How to Use Data Analytics to Optimize the Revenue Cycle

Providing an opportunity to enhance your revenue cycle

Between emerging payment models that emphasize value over volume and the dramatic increase in patient responsibility stemming from the rise in high-deductible health plans, there has never been a better time to optimize the revenue cycle. Yet, many organizations struggle to make meaningful improvements, finding it challenging to know where to begin.

Fortunately, due to the plethora of financial data that healthcare organizations collect, they can leverage analytics tools to quantify current performance, pinpoint improvement opportunities and reimagine underperforming processes, so they operate at full efficiency and effectiveness.

Not Everyone is Seizing the Moment

Regrettably, many providers don’t employ analytics when reviewing and refining financial operations. A 2016 survey of healthcare leaders commissioned by Navicure reveals that only 45% of respondents are currently using a data analytics and reporting solution to improve their revenue cycle. Of those who are using a data analytics solution, 88% said it is an important tool in making business decisions ― making it clear those who aren’t using one are missing out on a beneficial tool.

Why the disconnect? There are a number of reasons why an organization might not have a data analytics and reporting solution in place. Although 36% of survey respondents who don’t plan on implementing this kind of system indicated they don’t think they need one, they did not represent the norm. More organizations (48 percent) felt they simply didn’t have the time, budget or resources to make it happen. In addition, 7% said they don’t know where to start in obtaining and implementing an analytics platform.

Seize the Moment; See the Benefits

Data analytics tools are especially valuable in monitoring key performance indicators (KPIs). Regarding claims payment, they can track things like charge lag, first pass rates and denial and rejection rates.

The majority of organizations employing data analytics solutions are seeing the advantages of having them. The survey suggests that 71% of organizations with this type of technology improved cash flow by reducing days in A/R. Additionally, more than 50% increased revenue by spotting and resolving bottlenecks to getting paid. The solutions also helped 48% of users boost staff productivity by identifying opportunities for additional training.

Doing Your Homework Can Make a Difference

Even if organizations have analytics systems in place, they can face challenges in gaining useful insights from the technology. According to the survey, lack of time and resources hold 38% of respondents back from completely leveraging their solutions. Another 25% of respondents indicated they were unable to benchmark performance against peers, and 19% said it was difficult to get actionable reports that could help address issues.

Many of these stumbling blocks can be overcome by selecting the right solution. More specifically, organizations should seek business intelligence software that gathers, analyzes and reports data in a user-friendly and actionable manner, so using the system is effortless. One clear measure of a software’s ease-of-use is to test whether its dashboards help staff to visualize real-time performance at-a-glance, highlighting areas of excellence and risk. Dashboards should be customizable so that they only include those metrics that are important to the organization and user, allowing staff to focus on key areas that reflect the organization’s goals.

Another attribute to assess is the solution’s ability to facilitate root-cause analyses when problems surface. Analytics tools should house interactive reports that let users filter, sort and group data in various ways to determine the underlying sources of any concerns. The tools should also allow staff to drill down to the claims level, so they can figure out which claims warrant review and resubmission. Ideally, the solution should also enable users to fix identified problems, such as modifying and resubmitting a claim form, for example, directly within their data analytics application. By doing so, they will not have to juggle the challenge of identifying a problem in one system but fixing it in another. Finally, strong benchmarking capabilities are a must, so organizations can gauge their performance against peers and evaluate improvement priorities.

Making the Commitment

As organizations strive to fine-tune their revenue cycles, data analytics and reporting technology can be a true asset. By committing to use such technology and taking the time to select a system that delivers meaningful information, organizations will be able to proceed more rapidly toward their goal of better, tighter financial management.

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