Health Data Management – Revenue Cycle Q&A with Marty Callahan, RevSpring
RevSpring is a leader in patient communication and payment systems that tailor engagement touch points to maximize revenue opportunities in acute and ambulatory settings. Since 1981, RevSpring has built the industry’s most comprehensive and impactful suite of patient engagement, communications and payment pathways backed by behavior analysis, propensity-to-pay scoring, intelligent design and user experience best practices.
How can healthcare organizations best balance the need to move toward value-based models – while still addressing long-established revenue cycle concerns such as days in A/R and collections?
Balancing moving to new value-based reimbursement models while managing self-pay receivables is essential to maintain the financial health of any health system or provider. This is especially true as consumer financial responsibility for healthcare expense continues to rise and the pressures of lower reimbursements increases. We see savvy healthcare providers relying on vendor partners that can provide relief for A/R management in the form of analytics, advanced technology, and employee efficiency that improves payment performance. By using these vendor partner technologies and solutions, healthcare providers can allocate more resources to determine how to best comply with new reimbursement models.
What technologies can healthcare organizations use to more effectively deal with emerging riskbased contracts?
For Healthcare providers to effectively manage valuebased contracts and reimbursements they need to have viable data and analytic technologies to store and track data pertaining to patient diagnoses, treatment modalities and outcomes, and analyze the data at an aggregate and individual perspective. The challenge for providers is not only in the technology to support value-based pricing and reimbursements but also the expertise to analyze and support these new strategies and reimbursements.
What strategies and technologies can healthcare organizations adopt to improve pricing transparency?
Most estimation models that are used to provide cost transparency to patients are based upon the payer contract with this hospital. This methodology typically doesn’t consider a patient’s contribution towards their annual deductible or co-pay. It can also be inaccurate if the model is using the prior year’s contract information with that payer (in other words, not updated based on current contract). A best case scenario would allow the patient to make a deposit against the estimate and then the technology would automatically adjudicate the balance with the credit card information on file.
Do you expect the federal government’s focus on reducing administrative burdens to have an impact on revenue cycle practices? If so, how?
As the federal government gains administrative standardization around electronic healthcare records and billing processes it seems that healthcare providers will have fewer administrative burdens and lower operational costs regarding compliance with these revenue cycle programs. Overall, efficiencies should be gained that will affect revenue cycle operations across the country.