September 30, 2022
For every healthcare organization, including hospitals or medical practices, the most crucial duty is to ensure the highest quality of patient care. However, the health of an institution is also a significant aspect of how it will be able to take care of incoming patients. The most effective outcomes are a complete plan, from the first appointment, through the treatment process, and finally connecting with insurance companies during the billing process. A successful revenue cycle keeps business functioning in the competitive healthcare industry.
To ensure reimbursements for rendered services, manage denials, and boost revenue, organizations implement an approach known as revenue cycle management (RCM). At the same time, practitioners use healthcare analytics tools to track revenue health and practice efficiency. Since you can't measure what you don't calculate, you should use revenue cycle management solutions in unison with healthcare analytics software to increase your profitability and meet your revenue goals.
Thus, this guide will discuss four practical ways to track your revenue health. Kickstarting the discussion, we will see a brief overview of RCM and healthcare analytics, why monitoring the revenue cycle is essential, and what KPIs you should track to ensure your organization has positive financial growth.
RCM does not focus only on the payments of rendered services. It is a complete financial circulatory cycle that uses medical billing software front-end and back-end activities related to revenue generation. For example, the front-end activities involve patient registration, encounter, coding, claim creation, and submission. Similarly, it covers the entire back-office process from claim follow-up to reimbursements while optimizing account receivable (AR) days and minimizing claim rejection and denial rates.
On the flip side, healthcare data analytics tools help you consolidate financial, clinical, and business data for better insights so you can make more informed decisions that benefit your practice and revenue cycle. Mentioned below are key uses of healthcare analytics:
The revenue cycle metrics serve as the bridge between the business and clinical side of healthcare helping medical billers and administrators to get most of their revenue cycle and clinical process, for instance:
The practices that track their revenue metrics will help plan future expenditures and opportunities to take advantage of emerging technologies such as telehealth solutions or remote patient monitoring (RPM) systems. They also place them in the position of identifying any weaknesses they may have that they cannot address - particularly when navigating recent regulations in the healthcare space, payer schedules, and even the new protocols introduced as a result of the Covid-19 outbreak.
Healthcare Analytics should not be taken for granted if you want to stay profitable because it can solve some of the major roadblocks associated with the RCM. Three main challenges are as follows:
Margins are shrinking everywhere, and the landscape is shifting in the industry, particularly with value-based reimbursement. According to HCPLAN’s (Health Care Payment Learning & Actionable Network) latest APM Measurement report, 40.9% of U.S. healthcare payments, representing approximately 238.8 million people and over 80% of the covered population, generated from value-based reimbursement models in the period 2019-2020.
Providers are struggling to achieve quality standards in addition to the reporting requirements that MACRA or MIPS require. With physician burnout on the rise and the overall cost of healthcare at a record high, companies are trying to reduce costs wherever they can.
In a survey conducted by HIMSS (Healthcare Information and Management Systems Society), nearly 70% of healthcare facilities employ more than one vendor's solution to manage their revenue cycle. As a result, you have to deal with different numbers, screens, reports, siloed data, and inefficiencies.
Many solutions aim at data consolidation, but there are still a lot of challenges in sharing information. Some providers are using tools for data visualization to bring data together. However, issues arise when it's time to draw valuable and relevant insights from it, preventing businesses from understanding how they can modify their RCM processes.
Most analytics tools lack basic functionality leaving you with ambiguous reports from which you struggle to extract actionable insights. However, talkEHR's healthcare analytics tool, PrecisionBI, comes with financial analytics and clinical informatics.
Financial analytics help you leverage analytics from every corner of your healthcare facility. Analyze where your organization stands from billing to administration and everything in between. While the latter assist you in turning disparate data into comprehensive reports designed to help you assess the quality of your clinical performance.
According to Global Market Insights (GMI), the healthcare analytics market's size was $12.3 billion in 2021. Experts forecast it to grow at a compound annual growth rate (CAGR) of 11.8% from 2022-2030.
Following are the four ways; healthcare and financial data analytics help you track your revenue health and practice performance:
The analytics tool includes an intuitive business analytics interface enabling you to monitor performance across all departments of your facility. The interface comes with adequate parameters and a comprehensive data set to drive insightful comparisons. As a result, it becomes easier to compare metrics at any level of your practice assisting management in understanding forces shaping the organization without hiring professional data analysts.
With an analytics tool, you should be able to access a wide range of data and analyze key health metrics. It makes it easier to benchmark performance and analyze holistic reports of productivity statistics at a glance to understand recent trends and find potential causes for productivity drop. Features like quick-start, preset reports save your staff's time and help them grasp the organization's performance.
A good analytics tool will let you build custom dashboards based on roles with relevant key performance indicators (KPIs) for every team member and provide users with one-click access to precise drill-downs and targeted data sets.
Dashboards should include easy-to-use KPI data visualizations to evaluate and improve individual and group performance. Local administrators and clinicians can set the appropriate on-target, caution, or at-risk performance thresholds to design and monitor progress towards clinical and financial goals.
Additionally, it lets physicians view their performance relative to their group and colleagues. A decent dashboard should automatically highlight the optimal and under-average performance areas, allowing them to divert their attention to the indicators that must match the organizational goals.
It is crucial to examine the entire patient's experience and the various care locations and review the individual physician's performance level. The analytics platform can assist in standardizing performance across your organization and provide insights about the practitioner as well as the practice level:
Moreover, physicians often doubt the validity of performance data. Therefore, you should base the data on charges entered by clinicians to strengthen the system's confidence and avoid the notion that sicker or more complicated patients cause poor performance.
In this guide, we shared different ways to track your organization's revenue health with the help of healthcare data analytics tool. To back the discussion, we started by explaining revenue and healthcare analytics basics and why you should use these in unison to ensure a healthy revenue cycle. Proceeding forward, we discussed the four ways healthcare analytics can help you meet your financial goals.
If you are looking for a healthcare analytics tool that can help you stay on top of your practice and survive in the competitive healthcare space, get our PrecisionBI. It is a healthcare analytics and business intelligence tool that offers a modern interface, customizable dashboard, safe and timely reporting, in-depth analysis, and web and mobile support.
Besides healthcare analytics, talkEHR also has a wide range of health IT software, including electronic health record (EHR) system, telehealth, practice management (PM), and much more.