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Hospitals Aren’t Getting Much ROI From RCM Technology

Posted on July 24, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

If your IT investments aren’t paying off, your revenue cycle management process is clunky and consumers are defaulting on their bills, you’re in a pretty rocky situation financially. Unfortunately, that’s just the position hospitals find themselves in lately, according to a new study.

The study, which was conducted by the Healthcare Financial Management Association and Navigant, surveyed 125 hospital health system chief financial officers and revenue cycle executives.

When they looked at the data, researchers saw that hospitals are being hit with a double whammy. On the one hand, the RCM systems hospitals have in place don’t seem to be cutting it, and on the other, the hospitals are struggling to collect from patients.

Nearly three out of four respondents said that their RCM technology budgets were increasing, with 32% reporting that they were increasing spending by 5% or more. Seventy-seven percent of hospitals with less than 100 beds and 78% of hospitals with 100 to 500 beds plan to increase such spending, the survey found.

The hospital leaders expect that technology investments will improve their RCM capabilities, with 79% considering business intelligence analytics, EHR-enabled workflow or reporting, revenue integrity, coding and physician/clinician documentation options.

Unfortunately, the software infrastructure underneath these apps isn’t performing as well as they’d like. Fifty-one percent of respondents said that their organizations had trouble keeping up with EHR upgrades, or weren’t getting the most out of functional, workflow and reporting improvements. Given these obstacles, which limit hospitals’ overall tech capabilities, these execs have little chance of seeing much ROI from RCM investments.

Not only that, CFOs and RCM leaders weren’t sure how much impact existing technology was having on their organizations. In fact, 41% said they didn’t have methods in place to track how effective their technology enhancements have been.

To address RCM issues, hospital leaders are looking beyond technology. Some said they were tightening up their revenue integrity process, which is designed to ensure that coding and charge capture processes work well and pricing for services is reasonable. Such programs are designed to support reliable financial reporting and efficient operations.

Forty-four percent of respondents said their organizations had established revenue integrity programs, and 22% said revenue integrity was a top RCM focus area for the coming year. Meanwhile, execs whose organizations already had revenue integrity programs in place said that the programs offered significant benefits, including increased net collections (68%), greater charge capture (61%) and reduced compliance risks (61%).

Still, even if a hospital has its RCM house in order, that’s far from the only revenue drain it’s likely to face. More than 90% of respondents think the steady increase in consumer responsibility for care will have an impact on their organizations, particularly rural hospital executives, the study found.

In effort to turn the tide, hospital financial execs are making it easier for consumers to pay their bills, with 93% of respondents offering an online payment portal and 63% rolling out cost-of-care estimation tools. But few hospitals are conducting sophisticated collections initiatives. Only 14% of respondents said they were using advanced modeling tools for predicting propensity to pay, researchers said.

Hospital CFO Insights from Craneware Summit

Posted on October 22, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Today I had a chance to attend the Craneware Summit in Las Vegas. The Craneware Summit gives me a nice view into what’s happening in the financial world of healthcare. The Summit kicked off today with Todd Nelson speaking about the hospital CFO. Here’s a look at some of the insights he offered:


Todd Nelson is a former hospital CFO that is now a VP at HFMA.


Is this equation too simple?


I don’t think that meaningful use money will go away, but it’s worth considering. Would your organization survive if the rest of the meaningful use money were pulled out from underneath you?


This is often forgotten. It’s “easy” to get the billion dollar EHR implementation budget, but many forget to include the ongoing EHR support and optimization budget. In my experience this is often just bad planning, but in a few cases it’s done deliberately in order to allow the EHR project to go forward. They figure they can always ask for the support and optimization budget later.


This was an interesting comment coming from an accountant and former hospital CFO. He was willing to admit that he doesn’t have the skill or at least the desire to be the actuary for the hospital. However, as we shift to value based reimbursement, hospitals are going to have to become good at actuarial analysis.


Todd Nelson also extended this comment by saying that you can survive a long time even with losses as long as you have the cash. If you’ve worked with a hospital CFO, you’ve probably seen the cash focus first hand. That hasn’t and probably won’t change.


This is great advice as hospital executives evaluate how to approach the changing healthcare reimbursement environment. Hope is not a strategy.

What Would Make Us Not Delay ICD-10 in 2015?

Posted on July 3, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

While at the HFMA ANI conference in Las Vegas, I talked to a lot of people about the future of healthcare reimbursement. Talk of ICD-10 and the ICD-10 delay came up regularly with most of us rolling our eyes that ICD-10 was delayed again. Some argued that we still need to be prepared, but from what I’m seeing the majority of the market just pushed their plans out a year and will pick them up again later this year or early next year.

With that said, we all agreed that every organization will be much more hesitant preparing for ICD-10 next year since they’re afraid that ICD-10 will just be delayed again.

As I had these discussions, I started thinking about what will be different in 2015 when it comes to ICD-10? As I asked people this question, all of the same arguments that we made in 2014 are what we’re going to have in 2015. Some of them include: the rest of the world adopted this years ago, we’re falling behind on the data we’re capturing, we need more specificity in the way we code so we can improve healthcare, etc etc etc.

Considering these arguments, what will be different next year?

All of the above arguments for not delaying ICD-10 were valid in 2014 and we’ll be just as valid in 2015. Can you think of any reasons that we should not delay ICD-10 in 2015 that weren’t reasons in 2014? I can’t think of any. The closest I’ve come is that with the extra year, we’re better prepared for ICD-10. Although, given people’s propensity to delay, does anyone think we’ll be much better prepared for ICD-10 in 2015 than we were in 2014? In some ways I think we’ll be less prepared because many will likely think the delay will happen again.

Given that the environment will be mostly the same, why wouldn’t we think that ICD-10 will be delayed again in 2015?

Personally, I’ll be watching CMS and HHS closely and see what they say. I think this year they looked really bad when they very publicly proclaimed that ICD-10 was coming at HIMSS just to be hit from the side by the ICD-10 delay. I’d hope that this time CMS will work with Congress to know what they’re planning or thinking before they make such strong assertions. Of course, this would mean that they’d have to understand what Congress is thinking (not an easy task).

What’s unfortunate is that many of the things you need to do to prepare for ICD-10 can also benefit you under ICD-9. The smart organizations understand this and are focusing on clinical documentation improvement (CDI) as the best way to prepare for ICD-10, but still benefit from the program today.