Leveraging data analytics to improve revenue cycle – HFMA
Article Synopsis :
Now more than ever healthcare organizations are realizing the benefits of big data analytics for revenue-cycle optimization, as well as eliminating process inefficiencies.
The HFMA Educational Report “Leveraging Data analytics to Improve the Revenue Cycle”, explains the value of data analytics as a means to effect positive and long-term change and answers the most frequently asked questions related to analytics integration. The report suggests certain areas should take priority over others when applying analytics to the revenue cycle. These areas include:
- Enhancing the Patient Financial Experience – With analytics organizations can support more compassionate interactions, set patient expectations for payment, and make the financial experience less stressful for all parties
- Preventing and responding to denials – Traditional denial mitigation strategies have been reactive; however, organizations can use analytical pre-screening processes to identify potential denials and mitigate issues before a claim is submitted
- Identifying and managing under-diagnosed revenue leakages – Through the deployment of analytic engines capable of modeling payer/provider contracts, organizations can engage in a comprehensive review of all claims and payments to operationally protect themselves against systematic underpayments
- Raising staff productivity – Analytics can also help organizations elevate staff efficiency by highlighting ineffective or non-value-added touches or broken processes within a workflow
The report enumerates key steps for leveraging analytics to improve the revenue cycle, applicable to organizations just getting started or rebooting an existing initiative:
- Understand the current state and define goals
- Orient toward insights that are actionable in support of your goals
- Keep your eyes on all metrics—trending concerns as well as tried-and-true KPIs
- Evaluate what is being collected and measured to ensure ongoing relevancy
- Dedicate resources, including talent and technology
- Know your audience
- Operate on the belief that the answers are in the data
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Digital Insurer's CommentsIn the healthcare industry’s evolving landscape hospitals and health systems are continually challenged to do more with less. Data analytics applications hold enormous potential in this regard, helping organizations deliver greater value over a reduced cost base.
Key challenges include skills shortages and a lack of enthusiasm for analytics in general at the executive level. While these challenges are no doubt related they must be overcome as big data analytics are THE tool for rooting out inefficiencies and waste and preventing fraud in an increasingly digital world.
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