After careful scrutiny of productivity, processes and technology costs, many CFOs see the value in partnering with an external company that can take over day-to-day revenue cycle operations. Such a partner is built for revenue cycle management (RCM) and can likely do it better than most hospitals or health systems.
For CFOs, it may make more sense to spend resources on clinical care than trying to maintain revenue cycle expertise in the complexity and changing rules of the current and future reimbursement environment. They also know that revenue cycle mistakes are anything but inconsequential, so ensuring accuracy and consistency in billing and reimbursement is crucial.
The next three steps of our Roadmap to Partnership series provide insight into engaging the right RCM service vendor and what to look for in a partner you can trust. (Read the series intro here and see the first three steps in my previous post.)
Step 4 – Assess your alternatives.
There’s no one-size-fits-all solution for revenue cycle partnerships. Health systems are literally putting their financial well-being in the hands of the RCM partner, so choosing the right one requires asking the right questions. How flexible is the potential partner in molding its services to the health system’s needs? How committed are they to constantly upgrading and improving RCM technologies? Are they clear about how they’re going to make money? Will they continuously analyze ways to make improvements using sound metrics? Can they help improve the patient experience?
Step 5 – Develop a transformation plan.
Once the right RCM partner is found, it’s time to develop a transformation plan that efficiently and effectively moves responsibilities out of house. Plan development, led by the external partner, identifies strategies to success, establishes clear priorities and determines what technologies and human resources are needed to meet goals. The provider should conduct due diligence of the potential partner’s plan and work with them to outline the term sheet upon which the final contract is based.
Step 6 – Establish clear service agreements.
Any good partnership is built on clear understanding of what is expected of both sides, when deliverables will be met, and what metrics will be used to measure success. Providers should work closely with their RCM partner to establish a master services agreement (MSA) and various service level agreements (SLAs) that govern the relationship. CFOs should require agreement language that provides for availability, turnaround time, response time and standing meetings, as well as the metrics for which the solution partner will be incentivized.
In my next post, we’ll discuss change-management strategies and effectively transitioning revenue cycle work to your RCM partner. For more information or to view the full Roadmap to Partnership white paper, click here.Read part 4 in the Roadmap to Partnership series
About the Author:
Le 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.