Learning Objectives
- Level set on key health care industry trends such as denials,
underpayments, administrative burden, workforce, revenue leakage,
and uncompensated care. - Identify, Develop, Monitor, and Adapt KPIs for and effective RCM.
- Analyze the process improvement steps identified to achieve
benchmarked best-in-class performance.
Key performance indicators have become critically important as
providers face patients as payers, revenue leakage, and increasing
denials. Budgetary and operational constraints also can create staffing
challenges, and RCM departments must demonstrate successes and
justify the need for resources. Identifying, tracking, and reporting on key
datasets affords an RCM to convert their role from cost center to
revenue integrity centers.
Optimization of intake, staffing, accuracy, yield, and patient throughput,
can all be leveraged by consistently reporting KPIs. A process that
objectively measures performance, celebrating successes and
identifying opportunities, can help establish staff accountability and
achieve alignment towards strategic goals. Benchmarking to internal
operations, as well as to industry-recognized KPIs, can help ensure
RCM is on course.