As we attended multiple sessions and walked the show floor, we saw several trends and had six major takeaways:

1- Interoperability

• The industry is experiencing interoperability issues which have spawned a whole host of middleware and interoperability vendors and consultants.
• The true solution relies upon creating and enforcing healthcare standards within the software frameworks themselves instead of allowing health records companies to continue to develop proprietary software.

2- Technology, Data and Analytics…and what to do with it?

• In the early days of the internet, websites had the same challenges we see in many of the healthcare software products today: They are created under the belief that more is better, which creates an overwhelmed end user.
• These overly complicated products tend to be a result of the lack of clarity on how to use the technology and the data needed to provide useful analytics and visualizations.
• The end result: Too many functions that do nothing, too many screens that are under utilized and too many graphs and charts that provide little to no meaningful or actionable intelligence.
• The solution: Look past the clutter, focus on understanding the user/business/clinical/operational problems, and define a strategy on how to utilize the data and analytics.

3- Care Management/Pop Health and CRMs

• It’s my opinion there will be a collision of these two products in the near future.
• The reality is that these spaces overlap and the appropriate data served within a care management tool is useful within a CRM. More so, the data within a CRM is necessary within a Care Management tool if the care manager is to successfully contact patients (i.e. best method of contact, etc.)
• It’s extremely valuable for this intel to be incorporated in the Care Management tools in order to contact patients for the right reason at the right time.

4- Mobile Solutions

• In an attempt to treat patients as consumers, there are many vendors offering mobile solutions.
• Apps, portals…. Nothing really revolutionary, however, it shows that the industry is headed in that direction.
• More people search from their phone, rather than from their laptop; and now is the time to incorporate that consumer need into the healthcare industry.
• The right app development is critical to engaging with consumers.

 5- Patient Financial Responsibility – The Revenue Cycle Experience

• Due to HDHP’s and technology, patients are becoming more knowledgeable consumers who demand better communication, cost transparency, easy and convenient payment methods and plans, and easy & convenient scheduling/registration options.
• Health systems are addressing these demands through revenue cycle operational/workflow redesign, improved customer service and partnering with vendors that provide services and technology to improve the overall patient experience as it relates to billing/payments.

6- The self-fulfilling prophecy that healthcare is too complex

• Buyers realize that there are so many “solutions” and that some of them don’t solve their actual problems.
• The majority of products have become cumbersome with too many clicks, too many screens – leading to long educational hours of determining the right screens and data needed.  And like all technology, by the time they get something they can use, a new update appears and changes it all.
• Healthcare can be a difficult and complex industry. We all know that the software systems are lagging behind other industries; however, as experts, we need to realize that it’s a challenge we can overcome.  It’s time to take the leap and treat patients as consumers; and develop software systems that meet those demands.

We welcome you to contact us today to learn more about our Healthcare Consumer Experience & Relationship Management (HCxRM) and Revenue Growth & Integrity strategies as well as our team that can guide you in the right direction by emailing us at oursolutions@roundtablehit.com.

Experiences shared by Mike Schwob, Director of Management Consulting.

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In recent months, CFOs, Vice Presidents of Revenue Cycle, and Executive Directors have engaged RoundTable Strategic Solutions to develop a go-forward strategy to improve the financial viability and stability of their organization while identifying opportunities to enhance/optimize patient access and the overall consumer experience. Our proven approach provides clients with solutions that leverage operational re-design, reduce manual processes using information technology and create a sustainable model for growth within today’s healthcare delivery and rapidly changing reimbursement model.

RoundTable’s Management and Revenue Cycle Consulting teams are guiding many large and complex healthcare delivery systems in the following areas:

• DRIVING A NEW CULTURE OF PERFORMANCE & GROWTH: Providing Interim Revenue Cycle Leadership at a leading Academic Medical Center in the Northeast with responsibilities overseeing the day-to-day oversight of physician and hospital operations while serving as the “agent for change and innovation.”

Inattention to revenue cycle process, workflows and IT solutions can impact hospitals and physician groups upwards of $10M plus annually.

• DEVELOPING A NEW OPERATING STRUCTURE: Conducting a comprehensive revenue cycle assessment, reviewing staffing, size, structure, processes, and re-designing P&P’s for a Multi-State Integrated Delivery Network with 300 employed and community providers.

Implemented Denial Management Program and Policies & Procedures to reduce $8M in denials and assisted with the identification of two new outsourced RCM vendors.

• MAXIMIZING REIMBURSEMENT FOR ALL MODELS: Designing and implementing enterprise-wide Revenue Integrity programs to improve charge capture, CDM maintenance, physician documentation and compliance for a leading Academic Medical Center and Integrated Delivery Network.

Research states that 69% of organizations that implemented a new revenue integrity department increased net collections and gross revenue capture.

• OPTIMIZING ACCESS AND “KEEPAGE”: Overseeing the design and centralization of key revenue cycle and patient access functions including: registration, scheduling, eligibility verification and pre-authorizations for a 10-hospital IDN with 2,000 physicians in the Southeast.

Efforts resulted in a 12% increase in patient access and 36% decrease in registration related denials.

• LEVERAGING TECHNOLOGY TO IMPROVE PERFORMANCE: Advising Revenue Cycle and IT leadership on the advanced features and functionality available within their Practice Management and EMR solutions that drives automation, improves revenue cycle performance and clinical documentation.

79% of healthcare revenue cycle management priorities are enabled by health IT solutions and optimization.

We would welcome the opportunity to share more about our relevant background, experience and engagements while learning more about your current organizational needs and challenges.

The post Growth & Operational Re-Design: Building a Sustainable Model appeared first on RoundTable Strategic Solutions.