In today’s rapidly evolving healthcare landscape, revenue cycle management (RCM) has become crucial for healthcare organizations to maintain financial stability and optimize revenue streams. Many of these organizations are turning to RCM partnerships to streamline their revenue cycle processes and achieve sustainable financial growth. However, choosing the right RCM partner and establishing a successful long-term partnership can be challenging.
Odds are you’re one of the 93% of hospital leaders considering strategic outsourcing to combat margin pressure. Healthcare RCM is a high-impact area that’s prime for outsourcing and capable of delivering much-needed financial relief to hospitals, especially as hospitals are projected to experience $98 billion in additional costs from 2022 to 2023, which brings a total cost increase of $248 billion over 2019 costs.
But entering a committed relationship can be daunting. It requires vulnerability, trust, communication, compatibility and respect (just ask any marriage counselor). You have to find someone who really gets you. Because just like any significant relationship, it takes a lot more than chemistry to make a partnership successful.
Choose the right partner, you may go the distance together. This will be the company providing complete oversight of all processes throughout your revenue cycle from patient engagement to account resolution. The right RCM partnership can reduce operating costs, streamline vendor management, substantially increase revenue and ultimately allow you to devote maximum focus to patient care and engagement.
Choose the wrong partner, you may be stuck with them. If done incorrectly, there can be a significant negative impact to your staff, community and your bottom line. But these contracts are typically long, and the integration is extensive. So, like many relationships gone wrong, people often choose to stay in them instead of spending the time and resources required to unwind from the failed partnership. Who wants to go through terminating a contract, finding a new partner and implementing another solution?
Bottom line: It pays to be thoughtful about who you partner with.
Here are Six Revenue Cycle Management Tips To Consider When Looking for a Compatible Match
1. Make Sure They’re Who They Say They Are (Don’t Get Catfished)
Talk to the company’s current clients to determine if their results matched the sales pitch. It’s critical to check references and hear directly from your peers who’ve gone through the process. Evaluate their experience and expertise in the healthcare industry. An RCM partner should have a deep understanding of industry trends. Choosing a partner with a proven track record with organizations similar to yours will ensure you feel more confident they will be better equipped to meet your needs and drive positive outcomes. Don’t just take the vendor’s word regarding what they will potentially do for you.
2. Ensure They Share Your Values + You’re Both on the Same Page
Professional partnerships that are built to last have mutually inclusive priorities and shared values. Make sure your mission and cultures are aligned. Maybe you won’t be introducing them to mom and dad, but is this a partnership you’d be proud to announce to your community? Would your employees assimilate well into their organization? Does the vendor have the infrastructure and processes in place to smoothly transition, train and grow your employees?
It’s important to be very clear about what’s expected from each side, what the relationship deal breakers are and what vision everyone is working towards. Discuss your challenges, objectives and goals for the partnership up front. A strong partner will be invested in your vision for the long-term and will work collaboratively to ensure your goals and incentives are aligned with theirs.
Ask about their approach to technology. Will they be able to work with your existing systems and tools or require certain technology to be decommissioned? What IT support will your resources require and what training will be provided to your end users?
3. Evaluate Their Technology + Infrastructure
An efficient RCM is reliant on sustaining robust technology and infrastructure. A potential partner should offer robust technological capabilities, including the RCM software, data security measures and integration capabilities. They should have the necessary infrastructure to handle your organization’s volume and complexity, but should also be adaptable and able to upgrade their technology to keep pace with the evolving industry requirements.
4. Make Sure It’s Not One-sided
Ask your potential partner how they will work to ensure that decision making about policies and procedures is inclusive of leadership and aligned with your organization’s goals. Will a joint steering committee be established with equal representation by your organization and the vendor? If so, how early in the process? What other cross-functional communication channels will be established?
5. Set Clear Expectations From the Start
Ask them how they get started and how they ensure project success. These types of engagements are incredibly complex and require diligent project management and execution. Ensure the vendor has a process in place to get intimately acquainted with your processes, staff, workflows, systems and areas of opportunity. Make sure you feel comfortable with their ability to create and manage complex project plans and report out on key metrics before and after project go-live to ensure there is no productivity loss or dip in performance during the transition.
6. Look for the “Whole Package”
Ask what they bring to the table outside of day-to-day operational management. The best partnerships are the ones that bring ongoing value to the relationship beyond fulfilling day-to-day obligations.
Will your partner identify issues and help you resolve them, even if it’s not exactly what they signed up for? Will you be able to rely on them for insights and action plans related to payor policy changes to help you stay compliant and avoid preventable audits, claim rejections and denials?
Finding a partner who “completes you” can be difficult, but so worth it. The right RCM partner should provide support when you need it most and should grow beside you, helping you reach your full potential and deliver on your mission, through sickness and health, through good times and bad.
Moving Forward With an RCM Partnership
When you’re ready to optimize your healthcare organization’s revenue cycle and achieve financial stability, it’s important to establish a successful, long-term RCM partnership. By considering these six tips, you can rest assured your RCM partnership will be well-aligned and drive financial success in addition to enabling your organization to focus on delivering high-quality patient care.