What your health system needs to know
By Laura Chapman, VP of Product Management and Kevin Nicholas, VP of Marketing
It’s always refreshing to attend Becker’s annual Health IT & Revenue Cycle Conference, where there’s an opportunity to share ideas and network with hundreds of professionals in the healthcare industry. This year’s conference gave us the chance to hear from healthcare providers and fellow HIT experts about their top concerns and collaborate with them on solutions.
Our top takeaways from this year’s conference include:
- The growing need to strengthen ROI by managing the revenue cycle
- The need for integrated technology platforms that work together to solve multiple problems
- EHR limitations in analyzing performance and other key non-clinical data
- The reactions to healthcare disruption from non-traditional competitors, ranging from fearing them to embracing them
- The need for analytics to move beyond monitoring to improving performance and predictions at the point of care
While value-based care is still on everyone’s radar, it was not as prominent as we expected. Instead, providers recognize that accurately capturing charges at the point of care benefits them under any type of payment model; it represents the critical foundation for good revenue cycle management. This is especially important during the move to new technology, such as when a health system transitions to a single EHR system.
Managing the revenue cycle
One of the RCM themes was the need for greater collaboration between IT and revenue cycle leaders. We participated in a panel called At the Mix of IT, Revenue Cycle and Analytics along with several other healthcare leaders. One panelist explained how this issue was being addressed with greater transparency and solutions that span more than one function or department. One strategy is integrating technologies from internal IT teams and external vendors to form solutions that can solve multiple problems across different disciplines. Building an ecosystem of analytics, machine learning and AI is expected to be more effective than a single solution at making healthcare delivery more efficient.
Key to fostering IT and RCM collaboration is ensuring that any new solution’s functionality aligns with the expectations of physicians and administrators. New technologies can’t improve anything if they aren’t used. Discussing and agreeing on functionality and user experience at the outset of a project can prevent many headaches later.
Another theme that emerged as the need to give patients greater pricing transparency. As high-deductible health plans have gained in popularity, more and more patients are paying thousands of dollars out of their own pockets for medical care. That makes them far more price sensitive, yet existing efforts to put accurate pricing data in their hands remain woefully inadequate. A recent survey showed that addressing rising medical costs and increasing price transparency ranked number one on a list of healthcare executives’ top priorities for 2020.
Ingenious Med’s analytics can play a role in the move to transparency by helping executives better capture their charges at the point of care and enabling different departments to share information in real time. Our automated charge tracking and analytics capabilities optimize revenues and support margins while better delivering charges to billing systems.
A single EHR system doesn’t solve many RCM needs
A change this year is that many health systems have moved to a single EHR system. Their investment of millions of dollars in new technology, however, hasn’t solved many of their data interoperability challenges or their lack of streamlined processes and communication. Participants noted that EHRs have a limited ability to optimize the revenue cycle or to monitor and enhance performance. They also don’t offer much flexibility for customized reporting – and what is available tends to be very expensive for smaller organizations.
A recent survey underscores what we observed at Becker’s: nearly half of providers are going outside their EHR to outsource RCM or to find a tech partner to help them. It also echoes what we’ve heard from a number of our customers facing similar challenges. They used our solution as an insurance policy during their slow and expensive transition to a unified EHR system to preserve the integrity of their revenue cycle. Both during and after the transition, we helped them quickly identify and address charge and quality issues, continually monitored team and workflow performance and provided dashboards and automated reports to rapidly identify areas for improvement.
Non-traditional competition and consumerism
Perhaps the biggest topic of conversation at the event was the potential threat (or opportunity, depending on your point of view) from big tech and retail players entering the healthcare space.
While the unease about tech giants like Amazon, Apple and Google – or retail chains like CVS and Walmart – was palpable, a few are embracing the new world. For example, Allscripts recently partnered with Apple to offer its customers access to Apple’s Health Record. The platform enables patients whose providers use Allscripts to access and get a consolidated view of their health records across multiple providers. Allscripts’ move follows on the heels of hundreds of providers that already support their patients’ ability to access their health records on iPhones.
Competition in the healthcare delivery space is perhaps more of a tangible threat. Amazon continues to expand its healthcare footprint. It recently acquired a medical technology startup to support Amazon Care, a primary care program it introduced in its Seattle headquarters this fall. However, it remains to be seen how much they’ll expand healthcare delivery outside of caring for their own employees.
Walmart perhaps poses a more immediate threat. It recently launched its first Health Center – 10,000 square feet housing dental, behavioral and primary healthcare services – to supplement its massive pharmaceutical footprint. If Walmart can become a prescription-writing factory that takes care of all the paperwork, they could potentially become a physician’s best friend.
Many expressed concerns about how to best prepare for this new world. One strategy to protect their already narrow margins is squeezing every drop of potential revenue out of their services and keeping costs to a minimum. We believe that a viable long-term solution is working more closely with their physicians to optimize revenues and performance across multiple areas. The data that Ingenious Med captures gives them an immediate view into physician productivity across multiple areas of their enterprise; and, because our data is based on charges that physicians themselves have entered, it has the immediate credibility executives need to get physician buy-in.
Technology, as always, plays a critical role in reducing costs as well as streamlining and automating workflows, especially in areas like machine learning and AI. What will be important is using it in new, innovative ways. The healthcare and tech landscapes evolve constantly; merely repeating what has been done before is not a winning strategy.
While Ingenious Med focuses on physician productivity and hospital performance data more than clinical data, our solution provides an important foundation for all sides of the healthcare system. By ensuring that physicians accurately capture charges at the point of care (both inside and outside the hospital), health organizations have a much greater chance of successful downstream business decisions and revenues – and that means they can continue to provide the services that improve patient health.