Managing a revenue cycle has never been the most glamorous component of running a healthcare organization. 预注册的病人, 收集共同支付, 提交索赔, and ultimately obtaining reimbursement for services is a costly and cumbersome process. It’s also an essential one, since this is how healthcare providers are paid for the work they do.
Revenue cycle management takes on added layers of difficulty – and importance – in a healthcare landscape characterized by increasing alignment between hospitals and physicians. As the industry responds to shrinking reimbursement and the pressure to operate in a value-based care environment, more and more physician groups are turning to hospital employment or affiliation as a means of ensuring financial stability. 作为一个结果, leaders are waking up to discover that their hospitals have become health systems seemingly overnight.
这对卫生系统的收入周期意味着什么? In short, more complexity and the potential for less efficiency. Hospital-physician alignment tends to result in siloed financial operations, 是指复制函数吗, 不一致的过程, 和竞争的重点.
In an effort to streamline revenue cycle activities across systems, some healthcare leaders are turning to a solution that offers greater efficiency but has traditionally been encumbered by political challenges – adopting an integrated revenue cycle (IRC) model.
An IRC coordinates revenue processes under a common leadership team, 提供节约成本的机会, 战略联盟, 增加了患者的满意度. It’s an approach that establishes a single point of accountability; directs disparate teams toward common, system-wide goals; and promotes consistency and transparency throughout the revenue cycle.
While most healthcare executives see the benefit of an integrated approach, 很少有人有勇气去尝试.
Health system leaders often encounter internal roadblocks to integration, particularly from physicians concerned that a model combining hospital and physician finances will prioritize hospital billing. 医生动力学, 担心裁员, 它的局限性, and competing organizational priorities also converge to slow the momentum of IRC initiatives.
领导人应该注意这些考虑. IRC模型可以提供实质性的好处, but underestimating the effort and complexity involved in rolling them out is a mistake. 组织s that don’t engage in focused planning risk alienating physicians and other stakeholders, 干扰收入周期表现, 甚至增加了做生意的成本.
也就是说，一体化的程度和速度可能各不相同. Few health systems are prepared to attempt a full integration of their finances, and many will opt instead for a model that allows for a more gradual path to uniting their hospital and physician enterprises. But in a value-based healthcare environment, increased integration is inevitable. 为努力提高效率的卫生系统领导人, 等待行动意味着忽视改善的机会.
有关采用IRC模型的更多信息, see “Integrating the Revenue Cycle for Improved Health System Performance,” an article that ECG Senior Manager 本·科尔顿 and Senior Consultant Andrew Davis wrote for 间歇.