Alleviating financial pressures with revenue cycle improvements [Infographic]

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Alleviating financial pressureswith revenue cycle improvements

Combatting ongoing margin pressures by strengthening the revenue cycle

The modern healthcare landscape is complicated. As providers face mounting financial pressures, they must also address workforce shortages, shifting patient expectations, changing policies and regulations, and growing competition from new entrants in the industry.

Strengthening financial sustainability and enhancing business operations is key to tackling these complex challenges and delivering the high-quality care your patients and communities deserve. Revenue cycle transformation can help you improve margins and increase liquidity across your organization.

PROTECTING YOUR ORGANIZATION

Hospital CEOs ranked financial challenges as 2nd TOP CONCERN IN 20221.

Unfortunately, health systems are unlikely to see significant relief from the strain anytime soon.

  • Uncompensated care costs could increase for hospitals as states resume their annual Medicaid eligibility reviews. Between 8 TO 24 MILLION PEOPLE could lose coverage.2
  • In 2022, health systems saw a MEDIAN 7% DECLINE across their investments and a year-over-year decline of 45 days of cash on hand.3
  • Overall hospital expenses increased by 17.5% BETWEEN 2019 AND 2022. This far outpaced Medicare reimbursement, which ONLY INCREASED BY 7.5% during this same time.4
  • 2022 was the worst financial year for hospitals and health systems since the start of the COVID-19 pandemic with HALF OF U.S. HOSPITALS finishing the year with a NEGATIVE OPERATING MARGIN.5

Are the rising costs of UNDERPAYMENTS, DENIALS, AND SUBOPTIMAL CONTRACT NEGOTIATIONS hurting your organization’s balance sheet?

To help weather the storm, many organizations have turned their attention to implementing revenue cycle management (RCM) solutions.

Half of Respondents to the Bain-KLAS 2022 Provider Executive Survey named RCM solutions as a top five priority — the highest of any solution area.6

Healthcare Leaders listed revenue cycle as strategically the most important category for software investment in the industry over the next 12 months.7

ACHIEVING HIGH-QUALITY PATIENT CARE AND A SOLID BOTTOM LINE

Investing in technology solutions to optimize and automate revenue cycle processes can:

  • Enhance the Patient Experience
  • Decrease Administrative Burden
  • Reduce Waste
  • Improve Efficiency
  • Sustain Growth

There are opportunities for revenue cycle performance improvement and automation across critical functions including:

  • Patient Liability Management
  • Key Vendor Partnership and Management
  • Point-of-Care Service Documentation and Charge Capture
  • Referrals and Scheduling
  • Denial and Write-Off Reduction
  • Managed Care Contracts
  • Patient Financial Clearance
  • Access/Business Office Redesign
  • Accounts Receivable Strategy
  • Strategic Pricing
  • Case Management and Transition Planning

RETHINKING YOUR REVENUE CYCLE APPROACH WITH A TRUSTED PARTNER

With extensive experience in all major EHRs across 280 health systems and more than 60 academic organizations, Nordic can enable you to create a focused, intelligent revenue cycle that advances stronger margins through greater efficiency and increased revenue.

Nordic will bring a holistic approach to your revenue cycle strategy.

Our strategy includes:

  • ASSESSING an organization’s financial and operational health
  • QUANTIFYING potential vulnerabilities to external threats
  • IDENTIFYING opportunities for revenue enhancement and cost reduction whether it’s workforce efficiency, clinical variation, vendor management, or non-labor expenses
  • DEVELOPING data-backed, customized revenue cycle solutions with patients and care team members at the center

Our performance-based, data-driven approach to the revenue cycle focuses on key areas such as revenue integrity, charge capture, and complex claims.

To ensure success throughout implementation, we also consider:

  • Quality
  • Sustainability
  • Change Management
  • Clinician and Staff Engagement
  • Reduced Variation
  • Automation and Efficiency
  • Patient Experience
  • Knowledge Sharing

FINANCIAL HEALTH: OUTCOMES AND VALUE

Nordic is ideally suited to help provider organizations assess and implement lasting solutions with tangible results.

  • Better ROI on Existing Information Systems
  • Improved Managed Care Contracts
  • Increased Employee Knowledge and Satisfaction
  • Elevated Patient Satisfaction
  • Higher Productivity and Accountability

Typical Outcomes:

  • Net Revenue Improvements - 2 - 6% 
  • One-time Cash - 4 - 8%
  • Bad Debt Reduction - 3 - 5%

ADDITIONAL CLIENT SUCCESSES

  • IMPROVEMENT  up to 1% net revenue improvement related to documentation and charge capture
  • LESSENED CANCELLATIONS by 53% and 36% respectively in the main operating room and ambulatory surgery center
  • REDUCED DENIALS by 25% through root cause analysis and resolution
  • REVENUE increased annual net patient revenue by 2-4%
  • LOWERED SPEND by $2M net by bringing specific outsourced services in-house
  • DECREASED TURNAROUND for the average number of days to work a denial by 50%

Connect with Nordic today to discover how we can identify and deliver solutions that help strengthen your financial performance, improve efficiency, and enhance the patient experience. 

References

1. (2023, February 13). Survey: Workforce Challenges Cited by CEOs as Top Issue Confronting Hospitals in 2022. American College of Healthcare Executives. https://www.ache.org/about-ache/news-and-awards/news-releases/survey-workforce-challenges-cited-by-ceos-as-top-issue-confronting-hospitals-in-2022#:~:text=Financi al%20challenges%20ranked%20second%20in,survey%20for%2016%20consecutive%20years.
2. Tolbert, J., & Ammula, M. (2023, June 9). 10 Things to Know About the Unwinding of the Medicaid Continuous Enrollment Provision. Kaiser Family Foundation (KFF). https://www.kff.org/medicaid/issue-brief/10-things-to-know-about-the-unwinding-of-the-medicaid-continuous-enrollment-provision/#two
3. Muoio, D. (2023, March 6). Lower Margins, Softer Liquidity Sets the Stage for Hospital Dealmaking in 2023. Fierce Healthcare. https://www.fiercehealthcare.com/providers/lower-margins-softer-liquidity-sets-stage-hospital-dealmaking-2023
4. (2023, April 1). The Financial Stability of America’s Hospitals and Health Systems is at Risk as the Costs of Caring Continue to Rise. American Hospital Association. https://www.aha.org/costsofcaring
5. (2023, January 1). National Hospital Flash Report. Kaufman Hall. https://www.kaufmanhall.com/sites/default/files/2023-01/KH_NHFR_2023-01.pdf
6. Berger, E., Kassis, L., Feinberg, A., Dowling, C., Jain, N., & Murphy, K. (2023, April 10). Provider Information Technology: Mind the Gap. Bain & Company.

https://www.bain.com/insights/provider-information-technology-global-healthcare-private-equity-and-ma-report-2023/

7.LaPointe, J. (2022, October 19). Revenue Cycle Management Software Investments on the Rise. RevCycle Intelligence.

https://revcycleintelligence.com/news/revenue-cycle-management-software-investments-on-the-rise

Topics: featured, Performance Improvement

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