In this special edition of our Healthcare Leaders blog series, we have asked some of the country’s leading experts to give us their predictions for 2017. From analytics to consumer engagement to interoperability, we get a glimpse of best guesses on what is sure to be an interesting year.
Hayes' Healthcare Blog
Eight out of ten hospitals under 100 beds are engaging in Revenue Cycle Management outsourcing because of lack of skilled staff. The graying of the baby boomer generation and the resulting retirements is putting a personnel strain on all businesses and the healthcare industry is no exception.
Healthcare organizations are being hit particularly hard in regard to physicians and nurses, but they are also seeing a lack of trained personnel in unseen, under appreciated but critical areas. One particular skills gap involves revenue cycle management personnel, a workforce that operates in large part behind the scenes but one that is crucial to optimizing a healthcare organization’s revenue stream.
Filling revenue cycle roles can be difficult because historically these jobs haven’t been valued as much as other positions in the organization. That’s a major mistake and failing to change that attitude can lead to serious negative financial impacts.
From the beginning of the cycle where front end staff checks in patients to the back end business office where A/R representatives, payment posters, cash control representatives and customer service representatives toil in relative anonymity, the process relies on dedicated, trained personnel, operating at peak performance.
Individuals in these roles must understand a multitude of payer requirements and recognize the interrelationship of every step in the cycle. They have to know the process thoroughly and understand their customers intimately. Finding and retaining staff for these positions should be a high priority for any organization.
Unfortunately that’s not always the case. Many organizations underestimate the complexity of these jobs and the skillset required to carry them out effectively. Here are four things to consider to attract and retain the right people to keep your revenue cycle flowing smoothly.
When CMS released the Notice of Proposed Rule (NPRM) for the implementation of the Medicare Access and CHIP Reauthorization Act - better known as MACRA – in April of this year, howls of protest could be heard throughout the healthcare landscape.
Critics labeled the proposed rule “too complex, too onerous on small and solo practices, lacking in opportunities for many to participate in alternative payment models, and should be delayed for a full year at least.” Some physicians claimed the rule was an attempt to drive them out of private practice and predictions of mass retirements were rampant.
In the six months after the release of the rule, nearly 4,000 public comments poured into CMS. The agency also collected feedback from over 100,000 physicians at outreach sessions held across the country.
The agency was paying attention. The final rule was released in mid-October and not only offers a series of clarifications, but also significantly softens some of the more aggressive components presented in the original proposed rule.
CMS addressed one of the biggest complaints – that there wasn’t enough time to absorb and comply with the new requirements – by essentially making 2017 a transition year. This gives organizations additional time to figure out what they need to do to implement the mandates of the massive new law.
Here are seven of the key outcomes, changes and clarifications resulting from the release of the final rule.