BY LYMAN G. SORNBERGER
CEO/President, Lyman Healthcare Solutions, Inc., Broadview Heights, OH
The number one concern these days in healthcare is inflation, and over 70 percent of healthcare leaders say that their “financial health” is at risk. Hospitals and providers of all sizes have been on a mission now that prioritizes, among other goals, higher-quality care at a lower cost. Forward-thinking revenue cycle management (RCM) and other financial leaders are making moves now to prepare for the continual economic uncertainty.
The financial instability brought on by COVID-19 is beginning to ease for most organizations; and, over the next three to five years, healthcare transformational strategies will focus on creative cost-saving options with improved patient care.
THE PRIORITY OF COLLABORATION
In order to try to dig themselves out of their financial strife, healthcare providers and organizations are ready for new partnerships that will align talent and expertise from inside and outside their “four walls.” Their ultimate objective is to accelerate their financial results while supporting a broader transformation through managed services and expanded collaboration with their colleagues. Siloed organizations can no longer fiscally survive the increased burdens of diminishing reimbursement, increased cost and patient dissatisfaction.
Those healthcare organizations that create successful collaboration strategies will not only optimize their current systems through “lessons learned” and technology that aligns with their mission and goals, but they will promote their industry brand.
Seasoned healthcare leaders are now being cornered into looking at what they can realistically achieve alone versus looking to outside networking and business relationships. Nowadays, it’s career suicide to maintain the mantra of “go for the status quo; we always did it that way; and/or we are the industry’s best.”
Continued education will always be key to personal and professional growth, but reaching across the aisle will now revolutionize the healthcare RCM world. For years, outsourcing managed services models or aligning with the “competition” has been at arm’s length. For various reasons, leaders have been hesitant to think too far outside the box and only give lip service to the term collaborate. What they may not realize is that the future and financial health of their organizations will be at risk unless everyone is cognizant of the need to find strategic partners.
WHAT COLLABORATION LOOKS LIKE
Without question, those committed to collaboration will be required to be humbler and less threatened in their relationship vision. That does not mean that they relinquish control or become subservient, but rather that they realize that an amazing brain trust exists, and we just need to tap into it more aggressively. Healthcare organizations are becoming more complex while seeking to operate more seamlessly across the continuum of care inside and outside of their hospitals and provider offices.
New, more collaborative and holistic models are emerging that promote financial stability and performance improvement without sacrificing the healthcare organization’s mission, goals and culture. The traditional transactional or siloed outsourcing may work for a few areas, but a more realistic hybrid collaborative model will be the most effective way to accelerate the crucial revenue cycle business functions while also supporting the organization’s broader transformational strategies.
Without question, the approach will require RCM leaders to combine the demands of a high-performing committed revenue cycle team with a shared vision around patient loyalty, engaged employees and fiscal obligations. The heart of any healthcare’s plan is to rein in cost, accelerate and increase revenue and maintain the financial health and industry brand of its RCM. Among the biggest trends affecting how work gets done with RCM are staff shortages, diminished talent pool, automation and collaboration through education and networking.
Revenue cycle management is the ideal springboard for new ways of operation that brings together the expertise and talent from not only inside but outside of healthcare organizations. How much would we all learn if we could just listen to “what NOT to do?”
Healthcare financial leaders need and want more from their personnel, talent pool, technology and systems but lack the resources, internal expertise, education and time to optimize every part of their business. Case in point: before the coronavirus pandemic, most organizations did not have the structure to fully support remote workforces. Now, leaders face the challenges of improving performance, sustaining culture and reducing cost in a virtual environment. Seeking collaborations to carry some or part of the operational load will be critical to maintaining the momentum behind this major cost-saving trend.
THE FOCUS OF COLLABORATION
Technology strategy, now more than ever, should be a major consideration for any new collaboration, whether fully outsourcing the revenue cycle organization or selecting vendors for a portion of its functions. In the last decade, healthcare organizations made huge investments in their current systems, especially electronic health record (EHR) platforms, yet technology-related inefficiencies continue to frustrate the industry. Additionally, clunky, inefficient software has been a pitfall of past outsourcing relationships, particularly in revenue cycle optimization.
Organizations can’t afford to waste time and resources on new technology simply because it’s the next new thing. Their ability to realize quick returns on vendor or outsourcing investments depends on how well their partners understand and can leverage their technology stack. In the future of healthcare, collaborations should be designed to optimize current systems and address the interoperability of HER platforms. This enables smarter business decisions about when to layer in technology that truly aligns to the organization’s goals.
Whether fully or partially outsourced or insourced, the success of the revenue cycle hinges on talent and a pool of some of the same resources in the industry. Yet, for many health systems, years of status quo operating has stagnated its workforces’ skill sets. Revenue cycle employees, or more importantly leaders, are struggling to support trends like shifts to value-based care, integration and consumerism in spite of enterprise technology. Universally, organizations are experiencing a shortage of talent while also understanding they can’t hire for the same skills that they did five years ago.
The revenue cycle employee of the future is a data-driven problem solver who understands the patient consumerism and the financial experience of healthcare. But what now has changed? With the talent pool diluted from COVID burnout, retirements and experts seeking new careers, management education, communication and collaboration are more important than ever. Budgets are lean, but it’s not the time to cut your lifeline to enhancing reimbursement and decreasing cost through limiting education and collaboration opportunities. The cost to replace a seasoned RCM leader has been underestimated and the cost-benefit is well worth its investment. Rethinking how to upskill and retrain revenue cycle teams is needed, and organizations will have to evaluate if their internal capabilities will be sufficient.
Exploring collaborations that prioritize professional development, training and change management provides a foundation to make change stick and helps organizations build the culture to support their continual improvement. Clearly, the investment in business relations with other healthcare systems and third-party vendors are key for the “new world” transformation of the financial health of revenue cycle management. In summary, all parties—internal and external—will be required to plan and act differently and harness the momentum of major cost containment trends. This is the new definition of collaboration
Lyman G. Sornberger is President and CEO for Lyman Healthcare Solutions Inc. Prior to his roles at Lyman Healthcare Solutions, AHIMA Board of Directors, Knowtion Health Advisory Board, Hilton Law Firm and Source1 Healthcare Inc, Sornberger was the Chief Strategy Officer of Capio Partners, Executive Director of Revenue Cycle Management for Cleveland Clinic Health Systems (CCHS) from 2006 – 2012. This role comprised the revenue cycle management for all 11 Cleveland Clinic Health Systems Ohio and Florida hospitals and 1,800 foundation physicians. His responsibilities included all CCHS patient access services, health information management t and billing. Prior to his affiliation with CCHS Mr. Sornberger was with the University of Pittsburgh Medical Center for 22 years as a leader in revenue cycle management. Sornberger is a graduate from the University of Pittsburgh with a BS and a Master’s Degree in Business. He can be reached at 216.337.4472 or email@example.com.