Ensuring a Strong Revenue Cycle During a Pandemic

Ensuring a strong revenue cycle with its multitude of moving parts is complex during business as usual, let alone during a pandemic.

Hospitals are taking the economic hit from both sides: With the threat of the coronavirus, many patients have canceled or delayed elective procedures and in effect, hospital revenue. On the other end, hospitals are working around the clock to treat COVID-19 in thousands of patients, a potential hit to a hospital’s revenue as the course of the virus is unpredictable in each patient, at best. With protective supplies in short supply and roving treatment plans for varying severity of patient statuses, it’s a race for a hospital to make it through the day-to-day in a public health crisis, both clinically and financially.

To face this reality, hundreds of hospitals have furloughed workers after suspending elective procedures and many have reduced their workforces.

Now that your hospital may have gone through a reduction-in-force, may have furloughed employees, and likely has sent remaining employees home to virtually work for the foreseeable future, you’ll want to take a look at a few management approaches to keep your revenue cycle strong.

Here we take a high-level look at what hospital executives should consider to keep the revenue cycle strong:

  1. Assess the risk.
    Now that you’ve sent everyone home, it’s time to assess the risk. You’ll still want to monitor productivity. Can you benchmark that against historical productivity? Now that your teams are working virtually, it’s an important time to ensure that you’re providing the tools and the feedback the team needs to continue maintaining the same level of production. Work with your leadership teams to ensure your teams have the hardware and technology they need.
  2. Managing Teams Virtually
    We have now asked leaders to manage their teams differently. Work with your leadership and talk about how to manage their teams. The ability to walk around and check in with individuals is gone. How are you communicating with your teams? How are you providing feedback? How are you supplementing  “rounding” activities as a virtual manager? This will be a time to ensure you’re proactive in communication and letting your teams know that you’re there to support your people and are available for them. Feedback for your teams in a virtual world continues to be a huge component for continued productivity and being able to meet your revenue cycle objectives.
  3. AR Strategy: Re-evaluate your payer mix.
    Normally this is a process you’d want to perform twice a year, once every six months. Now, with quickly evolving economic factors during COVID-19, you should re-evaluate your payer-mix every three months. Increases in unemployment has translated to an increase in Medicaid enrollment. You’ll want to consistently watch unemployment numbers because that will impact the payer mix, and ultimately, your revenue cycle. You’ll want to understand how the fluctuating unemployment trends will directly affect how you’re going to be doing business.
  4. Understand risk in exposures
    Truly make sure you understand your security risks from various angles as well as any risks of exposure for HIPAA because employees are working from home. Is your staff using personal devices rather than firm-issued devices? What risks have we created by sending our teams home?
  5. Understand your vendors.
    Every revenue cycle has a vendor partner, and every vendor has had to do the same thing by sending their teams home. You’ll want to continue to monitor your vendor’s productivity, and you may want assurance from vendors that by sending their employees home, they aren’t potentially creating more HIPAA risks for my organization. They need to assure that they’re meeting security and HIPAA standards while they are virtually working as well.
  6. Monitor your payers for denials.
    This will be important for facilities as it’s possible that payers’ sent their staff home as well to work. You’ll want to look for stall tactics. We want a baseline for each of our payers and hold them accountable. Payers could be trying to take advantage of the fact that we’re in chaos right now. One way to handle this is to create a payer scorecard where you can track their historical percent of charge, track overall denial rate, and try to normalize it as their percent of volume. By doing this, you’d be able to see if there was a problem bubbling up for a specific payer.  The scorecard would include features such as inpatient, ambulatory, ED, types of denials, and more.
  7. Reevaluate your revenue cycle scorecard.
    Are these metrics the same metrics we should be monitoring now that we are operating under new conditions? We should view this through the lens of assuring the C-Suite that we are on top of everything. These are things that you’d be able to address on the spot when your top leadership asks.
  8. Reevaluate each of your policies and procedures to ensure that they address a remote workforce.
    Some aspects of your policies may need to evolve for the current remote workforce climate.

Windham Brannon’s Healthcare Advisory Team is here to serve your hospital and can assist in optimizing your Revenue Cycle. Our team has over 30 years of experience working directly with teams like yours to help your hospital achieve a strong, sustainable business model. Email Valerie Barckhoff to learn how our team can assist your hospital in achieving a strong revenue cycle.

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