The New NCQA Standard that Health Plans Can’t Afford to Ignore
As a health plan, you are likely familiar with the National Committee for Quality Assurance (NCQA). A government agency whose mission is to “work for...
To improve patient financial experiences and protect profitability, healthcare financial leaders need a strategy that focuses on end-to-end revenue management.
Today, revenue cycle strategies rely on a combination of core EHR functionality and bolt-on point solutions. However, this approach is beginning to change. In a recent survey of health system CFOs, 28% report they’d be making major investments in revenue cycle technology solutions in just the next 12 months, migrating away from point solutions toward an enterprisewide, end-to-end revenue management platform.
As you consider strategies like these to drive operational efficiencies across your revenue operations, the following emerging trends should be taken into consideration:
- It’s challenging to maintain a positive patient experience while collecting payment, but best practices are emerging. Communication with patients across the entire continuum of care needs to be clear and accurate. Using patient financial engagement technology to ensure that patients have upfront access to price estimates, out-of-network alerts, and payment plan options is key. And while technology can be a helpful tool, it should not replace person-to-person communication. Patients may not understand the payment process, including estimates, copays and outstanding balances.
- Robust analytics across the revenue cycle will help reduce all-cause denials. As a first step, it’s important to verify patient identification, insurance coverage, eligibility, and propensity to pay before your patients arrive for care. With the right technology in place, this step can solve coverage discovery problems and increase charity screenings, improving downstream operations. With end-to-end revenue management analytics and a continuous improvement process, you can identify and address the root cause of most denials before they occur.
- Automation strategies are accelerating reimbursement and reducing manual labor. Robotic process automation is creating value across all stages of the revenue cycle. Healthcare organizations are seeing triple-digit return on investment from well-designed automation implementations. It’s also having a positive impact on patient experience and front-office staff workloads. Automated appointment reminders and rescheduling, self-service check-in, and point-of-service collection processes have been a boon for patients and staff alike.
- Will the technology integrate with our existing systems?
- Will it position our organization to improve the patient financial experience?
- Is the vendor able to standardize our performance dashboards and reporting across all stages of the revenue cycle?
- Does the vendor have a mature end-to-end automation strategy?Healthcare revenue management technology should make everything as seamless as possible. When considering which technology to implement, ask yourself the following questions:
An estimated 70% of healthcare organizations leverage multiple third-party solutions for revenue cycle management. This approach is creating data silos, limiting automation programs, eroding workforce efficiencies, and, in some cases, negatively impacting patient satisfaction.
Learn how FinThrive is rethinking revenue management with an end-to-end solution.
