The Health Care Revenue Cycle Discussion Responses

The Health Care Revenue Cycle Discussion Responses

Peer 1:  The health care industry focus on reducing costs and improving quality is pushing for innovative ways to provide services and conduct business. Becker and Ellison (2019) published 8 hospital revenue cycle trends in 2019 which discussed the push for price transparency. Trend 1) is that hospitals moved to a more consumer-centric approach to revenue cycle management in efforts to lower cost for consumers.  2)Hospitals are required to publish a list of their standard charges per CMS, 3) hospitals are jumping ahead of the mandate to publish price transparency and are investing in tools to provide accurate price and adjustments to patients, 4) consumer-friendly transparency to receive payment ahead of time, 5) outsource revenue cycle, 6) Increased revenue cycle , 7) implementation of hospital independent physician practices, 8) alignment of hospital and physician IT, included EHR and revenue cycle management. The Health Care Revenue Cycle Discussion Responses

I think outsourcing is valuable in helping hospitals reduce costs.  Outsourcing has grown beyond the traditional functions such as housekeeping, laundry and food services. Outsourcing has expanded to information technology, and clinical services (beckers hospital review, 2013) Also, there is a high volume of physician burnout in the U.S. Outsourcing providers can decrease the number of tasks one physician would have to do reducing burnout. Outsource brings specific custom skills to get the job done efficiently and timely.

 

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Pros

  • It is cost effective for hospitals (save money on payroll taxes)
  • Provides full service without having to retain staff
  • Outsourced ED providers bring focus and expertise specifically for the department or position, takes way from competing responsibilities that full time physicians have.
  • Perform efficiently and high-quality job
  • Eliminates challenging transitions during training phase of permanent staff members
  • Reduces access problems
  • Customer specificity outsource may be turned into an organizational capability. This will provide familiarity with the ED facility and staff forcing good working relationship.The Health Care Revenue Cycle Discussion Responses

Cons

  • Companies may not uphold the same standard and values (patient care and safety may not be the primary motivator).
  • Privacy and HIPPA concerns. Confidential information of medical information may get transmitted to the outsourcing company. Example outsourcing IT, the hospital would have to ensure it follows the privacy laws to ensure patient safety.
  • Outsource provider may not interact well with permanent staff casing conflicts in the workplace (Bucki, 2018)

References

Becker’s Hospital Review (2013).  Outsourcing is Exploding in Healthcare — Will the Trend Last?  Becker’s Hospital Review.

https://www.beckershospitalreview.com/human-capital-and-risk/outsourcing-is-exploding-in-healthcare-will-the-trend-last.html

Bucki, J. (2018).  Pros and Cons of Outsourcing.  TheBalanceSmallBusiness.

https://www.thebalancesmb.com/top-6-outsourcing-disadvantages-2533780

“Hospital revenue cycle trends to watch in 2019 — 8 thoughts” (https://www.beckershospitalreview.com/finance/hospital-revenue-cycle-trends-to-watch-in-2019-8-thoughts.html.

Peer 2: Based on the trends I read about in the article provided in the discussion prompt, two of the eight trends that are most evident in the healthcare industry today are hospitals and health systems engaging in merger acquisitions to reduce costs and expand operational scale and a shift to a consumer-centric approach to revenue cycle management.

Mergers and acquisitions are on the rise with the emergence of value-based care. The article published by Revcycle Intelligence, a Healthcare Media, on July 20, 2018 titled “How Hospital Merger and Acquisition Activity is Changing Healthcare” states that Healthcare organizations announced 115 merger and acquisition transaction in 2017, the highest number in recent history, and that 2018 is likely to meet or even exceed the number of hospital merger and acquisition deals made in 2017. This growing number of mergers and acquisitions in the healthcare industry over the last four years with metamergers accelerated the financial growth of merger deals and hospitals acquitting physician practices to better manage revenue and reduce costs. In addition to reducing costs and improving, the consumer-centric model of value-based care makes it imperative for large organizations to work together through mergers or partnerships as part of an overall interconnected healthcare ecosystem in the context of revenue cycle management (Beckers Hospital Review, 2017). Furthermore, mergers make it easier to implement investments in technological solutions such as coding, system integration and clinical documentation demands.  The Health Care Revenue Cycle Discussion Responses

Secondly, the shift to a consumer-centric approach to revenue cycle management is another evident trend in the healthcare industry. According to a study conducted by Deloitte, moving from population-based care to targeted person-centered care is a trend driven by consumer demands, a higher focus on out-patient care and the growing influence of technology within the healthcare industry (Gerhardt & Arora, 2020). Most importantly however, the need for more cost-clarity and targeted care means that healthcare organizations seek to understand individual patient profiles and provide products and solutions that expand patient access and cater to specific medical needs (Beckers Hospital Review, 2017). The Health Care Revenue Cycle Discussion Responses

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