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May 10, 2022

Addressing Revenue Cycle Labor Shortage With Technology and Outsourcing

Written by: Melvin Miller, COO

The labor shortage is currently one of the biggest issues across industries. Be it restaurants, hospitals, retail, hospitality, and manufacturing – take any sector and you will find that this is perhaps the #1 problem operations managers are facing.

In healthcare, the labor shortage is not limited to clinical roles but extends across administrative functions. Front-office staff, billers, coders, accounts receivable, denial management, and physician credentialing experts are in short supply.

If you look at the revenue cycle, lack of timely filing and follow-ups can increase denials and result in delayed cashflows. When your revenue cycle faces a staffing shortage for core functions, you tend to ignore the optimization functions such as quality assurance and underpayment reviews, which can unlock additional revenue opportunities.

The staffing shortage is aggravating problems for the hospitals, which were impacted already by the pandemic. Over the years, we have seen declining reimbursements necessitating revenue cycle operations to deliver the best financial outcomes, which requires deep healthcare and reimbursement process expertise.

With expert revenue cycle team members already in short supply and the mandate to get all employees vaccinated for COVID-19, hospitals and healthcare systems are losing employees due to resignations and terminations. Due to the shortage of clinical and non-clinical staff, many hospitals are on the verge of closing; in fact, many rural facilities have closed already. Further, the shortage has resulted in a fight for talent, which led to increased salaries and the cost of operations.

In this blog, we look at some of the strategies revenue cycle CFOs are deploying.

  • Cloud-based IT infrastructure

With the need to operate remotely, IT leaders are tasked with making mission-critical EHR and RCM platforms available anytime, anywhere. In most physician practices, the adoption of SaaS-based EMR/RCM solutions is increasing.

  • Process automation

Within both clinical and non-clinical revenue cycle solutions, the application of machine learning, AI, and RPA technologies are enabling revenue cycle leaders to combat the staffing shortage to some degree. Technology and automation can move routine, repeatable, labor-intensive tasks to the machines and reduce manual effort. For instance, claims status automation and the adoption of portals reduce call center workloads. When you free up people from mundane activities, they can focus on higher-value activities and have better job satisfaction.

  • Operational rigor

While all revenue cycle leaders talk about managing tighter operations, few have gone on to invest time and money in implementing workflow systems that help them measure, monitor, and manage the productivity of each employee. Transactional productivity improvements will, in the short term, lead to gains in financial outcomes.

  • Analytics for sustainable transformation

Usually, revenue cycle success boils down to strategic A/R management, i.e., understanding the patterns in denied claims, addressing root causes, strategic touches to claims in higher revenue brackets, and not allowing claims to fall into longer aging buckets. Revenue cycle analytics and adoption of industry-standard reporting can help RCM managers create the focus.

  • Outsourcing

Perhaps the #1 strategy that organizations are looking at is outsourcing, which gives them access to trained, certified labor across the nation. And with offshoring, you also get the benefits of cheaper cost structures. With the outsourcing and offshoring market now nearly two decades old, you can find service providers who have invested in process expertise and technology to help you get access to best-of-the-breed practices.

  • Optimizing costs to collect requires simultaneous implementation of pervasive change strategies

Across the revenue cycle operations, the questions that leaders need to ask are:

o What can you automate?

o What technologies do you need to invest in - workflow automation, analytics,
front-end tech?

o Where will you find the money to invest in new-age technology?

o Does this function need to be done onshore, or can you offshore it? 

  • Cash is king. Leaving revenue on the table is a crime.

Faster cash flow cycles are critical to the survival of healthcare organizations. Address the problems such as revenue leakage and front-end processes sustainably to streamline operations.

  • Change the job content for your employees

Accelerating the adoption of technology and outsourcing can shift the focus of your employees to strategic tasks. The change in job content makes them feel empowered to impact the organization’s revenue cycle outcome, which is more satisfying.

  • Don’t just outsource. Choose your vendor partner well.

Plan along with your vendors, transition and stabilize operations, and then move the goal post for the vendor every quarter.

While you can take the short-term to address your revenue cycle issues, it is time for revenue cycle leaders to implement sustainable solutions. The labor shortage is not going away quickly, and reimbursements will continue to decline. Technology, operational rigor, and outsourcing are the only options you have. Choose well, plan well, and execute in style.

Additional Resources:

  • Medical Billing Wholesalers - https://www.medicalbillingwholesalers.com


    Melvin Miller is an experienced Chief Operating Officer with a demonstrated history of working in the healthcare industry for over 15 years, Satish, a.k.a. Melvin, has experience in team building, business development, Healthcare Information Technology (HIT), revenue cycle process training, US. Health Insurance Portability and Accountability Act (HIPAA), and Healthcare Management.


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