The third year of healthcare reform is only a couple months old, but there are five revenue cycle issues that will impact hospital executives throughout the remainder of 2013, according to a report from consulting firm Pyramid Healthcare Solutions.
1. Reimbursement and cash flow pressures. Healthcare
reform will lead to decreased Medicare payments, more Medicaid patients
and a larger percentage of high-deductible health plans, which will put
more costs on commercially insured patients. These pressures lead many
hospital executives to believe there will be a decline in patient
revenue and days cash on hand, meaning revenue cycle teams will have to
work harder to reduce days in accounts receivable and improve front-end
collections, according to the report.
2. Business office operations. Consolidation
among hospitals, physician practices, post-acute care and other
providers will drive a consolidation of business office operations.
3. Innovative payment models.
Accountable care organizations and bundled payments will impact
existing patient accounting systems, most of which are not built to
handle these types of new CMS-sponsored payment models.
4. ICD-10. This
will be a big year for providers and ICD-10, as it is the final full
year to formalize the transition. Revenue cycle teams will have to
invest resources and time to master the new coding system, which will
affect reimbursement trends and electronic health record implementation.
5. Outsourcing. As hospitals attempt to prioritize their
various challenges, many are looking to outsource certain operations,
including the revenue cycle, to handle and navigate the various