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Why a clinically driven revenue cycle is essential for your value-based care strategy

Published on 9/9/2019

Estimated read time: 3 minutes

The health IT landscape is constantly evolving. Shifting consumer behavior, coupled with the industrywide transition from fee-for-service to value-based care, means that hospitals and health care providers must adapt to remain successful.

As these trends continue, organizations can evolve their revenue cycle management (RCM) strategy across acute and ambulatory venues by optimizing existing workflows, connecting clinical and financial data and controlling collection costs. These initiatives will not only protect revenue but will ultimately deliver the best financial outcome for the consumer.

How the shift to value-based care is impacting RCM strategy

One of the most important levers to help navigate value-based care is to align financial and clinical operations. A cohesive view empowers administrative staff and physicians to improve financial and clinical outcomes as well as the consumer experience and access to care.

Aligning clinical and financial information has a twofold goal: improve clinical outcomes and reduce costs. Health care organizations are compelled to optimize their revenue cycle and collect payment for the care they deliver. They can’t afford to leave money on the table because of disjointed systems, processes or resources.

The value of an integrated revenue cycle

As the industry moves toward value-based care, payment will be tied to accurate and complete documentation of services. However, with disjointed systems in place, it’s challenging to collect all the clinical information that’s necessary to document care for reimbursement. That’s why more health care organizations are integrating their clinical, financial and operational data within a single platform across acute and ambulatory settings.

An integrated platform also comes with the benefit of analytical data. The ability to pull and derive meaning from data is becoming increasingly important. Analytics can be used to drive better clinical and financial outcomes across an entire organization. Ultimately, what gets measured gets managed, and having insight into even the most granular data can influence the decision-making process and refine workflows. When data is aggregated and shared on a single platform, it has the power to improve revenue cycle intelligence and the quality of health care.

Additionally, an integrated platform helps create a better experience for consumers who want easy access to their health information and are becoming more proactive in researching the quality and price of health care. This presents an enormous opportunity ─ and responsibility ─ to educate consumers about their care. A cohesive RCM strategy that promotes transparency will help establish trust, improve consumer engagement and build loyalty.

Connecting people, processes and technology with RCM services

Entering the era of value-based payments and population health management will require more solution and care team integration. Health care organizations should be thinking about putting the foundation in place to create sustaining and thriving businesses. Many financial leaders are considering RCM services, which can free up labor resources to focus on the consumer-facing side of the revenue cycle.

Impacting a health care organization's bottom line

Implementing a clinically driven revenue cycle is a significant step toward improving RCM performance and preparing for value-based care. It combines clinical, financial and operational health information to be available when and where it's needed so health systems can optimize workflows, improve cost-effectiveness and, ultimately, build a healthier bottom line.

Cerner's Clinically Driven Revenue Cycle™ portfolio of integrated solutions and services are designed to help health care organizations of all sizes navigate today's complex environment, drive down costs and increase cash flow. Contact us to learn more.

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