Value-based reimbursement leads providers to externalize revenue cycle management

As value-based reimbursement becomes the norm, consumers demand better-quality care, and federal agencies put new regulations in place, provider executives are feeling the impact. And perhaps no leader feels the effects of these changes more so than the chief financial officer.

Significant pressure is on CFOs to find new ways to manage their organizations’ revenue cycles. As the C-suite sees that reimbursement will be impacted by quality as well as cost, strategic investments in clinical excellence often compete for funding against improved financial and administrative operations.

Adapting revenue cycle management (RCM) to the developing economics of value-based care isn’t an easy proposition. But one thing is clear: Providers need to focus on their core competencies in the new world of value, and collecting revenue isn’t likely to be on the top of that competency list. As CFOs and other financial leaders consider strategic alternatives to the status quo, we recommend they consider externalizing revenue cycle operations so they can keep their focus on delivering high-quality patient care.

In our Roadmap to Partnership blog series, we’ll discuss the steps a finance executive can take to determine whether externalizing RCM functions to a partner is the right way to modernize their revenue cycle.

In the next blog post, post #2, we’ll discuss the need for a business assessment of RCM operations. I’ll cover how to conduct a revenue cycle assessment, identify specific and achievable goals, and evaluate opportunities for improvement.

Post #3 outlines strategies for contracting revenue cycle responsibilities to outside partners. I’ll show how to assess potential partners, develop goal-based strategies with RCM firms and evaluate opportunities for contracting.

Change management and transitioning to new RCM structures is the topic of post #4. In this post, I’ll talk about establishing a governance framework, developing transition and change management plans and launching transitions and transformations.

Our final post, #5, will be about measuring, monitoring and improving results.

To view the full Roadmap to Partnership white paper, click here.


About the Author:

Trachok_LeAnne_newbkgdLe Anne Trachok, Chief Strategy Officer
Le Anne Trachok leads enterprise strategy and innovation with a focus on understanding client needs, industry trends and new opportunities. Her team is responsible for solution design that encompasses services, technologies, content and analytics to improve financial performance and the patient experience for hospitals and health systems. Trachok also oversees and champions Optum360’s brand and culture.

With more than 20 years of experience in revenue cycle management and hospital advisory services, Trachok previously led Dignity Health’s revenue cycle function. Prior to that, she served in leadership positions at Arthur Andersen, UCLA Medical Center, and Tenet Healthcare.

Trachok holds a master’s degree from the University of Notre Dame’s Mendoza School of Business and a Bachelor of Arts degree in business administration from Washington & Jefferson College.

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