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CFO Perspective: Boosting Outpatient Profit with Optimized RCM

Many health system and hospital executives look to outreach, outpatient, and ancillary services to impact their organization's cost structure and quality performance.

However, these organizations typically employ EHR systems designed for inpatient service revenue cycle management. This leads to reduced visibility into key outpatient RCM problem areas and metrics that enable critical decision-making, ultimately leading to lost revenue.

In the on-demand webinar, "How to Boost Ancillary and Outpatient Profit by 15%+ via Optimized RCM," Bill Voegeli, HFMA head of custom research and president of Association Insights, XIFIN Executive Chairman & CEO Lâle White, and XIFIN Chief Operating Officer Kyle Fetter, discuss:

  • Important financial, organizational, and technology trends, challenges and opportunities hospitals are facing in a post-Covid paradigm
  • Problems endemic to hospital outpatient RCM.
  • Strategies to improve outpatient revenue and profitability

The Post-Covid Paradigm

Leading custom research initiatives for HFMA, Bill Voegeli has visibility into the issues and priorities hospital leaders grapple with. From this perspective, Voegeli provided insights into reimbursement models, technologies, and financial metrics, highlighting the forces at work, achievable goals, where to start, and what to be ready for.

Lâle White built on these insights, adding a seasoned CEO’s viewpoint on Covid-19 impacts, with respect to outreach and ancillary service developments. She further highlighted accelerating health care trends, including government oversight, changing social conditions, technology developments (e.g., telemedicine), and business models.  

Boosting Ancillary and Outpatient Profit

Diving further into the revenue cycle management, Kyle Fetter shed light on the growing scale, complexity, data requirements, compliance, and productivity issues driving elevated unclean claim and denial rates for outpatient services. Moreover, he explained, that much of the resulting revenue shortfall is incorrectly categorized under “contractual allowance” rather than bad debt.

Summarizing the ineffectiveness of classic solutions to these challenges, Fetter offered that "throwing bodies at it in a clinical health care setting raises compliance risk and you have a higher error rate. So effectively, that is where technology is playing a greater part of the solution."

Fetter then discussed the necessary capabilities an RCM solution built to handle these challenges would require, elaborating on the functionality and benefits associated with:

Automation
Data Sharing
Interoperability
Business Intelligence
End-to-End RCM Workflow Functionality
Consumer Engagement and Digital Capabilities

Expanding on the sizable benefits afforded by automation, Fetter concluded with a compelling case study and supporting data, substantiating the improvements hospitals are realizing in clean claim rates and cash collections, when making this transition.

Want more information on how to boost outpatient profit with optimized RCM? Watch the full webinar:


Published by XIFIN
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