How Innovative Is Your RCM Outsourcing Partner?
November 16, 2023
Please note: This article series addresses the unique issues and complexities that hospital and IDN ancillary services and outpatient diagnostic departments face. If you’re interested in a methodology tailored for clinical laboratories or medical device, remote patient monitoring, and durable medical equipment departments, we recommend those series instead.
PART 3: INNOVATION
It’s no secret: Ongoing financial pressures are driving hospitals and health systems to continuously improve operational and financial margins. That means optimizing clinical and operational staff and workflows–within acute settings–and beyond. And they’re leaning on a growing, dynamic ecosystem of technology providers and outsourcing partners to pull that off.
Hospital outpatient and ancillary services departments are no exception here. Because in today’s climate, yesterday’s write-offs are today’s essentials. That’s why they need an RCM partner who truly understands their unique processes and challenges, one who can help them:
- Improve financial margins
- Mitigate staffing challenges
- Accelerate cash flow for the department–and the entire health system
If you currently have an RCM outsourcing partner, are you realizing the fullest extent of those benefits? If you’re seeking out a new partner, do you know where to start? At XiFin, we recommend assessing an RCM outsourcing partner using four key criteria:
- Expertise and Excellence
- Security, Compliance, and Trustworthiness
- Innovation
- Quality of Service and Value
Previously, we covered Excellence and Expertise and Security, Compliance, and Trustworthiness. In part 3 of this series, we examine the role Innovation plays in evaluating an RCM outsourcing partner.
The Importance of Innovation in a Partner
Innovation, once a nice-to-have, has become a critical competency for healthcare technology and service providers. It is particularly essential in an RCM service partner. Regulations change. Payors rapidly and unpredictably shift requirements and policies. New tests, drugs, and procedures enhance–and complicate–the way you provide care. Patient expectations evolve. Technologies emerge, merge, and evolve. New competitors appear and draw patients away from your health system. There’s quite a lot to manage. Especially on your own.
When you have a solid relationship with an innovative RCM outsourcing partner, however, you are not facing those challenges alone. You’re facing them with someone who can help you navigate and even anticipate them.
What makes for an innovative partner? For RCM outsourced services, it’s one who:
Pushes the envelope with new, cutting-edge technology and service enhancements–without compromising quality or trust.
Stays abreast of and responds to market changes and customer recommendations–and often anticipates those dynamics.
Continuously seeks out new ways to help customers manage RCM operations more effectively and reduce their operating expenses.
Behind all that is a partner who thinks creatively and differently. One that sees beyond the current state and into future possibilities—both the exciting and scary ones. In an innovative partner, you want an organization that not only grows and adapts with you but also brings its innovative drive into your organization, positioning you for long-term success. One for whom artificial intelligence, for example, is more than a buzzword. It’s a core component of their “technology” and services. After all, today’s innovation is tomorrow’s best practice.
How Innovative Is Your RCM Partner?
Honestly assessing something like innovation can be tricky, especially if you’re evaluating a new potential partner with whom you have no established relationship. Insights from your peers can help. And as mentioned in previous posts, the Black Book Market Research annual report, “Diagnostic/Laboratory/Ancillary Services Revenue Cycle Management: Outsources & Managed Support RCM Services User Survey,” helps provide that insight.
Quick refresh: Each year, Black Book Research conducts an in-depth study to understand how ancillary services and diagnostic leaders evaluate outsourced RCM service providers across eighteen (18) key performance metrics. Those performance metrics directly inform the four partner assessment criteria mentioned above, including innovation. Here are three examples of how.
For one performance metric (Question 2, page 11), Black Book Research asked study participants to evaluate whether RCM customers experienced increased accuracy of billing, accelerated the speed of reimbursement, and reduced overhead costs “in ways that were difficult or impossible to accomplish before the current outsourced services were implemented.” For these capabilities, which Black Book Research classifies as “Innovation and Optimization,” Black Book Research also asked survey responders to evaluate such attributes as:
- Excellence in contract management and managed services.
- Providing the highest quality capabilities, processes, technology, staff, leadership, and quality assurance.
- Delivering RCM services “above current/former service levels.”
A second performance metric asks survey respondents if their RCM outsourcing partner “true business transformation opportunities” (Question 14, page 23). Black Book categorizes this, along with other key attributes, as a “Marginal Value Add.” Those other attributes for which RCM partners were evaluated include providing:
- Cost savings that are realized as generally estimated and not over-positioned or over/underestimated in ways that affect major client satisfaction or costs.
- Value-adds in cost savings and avoidance initiatives and creative programs through bundled product design.
A third performance metric (Question 18, page 27) that informs innovation, Black Book Research classifies as “Best-of-Breed Technology and Process Improvement Developments.” Under this umbrella, points of survey evaluation included:
- Delivery of managed services at or above current/former service levels.
- Best-of-breed contract management and related managed services.
- Capacity to elevate customers via vendor capabilities, equipment, processes, deliverables, technology, professional staff, leadership, quality assurance, and innovative initiatives.
RCM outsourcing partners that lead in these categories are proven innovators, backed by the real-world experiences of over 2,600 survey respondents–of which more than 450 serve in peer hospitals and health systems. Those partners understand the unique everyday financial intricacies burdening your department, aligning and designing solutions to help you overcome them. And they understand what lies ahead, building and delivering the technology, and services that will help you thrive and excel.
We’ve now examined three categories of core RCM services capabilities. In our next post, we’ll wrap up our series with a guide to evaluating Quality of Service and Value. Until then, download the full 2023 Black Book Market Research report to see which outsourced RCM service partners can help you accelerate cash collection and improve margins.
