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Data-Driven Approaches to End-to-End Revenue Protection

Data-Driven Approaches to End-to-End Revenue Protection

To improve patient experience and optimize revenue cycle processes, healthcare organizations need to develop revenue protection strategies that focus on the full patient lifecycle. At TransUnion Healthcare’s recent video-based, virtual event — Actionable Insights for Healthcare: A Data-Driven Approach to End-to-End Revenue Protection — hospitals and healthcare organization leaders discussed the strategies they employ to drive operational efficiencies and success.

The session featured:

  • Joan Cox, National Senior Director of Patient Experience at Steward Health Care System
  • Jamie Davis, Executive Director at Banner Health
  • Jim Heffernan, Senior Vice President of Mass General Physicians Organization at Mass General Brigham

The top takeaways from the panel discussion included:

  • Sufficiently maintaining patient experience while collecting payment is a major challenge. When it comes to ambulatory care, Joan Cox asserted that organizations must ensure communication across the care continuum is clear. Joan said her organization is “leveraging technology to try to make sure that the patient is coming to [an] appointment with as much information as possible and an understanding of what the next steps are.”

    Healthcare organizations cannot fully rely on technology to converse with patients, however. Technology is an asset, but Joan noted without person-to-person communication, a patient might not understand the payment process, including cost estimates, copay collection and outstanding balance.

  • Robust analytics across the revenue cycle is key to reducing patient ineligibility denials. Jamie Davis said her organization takes a multipronged approach to patient eligibility. She relayed, the first step is to verify a patient’s insurance is eligible before they arrive at the hospital. When the right technologies are in place, this step can solve care coverage discovery problems before and after patients submit claims.

    Banner’s in-house continuous improvement team uses a robust set of analytics to drill into eligibility denials and find their upstream root causes. As a result, they’ve seen about a 15% volume reduction in acute eligibility initial denials, Jamie noted.

  • Healthcare organizations can enhance their revenue cycle by automating the professional billing process, as well as denial management, contractual payments and charge capture. Speaking about how his hospital system uses automation strategies to improve their revenue cycle, Jim Heffernan said, “Having [automation] gives you a consistency that you can’t maintain when you’re relying on individual people.”

    Hospitals and health systems can also use automation strategies to improve patient workflow, including automating self-service check-in and copay collection processes.

  • Healthcare vendor technology should make everything as seamless as possible. When considering which technology to implement, Banner uses a few evaluating questions: Will the technology integrate with our host systems or bolt-on solutions? Is the technology scalable? Will the technology contract in a way that improves our overall performance?

    An estimated 70% of healthcare organizations leverage multiple third-party solutions for revenue cycle management. However, leveraging multiple data management vendors for workflow comes with its challenges. In some cases, an organization can overcome these by consolidating crossover vendors.

Access the full discussion and other content on our event web page.

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