All long-term post-acute care (LTPAC) organizations must generate revenue in order to serve patients and residents and pursue sustainable growth. However, generating revenue by itself simply is not enough; your LTPAC must also collect the revenue while minimizing leakage and potential lost dollars. In this regard, revenue cycle management is key.
If you seek ways to boost profitability and enhance outcomes in your long-term post-acute care facility, optimizing revenue cycle management (RCM) is a prime place to start. In this blog, we explore one strategy to do so: optimize the RCM process through thorough and effective communication.
You can establish all the processes you want, but if you don’t communicate clearly and regularly to stakeholders throughout your LTPAC, then those processes will fall far short of their intended goals.
Think about it: If an existing process was changed even slightly on the back end, and that change isn’t communicated to people who need to know about it (on the front end, or anywhere in between), then time and effort are spent on reactive measures, rather than proactive, client-centric activities.
So, what does effective communication in the RCM sphere entail?
Maintaining consistent dialogue and updates regarding processes – analyzing what is working well, what could use improvement, sharing lessons learned and revising plans and processes as appropriate. Ideally, communication should be consistent and inclusive so that everyone has updated and accurate information at the same time.
Documenting insights, ideas, plans and processes as a preventive measure, and as a means to providing enterprise-wide access.
According to Medical Economics, 70 percent of patients or patient families would have been more satisfied with their care had the bill they received at the end been better communicated throughout the duration of the stay. Therefore, effective communication shouldn’t be limited to internal communication among LTPAC executives and staff. Rather, it’s just as important – one could even argue more important – to optimize communication with clients and their loved ones.
If your RCM function seeks to make a truly tangible impact on your facility, look no further than client engagement and satisfaction—it’s one of the most significant indicators for Medicare and Medicaid quality initiatives. Many strategies can be used to address this key indicator, but communication is chief among them. Indeed, communication protocols with clients and family members or responsible parties should be built into every facet of the RCM function so that your staff can keep them involved and updated on the progression of their care. A recent Medical Economics study found that 70 percent of patients or patient families would have been more satisfied with their care had the bill they received at the end been better communicated throughout the duration of the stay. In working with LTPACs throughout the country, we find time and time again that it’s not so much the amount of the bill that fosters dissatisfaction, but the surprise of the bill, combined with an inability to discuss it with an informed staff member.
Consider some practical steps:
From a long-term post-acute care standpoint, one of the simplest things that a provider can do is sit down and have a conversation with a client and/or their loved one(s) about what coverage is in effect relative to their care, what coverage limitations exist and what the corresponding financial liability will be. From there, communication should transition into documenting this information in writing, sharing it with the client/responsible party and having them sign off to indicate their understanding. Ideally, this should occur upon admission, or even prior to it. Ultimately, this conversation helps with collection of client balances.
Designated staff should communicate all information about charges with clients and/or loved ones up front. Clearly articulating costs and their relation to out-of-pocket costs or coinsurance copays helps to minimize or even eliminate shock, since expectations have been set.
Any updates to care – and the corresponding costs – should be communicated up front with clients and/or loved ones (i.e., “There is now a charge pending for this particular service; we wanted to make sure you’re aware of that.”).
Any planned, recommended or requested changes to care should also be communicated up front with the goal being to make the client and/or their loved ones aware of potential treatment and/or timing options that may exist. In other words, be clear and proactive about the costs for specific services, as well as the coverage determinations and associated financial obligations for the client or whomever is financially responsible for them.
Do you have questions about optimizing your RCM process through communication, or other RCM challenges? Read our e-book, “Six Strategies to Optimize Your LTPAC Revenue Cycle Process” or call Richter’s revenue cycle management consultants at 866-806-0799 to schedule a free consultation.
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Ken Voll is Director of Revenue Cycle Management with Richter.