JUN 17, 2009 12:16pm ET

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Revenue Cycle Best Practices Outlined

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The Healthcare Financial Management Association this fall will release a detailed report on best practices for implementing efficient revenue cycle management that provides timely, useful information to patients. The report will outline the role that information technology can play.

The Standards of Excellence report is the latest component of Westchester, Ill.-based HFMA's eight-year Patient-Friendly Billing effort. Its findings will be based on two research efforts. Researchers are conducting in-depth interviews at 14 hospitals pinpointed for their excellent financial performance. Plus, they will conduct a national hospital survey in the coming weeks.

At HFMA's Annual National Institute in Seattle, two independent consultants involved in the project, Terry Rappuhn of Rappuhun Consulting and Claudia Birkenshaw of Modern Management Muse Inc., shared some preliminary conclusions based on interviews with 11 hospitals. Common themes discovered, they said, include:

* Many have a group of I.T. staff members devoted full-time to the revenue cycle.
* All have re-engineered revenue cycle processes.
* Most use point-of-service collections, asking patients for payments upfront.
* Many provide up-front pricing estimates.

The hospitals use a variety of technologies. For example, 25-bed Henry County Hospital in Mt. Pleasant, Iowa, has a Web site that enables patients to pre-register, update insurance information, pay bills and review quality data. "They view technology as a critically valuable enabler," Birkenshaw said.

Touchette Regional Hospital in Centreville, Ill., uses applications for Medicaid, insurance and charity care verification as well as advanced coding software and an address verification application. Executives use a dashboard to monitor financial reports.

And Oaklawn Hospital in Marshall, Mich., provides upfront estimates of patients' out-of-pocket expenses and uses an automated voice calling system to remind patients of balances due.

More information on HFMA's efforts in this arena is available at patientfriendlybilling.org.

--Howard Anderson

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A major success factor for accountable care organizations will be linking caregivers across the spectrum of care delivery. If history is any indication, that's going to be an industrywide struggle.

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