Healthcare as a business is evolving rapidly, partly driven by changing reimbursement models. Health information professionals expected to be on the front lines of initiatives aimed at improving population health, increasing patient engagement and reducing overall healthcare costs.
That, in turn, is having a profound effect on payments and governance. As providers adjust their processes in reaction, it is important for the revenue cycle to keep pace with value-based models that increasingly tie reimbursements to payer definitions of quality and clinical appropriateness.
Healthcare revenue cycle management solutions can also help practitioners ensure they receive incentive payments for participating in government programs such as the Physician Quality Reporting System and E-Prescribe, further increasing a practice’s revenue. Other coming advances in revenue cycle management include charity screenings and propensity to pay. These measures can help physicians decide how to handle patients who may be unable or unlikely to pay their medical bills without compromising the financial success of practices. Outsourcing this process makes it more cost-effective to provide these services, as administrative staff does not have to spend their billed hours dealing with these tasks. Thus, RCM systems, methodologies, and technologies provide viable solutions to all players involved.