs, but improvements are still attaining savings of 20-60%! So there are improvements which can be done without using external resources.
Some say, a consultant is someone who comes in to solve a problem and stays around long enough to become part of it. That may be the case, but consultants play an important part of our industry and will support the efforts of improving the revenue cycle in the future!