A Focus on RCM: A Sure Bet in an Uncertain World

January 20th, 2017

On December 20, 2016, Black Book Market Research released the results of a survey on healthcare tech trends for the New Year.

Among the nine listed was this: “Middle office functions such as coding and clinical documentation improvement initiatives will be recognized as critical functions in favorable revenue cycle performance.”

While those squarely in the center of that cycle may have dismissed this as a “gee, ya think?” kind of revelation, it also should be taken by department heads as a warning sign of potential closer scrutiny. Some things that could come up:

  • Are you where you hoped to be at this point post-ICD-10 implementation? If not, why not and what are you going to do about it?
  • Are there areas that need improvement? This is an opportunity to make the case for staff competency assessment and training.
  • What’s your retention rate for coders, given their short supply? Why are they staying? Why are they going? Find out now.
  • Are all the cogs in the wheel working together? Seek out constructive criticisms from area to area to identify and remedy any disconnects.
  • Look back at the lessons learned in ICD-10 training and implementation. Have you taken full advantage of that hard-won knowledge to promote continuous improvement?
  • How have your relevant vendors weathered the ICD-10 storm? They may require a closer look.
  • Do you have a Clinical Documentation Specialist in place? If there’s no one currently in this key spot, should you hire in or train up?

As noted in the report, political and funding uncertainty are standing in the way of long-term strategies and major purchasing by providers, as the ACA is on the line and value-based care looms. That’s apparently why so many CFOs are looking to retool their revenue cycle strategies to better manage the factors over which they do have control – creating the strong financial foundation essential to meeting whatever comes next.