Better margins, better healthcare: 3 trends driving IT for the revenue cycle

Better margins, better healthcare-3 trends driving IT for the revenue cycleFor the past few years, “meaningful use” has put healthcare IT’s focus on the clinical side. But, as I’ve seen over my time in the industry, the pendulum will inevitably swing back the other way: to the revenue cycle. And based on the impending issues that will be discussed next week at the Healthcare Financial Management Association (HFMA) annual conference, this swing is coming very soon.

Why now? There are three movements in healthcare that, in my opinion, will put the IT focus back on the revenue cycle. 

CFO influence
If you’re in an IT capacity, you clearly understand that this isn’t unique to healthcare. But at HFMA, I have the opportunity to discuss enterprise technology with a roundtable of CFOs, VPs of Finance and directors of patient financial services. Their ever increasing level of interest in IT speaks volumes about leaders in the organization who are involved in the decisions, doesn’t it?

With these financially-minded folks at the IT buying table, you can bet that “improving the business of healthcare” – as HFMA refers to it – will once again take hold of IT budgets.

Changing standards
The most wide-reaching change in the next calendar year will be HIPAA’s change to version 5010, in preparation to the change to ICD-10 on October 1, 2013. The issue here is that if healthcare providers don’t meet the new standard by the beginning of 2012, a financial strain on the revenue cycle will negatively impact the hospitals’ reimbursement, denials management, bad debt and ultimately send a ripple effect throughout organization’s operations. 

With IT’s sphere of influence greatly linked to the financial elements, the impact could be compounded. Changes and updates to the information technology infrastructure, billing systems, order entry systems, CDMs and the like put extended pressure on IT to stay ahead of the curve as the ever-changing requirements evolve. In response, IT must make sure that all relevant systems, including enterprise content management, can support the standard. 

Focus on efficiency
In the healthcare industry, patient safety and quality of care is and always will be the end goal. But with increasing government regulations, the only way to reach that goal will be to create more efficient processes within the revenue cycle. 

Think about every step of the revenue cycle, from initial order entry to final payment posts and reconciliation.  Between the many IT systems involved and many more manual processes that exist, there are huge opportunities for improvement. For example, in the payment posting process, hospitals often must connect multiple billing systems for payment validation. Using a solution like content management, charges are reconciled and automatically posted to these systems at the same time, taking out the potential for human error and dropping days out of accounts receivable. 

“Meaningful use” will continue to drive adoption for systems like EMRs. But with these three trends in the works, IT will undoubtedly have to make sure that if they’re looking at an enterprise application, it is a comprehensive solution that encompasses all areas of the organization. From the clinical side throughout the revenue cycle and the administrative suite, the proper enterprise content management application effectively rounds out the electronic health record and creates a truly paperless healthcare delivery network.

2 Responses

  1. John Orth says:

    Michael:
    The ICD-10 standards are being implemented by the EMR industry to automate the CPT coding process so the input for the billing software is created automatically on a daily basis, rather than a batch process when a patient is discharged.
    Further more the ACO model of operation for hospitals in the future will have to treat all of the ICD-10 costs as expenses that have to be managed. This will revolutionize the processing of managing both patient care and expenses and require an IT system that communicates this information to both the clinical managers and financial managers. This is an opportunity for Hyland that should be considered

  1. 06/24/2011

    […] charges are reconciled and automatically posted to these systems … Here is the original post: Better margins, better healthcare: 3 trends driving IT for the … jQuery(document).ready(function($) { var data = { action: "cbm_ajax", tags: […]

Leave a Reply

Your email address will not be published. Required fields are marked *

You may also like...