5 Main Revenue Cycle Issues Spurred by Healthcare Reform

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 deadlines.