What is Revenue Cycle Management in the Age of Healthcare Consumerism?

Healthcare Consumerism: What is Revenue Cycle Management and Its Role?

For the longest time, the healthcare industry’s status quo has been more or less intact. Yes, technological advances have been introduced, but the way hospitals conducted business was mostly the same: patients come in, they get treated, then they get billed.

However, public policy driven changes have led to a shift in the way patients receive medical treatment. For one, there are more walk-in clinics and ambulatory care centers that offer many of the services one could find only in a hospital years past.

Moreover, more patients are opting for high deductible plans from the health exchanges, which means that more of their medical costs are being paid out of pocket. Many feel that this is a more cost-effective option, especially those who are relatively healthy and very rarely get sick.

That being said, such a shift in patient behavior naturally affects a healthcare facility’s revenue stream. After all, the fewer the patients who walk through the door, the lower the revenue a hospital can expect. Moreover, the more people pay out of pocket, the greater the risk that unpaid medical bills will become personal debt and possibly unpaid.

The Age of Healthcare Consumerism 

Because of these changes in patient attitudes, many experts in the field have dubbed this era as the age of healthcare consumerism. That is, patients treat medical care as they would any other product: They shop around until they find an option that gives them the best value for their money.

This, of course, begs the question: What is revenue cycle management in the age of healthcare consumerism? Its fundamental role—making sure that there is enough cash flow for the facility—remains unchanged. However, how hospitals do this must change. Rather than treating people as patients, they must now treat them as customers.

Shifting Perspectives 

Once healthcare facilities understand that patients have more options than ever, they are poised to take advantage of and thrive in the age of healthcare consumerism. As RevCycle Intelligence puts it, the goal is to “attract loyal, adherent, and engaged patients to improve health outcomes.”

To do this, an institution or health group must put patients at the center of everything they do. If they can manage to do this, the revenue will surely follow. There a few ways to accomplish this.

Improve Customer Service

Consulting firm McKinsey conducted a survey to gain patients’ views on healthcare consumerism. As it turns out, patients expect the same level of customer care that they get from non-healthcare companies, such as Apple and Amazon. That’s right—McKinsey found that customer care expectations are being set by companies outside the medical field. One way to improve on this aspect of your business is by making scheduling and registration as easy as possible by allowing online booking of appointments.

Cultivate loyalty

According to the same survey, 84% of respondents who don’t have a primary care physician (PCP) were willing to see one as long as won’t cost them more than what they currently pay. However, 45% of those who did have a PCP had made an appointment with any available doctors in the facility. In short, patients want a PCP, but are willing to see other doctors if it’s more convenient to their budget or their schedule.

In line with the value-based model that the Affordable Care Act espouses, doctors must become more active health advocates for their patients so that their patients have a reason to keep coming back.

Make Healthcare More Inclusive

A lot patients do not know that they qualify for Medicaid or Medicare. Many others also struggle with the healthcare exchanges. One way to make healthcare more inclusive—and to go above and beyond the call of duty—is to hire eligibility experts who can help shepherd patients through the application process. Moreover, when more patients are covered under such programs, hospitals stand a better chance of being reimbursed for the services they render.

Debunking common myths about healthcare consumerism, McKinsey.com
Healthcare Consumerism Challenges Primary Care Business Models, RevCycleIntelligence.com
Revenue cycle pressured by consumerism in healthcare, vendor report says, HealthCareFinanceNews.com

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Categories: Revenue Cycle Management