In its annual survey, the American College of Healthcare Executives (ACHE) asked community hospital CEOs to rank 11 issues facing their organizations. Personnel and staffing shortages leapt to the forefront – ranked as the number-one concern for the first time since 2004. Equally noteworthy, staffing shortages skyrocketed from an average ranking of 4.6 of 11 in 2019 to 1.6 in 2021. RNs topped the list of specific roles (94%), and technicians (including radiology and lab) came in second at 85%.
To compound matters, financial challenges ranked second (4.7 out of 11). 87% of CEOs cited rising costs as the primary financial issue (staffing among them). And 53% saw pressure to reduce operating costs.
What’s clear: Hospitals face elevated pressure to address staffing shortages – while navigating rising FTE salaries.
Pathway to relief: Optimizing Revenue Cycle Management
Optimizing RCM, even on a departmental level, carries the dual benefit of alleviating staffing and financial pressures. Optimizing your revenue cycle – finding new efficiencies and accelerating time to reimbursement – provides a clear financial payoff. An efficient RCM process can help you:
Increase clean claim rates with systematic eligibility verification, insurance discovery, and prior authorizations.
Reduce back-end denials, ensuring your hospital is paid for the services it performs.
Speed reimbursement through automation, especially for repetitive tasks and subprocesses.
Identify ongoing opportunities for improvement by incorporating AI-enabled analytics and financial reporting.
Improve customer service and patient experience through heightened transparency.
In turn, you can use those savings and recaptured funds to help address staffing shortages, reallocating dollars toward recruitment, retraining and even higher salaries to help attract and retain critical personnel.
Quick wins: Opportunities for faster ROI
But where to start? Overhauling RCM process for acute care is inherently complex and time consuming because the processes and systems that support it – along with the care itself – is by nature also complex. And it involves a wide array of stakeholders.
Start smaller – and with meaningful improvements. Although most hospitals have an enterprise EHR with embedded or complementary RCM system, those systems are typically optimized for acute care. When it comes to outpatient ancillary services – such as with radiology, pathology and clinical labwork – there can be gaps and opportunities for RCM efficiencies. If your hospital lab performs outreach services, that holds doubly true, given the chance to heighten customer service and streamline communication among organizations.
Scrutinize your billing processes. High-volume, low-cost procedures can especially benefit from automation. And if you need help, look for a partner with dedicated knowledge of those ancillary departments, which can help unearth new efficiencies and accelerate ROI. XIFIN data indicate organizations with a purpose-built RCM solution for outpatient and outreach billing realize a 10% to 30% profitability boost.
Outsourced billing and revenue cycle management automation can provide additional relief. In today’s difficult financial climate, where hospitals need to be especially nimble and adaptive, outsourcing allows you to delegate the high-volume, lower-value work – along with the pain of keeping up with changing regulations and payor requirements. It helps mitigate the hassle and cost of filling empty positions. It opens the opportunity to reallocate staff to more complex, higher-value work – or potentially retrain them for other roles. And if your hospital’s financial needs are especially urgent, it provides the speediest path to ROI.
Staffing and financial challenges present a potent one-two punch for hospitals to navigate. Improving your hospital’s RCM processes helps mitigate both.
For additional information on improving outpatient revenue cycle processes through workflow gap analysis, view our webinar, Outpatient RCM Gap Analysis for a Better Bottom Line or read the ebook “Stemming the Outpatient Profit Squeeze."