Leveraging Data is Critical to a Healthy Bottom-LineIn theory, practice software solutions like practice managers (PM) and electronic health records (EHR) are supposed to provide whole-office perspective as centralized data repositories. The more data you have at your fingertips, the more insight you can achieve pertaining to the financial health, stability and operational efficiency of your practice. Unfortunately, all that data doesn’t necessarily translate into actionable information when practices rely on solutions that make it difficult to access or only available in standardized formats. Practices also need the ability to create custom reports to highlight indicators of their practice's health and unique performance indicators. These include but aren't limited to:

  1. Revenue Cycle Management: A private practice is ultimately a business and one that requires a fluid revenue stream to be solvent, let alone generate profit potential. How can you possibly optimize RCM without a 360-degree view of your practice's financial circumstances? Every expense, every source of overhead – from utility bills to the replenishment of your cotton-swab inventory – needs to be tracked meticulously and measured against your revenue income.
  2. Practice Management: Every aspect of your practice's operations influences your bottom line in some way. For example, the bulk of revenue for U.S. healthcare practices comes from insurance companies. It's entirely your practice's responsibility to handle eligibility verification and check for pre-authorization prior to the time of visit. It's also your practice's responsibility to make sure that it's actually filling as many of its available time slots as possible, and that it's nipping potential sources of no-shows in the bud. These are only some of the many facets of practice management that directly impact the bottom line. Every healthcare organization is a little bit different, which means that no two practices will report on the exact same types of PM processes.
  3. Patient Collections: One of the most dramatic changes impacting practices in recent years is the staggering increase in patient balances after insurance (PBAI), which a recent TransUnion Healthcare study found to have risen by 88% in only the last five years. This rise, coupled with the difficulty of collecting patient balances, led the study’s authors to assert that “patient balances after insurance is a major factor in increases in uncompensated care”. And, as payments from patients are now the #2 or 3 largest source of most practices’ revenue, groups can’t afford to be in the dark regarding the specifics of their staffs’ pre- or post-encounter collection performance.

Medical and specialty practices also have to deal with changing regulations, coding challenges tied to payment denials, varying patient requirements, shifting care delivery models, and so on and so forth. All of this can begin to feel overwhelming, but it doesn't have to.

Take a deep breath, and let's talk about report building.

What Makes a Good PM Report?

Seamless Integration

The most obvious aspect of report building is integration with existing healthcare data that originates from your entire practice, including that provided by your EHR, practice management solution (PM) and online patient portals. Your insights are only as trustworthy and as useful as the data they were extracted from. Again, this is particularly important for Value-Based Care (VBC), which requires close examination of patient-recorded outcomes and the relationship those outcomes have to existing operations.

On the RCM side of things, VBC-driven regulations like the Medicare Access and CHIP Reauthorization Act's (MACRA) Merit Based Incentive Payments System (MIPS) put greater pressure on practices to accurately track their charges. In order to excel in the Clinical Quality Measures (CQMs) that now directly impact reimbursement values, practices will invariably need to make changes to their operational workflows – if for no other reason than to track CQMs effectively. Process adjustments should be well-thought-out, and implemented only if and when you can quantitatively demonstrate your practice's ability to maintain financial independence.

The rise of VBC introduces a host of new practices and complexities, not only to the process of patient care, but also to your cost of providing it. Therefore, it’s critical to track the burdens imposed by these new processes, so that those that are too costly can be identified and adjusted before causing significant harm to your bottom-line. This will require your PM’s report builder to not only have seamless integration with EHR data that demonstrates patient progress but also with the different PM processes involved in facilitating that progress. In other words, it answers this question: "What resources, technology and additional steps have we taken to achieve our desired QCMs, how much did it cost, and what was the monetary value of the yielded healthcare outcomes?"

Ideally, your front-desk staff shouldn't have to spend hours chasing down the information that would go into this type of high-level business analysis. And with a good report builder that's integrated into your PM tool and EHR, they won't have to. That data will already be recorded and ready to be incorporated into a report.

Intuitive Visualization

Let's consider another example: referrals. One-third of patients do not follow up on referrals, according to research published in the Milbank Quarterly. HFMA contributor Lance Fusacchia believes this has "deep ramifications" for a specialty practice's revenue.

"When patients forgo referrals, provider organizations lose revenue because the missed opportunities translate into problems, such as low completion rates (no-shows), lost staff efficiency from time spent coordinating appointments, and a poor patient experience for those who never receive the care they were prescribed," Fusacchia wrote.

It seems like a pretty obvious correlation when you look at it that way. Yet, not many practices will pause and linger on the fact that something as simple as not being more proactive with referrals might be a missed source of revenue - it's simply because they couldn't see it.

The purpose of creating and reviewing reports on a weekly, monthly or even quarterly basis is to see these types of opportunities. A spreadsheet won't make something like that jump out at you. But a referral-to-patient conversion report might give you enough pause to ask the question, "what's happening here?" Some say a good picture is worth a thousand words. In practice management, it's worth thousands of dollars.

Ease-Of-Use

Last but not least, the amount of time spent creating these visualizations should not interfere with other job functions and responsibilities. You're already at an advantage if your PM comes equipped with a report-building function, since the data is already structured and there for your convenience – no IT support or manual, painstaking data migrations necessary.

But, a best-in-class report builder like AllMeds' Report Designer goes yet a step further by providing pre-made reports for the obvious metrics such as billing collection rates, charge lag days, percent of denied claims, days to account receivable and so on. What's more, AllMeds’ Report Designer uses a simple drag-and-drop interface to facilitate the creation of custom reports that can feature drill-down capabilities for deeper data analysis. Reports can be easily exported in a variety of formats to share with practice stakeholders.

To learn more about how AllMeds' Report Designer provides the perspective your specialty practice needs to thrive, click here, or contact us today.

 

Sources:

https://revcycleintelligence.com/news/hospital-revenue-from-patient-financial-responsibility-up-88

https://www.hfma.org/Content.aspx?id=49282

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3160594/

https://newsroom.transunion.com/patients-may-be-the-new-payers-but-two-in-three-do-not-pay-their-hospital-bills-in-full/

AllMeds EHR PM RCM

Leveraging Data is Critical to a Healthy Bottom-Line

But, a best-in-class report builder like AllMeds' Report Designer goes yet a step further by providing pre-made reports for the obvious metrics such as billing collection rates, charge lag days, percent of denied claims, days to account receivable and so on. What's more, AllMeds’ Report Designer uses a simple drag-and-drop interface to facilitate the creation of custom reports that can feature drill-down capabilities for deeper data analysis. Reports can be easily exported in a variety of formats to share with practice stakeholders.

AllMeds Specialty Practice Services

Leveraging Data is Critical to a Healthy Bottom-Line

AllMeds Specialty Practice Services

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AllMeds EHR PM RCM

Leveraging Data is Critical to a Healthy Bottom-Line

AllMeds Specialty Practice Services

Leveraging Data is Critical to a Healthy Bottom-Line

AllMeds Specialty Practice Services