Your Next Step: Prioritizing Revenue Cycle Management Initiatives

Foundation ResourcesCrazy times in the world of revenue cycle management. Based on everything you see, hear, and read: revenue cycle management teams have their hands full with a ‘to do’ list that runs the gamut on areas of concern – system conversions, new systems, new processes, new laws, new regulations, new financials, change management, and a ton of uncertainty.  How to prioritize the work, how to parse out the work, and how to execute change has a lot of Revenue Cycle Management teams really stressed out.   

I wrote this blog to suggest a great place to regroup or start (before you take another step moving forward on ICD-10 or your conversion to EPIC): review and sure up the utilization of your “foundation resources”. 

Foundation Resources

Your “foundation resources” are the resources that are always there regardless of the time or circumstance. Your “foundation resources” are also resources that are always on the critical path to achieving every initiative you face – see if all the resources I’ve listed easily map back to your current initiatives list.

In the end: use your “foundation resources” the right way and it’ll surely make you…use your “foundation resources” the wrong way and it’ll surely break you.

People – The right amount of highly motivated, well trained people, covering the right jobs will always make big problems (all problems) small. Conversely, understaffed departments with low morale and lacking skillsets will always make the simplest of tasks insurmountable.  

Think about:

  • Comprehensive capacity plans (covering all functional areas within your organization) and the methodologies behind the plans
  • The quality of training materials and more importantly, the means and quality of delivery (how are your people trained and who trains them?)
  • What is the means and delivery of evaluating the productivity and performance of people throughout your organization? (How are people evaluated and who administers the evaluations?) 

Vendors – Just like people, the right vendor (they can do the job and they will do the job) in the right place will make big problems (all problems) small.  Conversely, incompetent vendors, vendors who’ve taken on more that they can handle, or vendors who haven’t been sized right for the job (too big / too small) will quickly magnify and compound problems (all problems). One other quick note: the “irony” of poorly managed, bad vendor relationships is that you’ll pay more premium dollars for less product and/or service – well-structured vendor relationships yield maximum product and/or service at a right price.

Think about: 

  • What is the structure of your vendor service level agreements? (Do your service level agreements create the right expectations?)
  • What are the performance and quality tools (performance reporting, audits) you use to regularly evaluate the performance and quality of your vendors?
  • Who manages your vendors to keep performance at its best, engagement high, and service levels up to date?

Technology – Setup and utilized the right way, technology can have an awesome impact on production and performance. It can also be an amazing tool to produce information that makes you and your team exponentially smarter when it comes to managing your business. Unfortunately, it’s as the saying goes: garbage in, garbage out. Poorly setup systems, mismanaged changes, and a lack of knowledge (how to troubleshoot problems and/or best utilize systems) can create horribly paralyzing outcomes – production gets stuck and reporting is worthless because the data has no integrity.

Think about:      

  • What is the quality of due diligence done to ensure the technology purchased comprehensively meets the needs of the organization? (How are needs evaluated and what is the vetting process)?
  • What is the process to troubleshoot and resolve gaps with the hardware/software vendor you bought from? (See my third bullet under vendor).
  • What is the quality of your change management protocol? (How are changes requested, approved, tested, implemented, and documented?). Two other notes to this bullet: 1) poor change management produces garbage in, garbage out and 2) as many can attest: the further you drift away from the hardware/software provider’s product (and the further you get into production), the harder it is to correct and get back home.

I hope this helps. As always, I’m always interested in questions, comments, or feedback. Please feel free to comment on this blog, or reach out to me., 484-459-8723. 

Topics: healthcare technology, vendor management, Revenue Cycle Management, ICD-10