A Guide to Creating a Revenue Cycle Management Culture and a Gung Ho Team

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We were recently leaving a meeting with a client’s billing manager when she said something that made us pause. “I wish the whole team here were as gung ho about revenue cycle management as you guys are,” she said.

The Americanization of the term has come to mean “enthusiastic” or “zealous.” In the original Chinese, gung ho means “work together.” If you think about it, all organizations will benefit from that attitude at all levels, especially healthcare teams in the midst of some major transformations in our industry. Following sweeping regulatory and legislative changes like the Affordable Care Act, we’re seeing huge increases in patient payer responsibility, an emphasis on data, and a seismic shift in the insurance and claims sector.1

Revenue cycle management remains one of the most important areas of focus for healthcare organizations. Creating and nurturing an organization-wide culture of revenue cycle management can foster that gung ho attitude where everyone pulls together toward the common goal of excellent patient care and healthy revenue.

It Starts from the Top—Exercise Leadership on Revenue Cycle Management

Today, the “C” in C-suite might as well stand for “culture.” Executives in healthcare set the tone for their organization’s culture as much as their business counterparts.

Stewardship of a healthcare entity is infinitely more complex today than it was just 10 years ago. Leaders must shepherd organizations made up of a huge variety of practices, more complex payer relationships, more complex board relationships, a dynamic compliance landscape, and all the data and security variables that come with modernization.2

With so many external factors competing for your attention, it can be hard to focus on building a strong internal culture, but it’s more crucial than ever for running a successful healthcare organization.

Building a culture that engages all levels of your medical office or clinic in active revenue cycle management starts with modern leadership. Make sure your executives help to promote revenue cycle management in all aspects of your culture by taking the following actions:

  • Listen. Research shows that the best leaders are collaborative and make their teams part of the process. No one knows the challenges your physicians and staff face better than said physicians and staff. Implement listening tools and mechanisms so you can solicit and gather regular feedback, especially if you’re embarking on a large-scale revenue cycle management audit or changing a related process.
  • Promote initiative and problem-solving. Too often, billing offices can become overly reactive, waiting for rejections or denials to come back from payers before acting on identified issues. If your executive team encourages front-line and billing staff to exercise judgment and empowers them with the right tools, those staff can make micro-decisions every day that positively impact your bottom line.3
  • Implement incentives and key performance indicators (KPI). High-performing organizations combine executive leadership, peer-to-peer encouragement, and the hard data of KPIs for success. KPIs on the organizational, departmental, and individual levels allow you to track and target specific areas of the revenue cycle and identify areas for improvement.

Rather than addressing a struggling department with vague managerial tropes, use hard data to help staff find actionable ways of improving—and incentivize performance to give everyone a more concrete goal. Of course, everyone’s lot improves if your organization performs well, and employees feel more engaged at a high-performing company with a clear vision, but more personalized incentives drive individual performance better than always relying on “for the greater good” messaging.4

  • Use education to set goals. As a healthcare leader, you spend a lot of time thinking about KPIs, revenue cycle management, finances, culture, and other bigger-picture initiatives. Your physicians are thinking only about the hip replacement on the docket for this afternoon; your interns are thinking only about the incision they’re suturing right this minute; and your administrative staff is thinking about the patient at the desk right now or the code they’re retrieving this instant. Don’t assume that everyone will know their role in promoting healthier revenue cycle management.

Take the time to educate all departments on how their actions affect the cycle as a whole. Every interaction should prioritize three things: 1) patient experience through excellent service, 2) waste reduction through efficiency, and 3) ensuring compliance through systems and attention to detail.5

Better Culture Breeds Better Revenue Cycle Management

Think of every benchmark of a successful healthcare organization. High-quality service. High-profile talent. High compliance rate. High and consistent revenue. Excellent reputation. What’s the common denominator in all of those things? The performance of your staff.

Creating a culture in which everyone is gung ho about revenue cycle responsibility is ultimately about demonstrating and embracing the idea that a healthcare organization needs to create a culture at all. Building an environment in which your staff wants to work, is empowered to pull together toward common goals, and works within the appropriate systems and structures will lead to healthier revenue cycle management as a matter of course.

Physician Revenue Navigators is a leading healthcare revenue cycle management partner. Contact us to learn more about how we can assist you in building a culture of revenue cycle management with our services, including workflow review, practice management, medical billing and A/R, medical practice bookkeeping, accounts payable, and more.

Show 5 footnotes

  1. “Why You Need to Build an Analytics Culture in the Revenue Cycle,” Revenue Cycle Insights, June 16, 2015, http://www.revenuecycleinsights.com/news/why-you-need-build-analytics-culture-revenue-cycle.
  2. R. Timothy Rice, “Changing Nature of Healthcare Leadership Demands New Vision, Empowerment Culture,” Modern Healthcare, Feb. 13, 2016, http://www.modernhealthcare.com/article/20160213/MAGAZINE/302139978.
  3. Brooke Murphy, “6 Great Quotes from Revenue Cycle Leaders in 2015,” Dec. 23, 2015, http://www.beckershospitalreview.com/finance/6-great-quotes-from-revenue-cycle-leaders-in-2015.html.
  4. “Developing a Culture of Revenue Cycle Excellence,” Healthcare Finance Management Association, Nov. 7, 2010, http://www.hfma.org/Content.aspx?id=1024.
  5. Matthew Bayley, Sarah Calkins, Ed Levine, Monisha Machado-Pereira, “Hospital Revenue Cycle Operations: Opportunities Created by the ACA,” accessed Feb. 29, 2016, http://healthcare.mckinsey.com/sites/default/files/793544_Hospital_Revenue_Cycle_Operations.pdf.

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