The Healthcare Financial Management Association (HFMA) has conducted extensive research on which factors build towards a high performance revenue cycle. After working with focus groups, patients and providers, a seemingly commonsense conclusion was arrived at: patient billing is a significant problem for patients and providers. This is why the HFMA dedicated a website to the topic called patientfriendlybilling.org. The main focus of the content is strategies to provide clear, concise, correct financial communications and overall, patient friendly billing. But reading about strategies and actually implementing and achieving them within your own organization are two separate things.
Fortunately, the HFMA regularly publishes strategies for effective implementation of patient friendly billing. “Strategies for a High-Performance Revenue Cycle” is one article of great importance for those organizations looking to revise or overhaul their processes. The report asked questions of physicians and administrators, staff, and patients to determine just what the perfect combination is for success. What is it that enables some organizations to achieve success in times of change while others struggle? For some, the answer may be what you expected to hear – that revenue cycle strategies of successful healthcare providers vary greatly and there is “no one size fits all” model. But at the same time it’s the perfect answer: success isn’t for one “size,” rather it’s a mix of organizational culture and having the right focus at the right time, then setting goals and taking action.
Perhaps most importantly, the research demonstrated that no matter what your patient mix, size, location or financial means, success was obtainable for organizations that applied certain basic concepts: clear, concise, and correct patient friendly billing. But how is this achieved and which factors are most pressing? In sum, an organizational focus on specific areas that pertain to people, processes, technology, metrics, communication, culture and roles are emphasized. Each area is defined in how it collectively relates to creating a high performance revenue cycle.
The importance of organizational culture
For Outsource Receivables Incorporated, a point that strikes a chord is organizational culture. Culture will ultimately determine how successful change initiatives will be and what they will look like long term. Organizational culture is made up of shared attitudes, values and goals that are lived out every day in the interactions with customers. It can be difficult to define just what these sometimes intangible cultural attributes are for an organization, but that doesn’t decrease the importance.
For organizations that consistently achieve high-performance in their revenue cycle commonalities in culture are usually found. They employ specific strategies which create a sense of importance amongst organizational staff not necessarily associated with the revenue cycle management. These include the front desk as well as physicians and executives, non-finance staff as well as patient facing employees. ORI cross trains staff so they can better understand and communicate with their peers as well as respond to client inquiries. ORI has helped clients train patient facing staff that play a role in the billing process but don’t always fully understand the importance. When clinic staff and leadership connect patient friendly billing concepts to their every day interactions, it not only gives staff and leadership a sense of purpose, but it makes good economic sense as well. At the heart of how these ideals are implemented, sustained, and owned by employees on a day to day basis is organizational culture.
Leadership must understand and acknowledge the importance of the revenue cycle and its relationship to the delivery of care. Organizational culture will determine the level of emphasis and importance, as well as how strategies are implemented. For example, a culture that links financial performance goals to patient satisfaction may have more success than trying to motivate direct service staff with just the bottom line. Strategies may take the form of setting high expectations, acknowledging success and rewarding innovation around patient friendly billing. Culture will determine how employees view these actions and the value placed upon them.
Rewards may take the form of improved training and compensation and non-traditional measures may look at patient satisfaction as well as financial metrics. Culturally integrating other staff through cross training could be a great strategy for building understanding and appreciation across the organization of the importance of billing and how they play a role.
Patients provide the “why” for culture building around revenue cycle management. By including patients in focus groups, surveys or in advisory roles, they become active agents with employees in the building process. A story or a quote from a patient or family can be inspirational words for a committee and a reminder to focus on the patient perspective. Open communications through consistent patient friendly messaging, whether on the phone, at the reception or on statements, is important as well for supporting organizational culture. For example, ORI assists clients with the development of effective self-pay collections at the time of service.
Lastly, organizational leadership must ask for high performance and reward it when it happens. Just as leaders must develop innovative strategies and change initiatives, employees must take ownership of the process of improvement. Continuously working to improve cultural elements and consistently recognizing the small steps toward success will ensure that the goal of high performance revenue cycle management is part of the culture within the organization, and not just a passing fad.
How to get started…
Outsource Receivables can be a strong partner in implementing the best practices that ensure a culture of support for high performance revenue cycle management. We recommend that you take the time to complete an organizational culture assessment with your staff. Download the Culture Assessment Worksheet to get the process started. The exercise will provide a snapshot of strengths and areas of importance to staff. It is a simple exercise that can get the conversation started today and provide direction for change.