Many healthcare organizations overlook untapped resources that can improve the revenue cycle management process, which depends on accurate charges and quickly processed claims to strengthen your bottom line. But the problem usually isn’t accessing data – it’s making effective use of that data.
These questions will help you gauge where you are on your data journey so you can improve your revenue cycle analytics:
1. What are revenue cycle analytics?
Revenue cycle management (RCM) is the process used to track patient revenue from the initial appointment or healthcare system encounter to the final payment. RevCycleIntelligence defines RCM as “the financial process that facilities use to manage the administrative and clinical functions associated with claims processing, payment and revenue generation.”
RCM health is determined by key indicators including charge lag, bill lag, average time in AR, denial rate, percent of charges that are undercoded and the percent of charges that are overcoded. (You can learn more indicators and revenue cycle optimization tips in this study of the top-performing healthcare organizations.)
With effective revenue cycle analytics tools, the data collected in the RCM process can do much more than improve your organization’s financial health. It can be used to evaluate and standardize healthcare efficiency, effectiveness and quality.
2. Is your end user getting the right information?
Data analysis can be daunting, especially for smaller healthcare organizations. By using a revenue cycle analytics tool with automatic reporting and drill-down functionality, forward-looking healthcare organizations can uncover actionable insights that lower costs, increase revenue and improve care quality.
Making healthcare delivery more efficient and effective requires aligning physicians and other front-line teams to support strategies at the “last mile” of patient care – where strategies are put into practice.
3. Can you evaluate performance of providers, teams and locations?
Gaining insights from your data does not necessarily require a significant investment. The same data that helps you process and analyze charges and claims can – and should – offer more value for your investment.
Evaluating and standardizing performance requires timely, actionable insights for the front-line clinicians who directly affect productivity, performance and revenues. An effective revenue cycle analytics tool can help.
Tying individual charges to outcome data is essential to improving quality and optimizing workflow. The Ingenious Med analytics platform is a data warehouse focused on real-time dashboards for directors, managers and clinicians. Ingenious Med’s streamlined census management and charge capture workflow results in a significant uptick in an organization’s per physician profitability and accelerates the revenue cycle.
4. Do your revenue cycle analytics tools give you actionable insights?
IM Analytics™ delivers reporting that helps standardize performance and enhance revenues from the practice level down to individual providers. Using real-time claims data, it uncovers trends so clinicians and administrators can identify underlying causes. Its intuitive interface delivers insights without impacting workflows, while its mobility extends practice analytics to all stages of the patent journey.
Adfinitas Health, the Mid-Atlantic’s largest private hospitalist group, has been using the Ingenious Med platform since 2008 to leverage insights into individual provider performance. By assigning outcome results to the discharging provider, Adfinitas can find patterns in readmissions and length of stay. In one case, a provider had a stellar length of stay for chronic obstructive pulmonary disease (COPD) patients. However, when the Adfinitas quality care team reviewed the metrics to see if care redesign could be applied to other providers, they found that a higher number of that provider’s patients were being readmitted. Armed with this new information, the provider altered his routine and further monitored patients before discharging them.
5. Can you customize reporting with your current platform?
With tools that allow you to combine all available data feeds, your organization can create a custom attribution system for billing, quality measures and patient outcomes.
Scripps Health, a San Diego-based private integrated health system with more than 3,000 affiliated physicians, has used Ingenious Med since 2006. Jason Cook, Assistant VP, Medical Management at Scripps, said, “The enterprise dashboard gives me 90 percent of what I need. But then I can waterfall down, and if I’m trying to get into differences, I’ll slice it at a local level and compare all five or six groups together to find out what’s driving an RVU per encounter delta between Site A and Site B.” Scripps uses the Ingenious Med platform in many ways, including guidance in contract negotiations. When COVID-19 turned the healthcare system upside down practically overnight, Scripps used Ingenious Med’s tools to adapt quickly and optimize its productivity and revenue.
Financial success depends on more than merely reducing charge lag and identifying missing bills. While these are certainly important components, healthcare organizations should optimize every step of the revenue cycle. Gaining insight from the data you already have is critical.
Every step you take – from preset reporting, to customized dashboards, all the way to enterprise data analysis – takes you closer to gaining more detailed insights into the many aspects that affect your business performance.
To learn more about using revenue cycle analytics to optimize charge capture, increase care collaboration, and improve your performance and productivity, contact an Ingenious Med representative at 770.799.0909 or visit ingeniousmed.com/demo.