hmicorp

Revenue cycle management optimization companies have been talking about automation for years.  

Automation is not a secret, yet many organizations are not investing in automation in the right way.  

A strategic approach to investing can work wonders for your organization. Instead of shoehorning robotic process automation (RPA) into fields where it doesn’t fit, you can target the best opportunities for automation, artificial intelligence, machine learning, and RPA. 

How should your organization intelligently invest in automation for revenue cycle management? Here are some of the strategies organizations are using to maximize their success.

Healthcare organizations are facing more competition than ever. If your organization does not have patient-friendly billing, then you could be pushing patients to competitors.  

Adopting patient-friendly billing may be easier than you think. By implementing patient-friendly billing standards today, you can create better patient outcomes, customer service, and revenue cycle optimization. 

Keep reading to discover some of the best and most proven strategies for creating patient-friendly billing standards. 

Digital healthcare and telehealth are at the top pf the list of healthcare trends in 2021. 

Leading healthcare organizations have invested significantly in digital healthcare, expanding services and optimizing patient outcomes. 

Other healthcare organizations are already falling behind. Since digital healthcare isn’t going away any time soon, that’s a problem. 

Today, we’re highlighting some of the best digital healthcare strategies you can use to optimize revenue. 

Lean Six Sigma is a business optimization method that focuses on eliminating defects. In healthcare, defects can be the difference between life and death. That’s why many healthcare organizations have implemented Lean Six Sigma principles. When properly implemented, Lean Six Sigma optimizes every stage of patient care – from revenue cycles to patient outcomes. Today, we’re explaining how Lean Six Sigma works in healthcare – and how it can help your organization eliminate defects. What is Lean Six Sigma? Lean Six Sigma is a method that emphasizes a collaborative team effort for improving performance and reducing inefficiencies. The method is based on lean manufacturing techniques. If you’re familiar with lean healthcare practices, then Lean Six Sigma may sound familiar. In addition to targeting defects and waste, Lean Six Sigma targets overall cultural change. The system emphasizes growth and optimization. You’ll encounter Lean Six Sigma at a range of corporations. It rose to popularity with electronics companies and car companies. Since the mid-2000s, however, we’ve seen Lean Six Sigma in healthcare, finance, supply chain, and other sectors. When implemented successfully, Lean Six Sigma maximizes efficiency while increasing profitability – in any field.

It’s been challenging for some healthcare organizations to keep up. However, by implementing certain strategies today, your healthcare organization can maximize revenue in 2021 and beyond. 

How are today’s top organizations optimizing revenue? Today, we’re highlighting some of the healthcare organizations strategies firms are using to get ahead. 

Securing Domestic Manufacturing of Medicine, Supplies, and Equipment 

The COVID-19 pandemic showed how fragile international supply lines can be. As the COVID-19 pandemic surged, countries with domestic medical manufacturing facilities reigned supreme. 

Countries that had traditionally relied on China for PPE, for example, were suddenly unable to procure necessary amounts of equipment. Others struggled with drug supply lines. Some continue to struggle with vaccines. 

None of this has been secret: it’s been painfully obvious. 

Expect a significant “made in America” push in the coming years. Expect more domestic firms to rise to manufacture supplies, drugs, and equipment for healthcare organizations. 

There have been increasing calls for domestic manufacturing of crucial medical supply lines. It’s not just a convenience or cost issue: it’s a national security issue. Watch for significant growth in this space throughout 2021 and beyond. Healthcare providers will switch to domestic suppliers if they offer better, cheaper solutions.  

Making Large Investments in Telehealth  

Telehealth isn’t going away anytime soon. It was surging in popularity before the pandemic, and the pandemic illustrated the importance of telehealth even further. 

Virtual patient care is more common today than ever – and it’s going to become increasingly common in the coming years. 

Smart healthcare providers invested in telehealth yesterday. They stay on top of remote health regulatory requirements. They invest in the latest telemedicine technology to optimize patient care. 

Healthcare organizations that are not investing significantly in telehealth risk falling behind.  

With Medicare, Medicaid, and major healthcare organizations now covering telehealth, you can’t ignore telehealth any longer. It’s here, and it may be more popular than in-person patient care in the near future.  

One study showed 53% of all employers plan to offer more virtual care options in their benefits packages, making it the biggest change of the year. 

Meanwhile, CMS data showed that telehealth adoption increased 50% for primary care visits with Medicare beneficiaries.  

Telehealth has improved significantly in recent years. As telehealth grows to cover psychiatry and other areas of medicine, it will only become more popular.  

Increasing Focus on Genetic Health and Wellness 

We know more about our genetic code today than at any previous point in history. Our genetic health and wellness is becoming increasingly important. We won’t be changing our genetic code by the end of 2021, but it’s a space to watch moving forward. 

As The Motley Fool reports, there are only 6,000 genetic experts in the United States, which isn’t enough to serve 330 million people (especially for in-person visits). Expect more virtual healthcare platforms in the genetic space – and more genetic health specialists – as we move forward in one of the most exciting areas of patient care. 

Making More Value-based Arrangements to Optimize Patient Care 

Providers took a huge hit in 2020 when they were forced to halt services for COVID-19. 

However, there was a silver lining to this shift: it forced providers into value-based payment arrangements.  

Some analysts believe this will have the long-term effect of curbing healthcare spending in the United States. Payers will reimburse for improved outcomes instead of volume, which means lower overall spending. 

In other words, people are realizing the risk of antiquated, fee-for-service models – so they’re embracing new alternatives.  

Instead of focusing on caring for sick patients, for example, healthcare organizations may focus on keeping patients healthy. They’ll move further upstream, which ultimately reduces costs and improves patient outcomes.  

This shift is particularly important for providers that are heavily reliant on fee-for-service reimbursements. These providers took a huge hit last year – and smart providers are taking steps to end 2021 with a better financial picture.  

Making Better Insurer Partnerships 

Many healthcare providers have also sought better insurer partnerships as a result of the pandemic. The pandemic has illustrated the importance of good health insurer deals and partnerships. 

It’s no secret the pandemic will lead to more payer-provider partnerships. Multiple analysts have made similar predictions in recent years. As healthcare organizations see the benefits of a fully integrated health system, it’s illustrating the importance of maintaining good partnerships. 

Preparing for Increased Numbers of Medicaid and Self-pay Patients 

Millions have lost healthcare because of the pandemic. Healthcare organizations are seeing record levels of patients using Medicaid or self-pay to cover their healthcare costs.  

Organization that are prepared for this surge are doing great. Organizations that are not prepared are falling behind. 

Organizations with improper medical coding, limited Medicaid or self-pay optimization, and other issues are losing revenue.  

As furloughs end for employees, and as jobless numbers continue to remain high, expect more Medicaid and self-pay patients throughout 2021. 

We Implement Proven Solutions for Healthcare Providers  

HMI, LLC stays on top of healthcare trends so you don’t have to. 

Schedule a consultation with HMI, LLC today. We have decades of proven experience optimizing healthcare organizations – from revenue cycle management to medical coding.  

Telehealth isn’t going away any time soon.  

Telehealth was surging before the pandemic – and the pandemic pushed telehealth to new levels.  

As telehealth rises in popularity, organizations are implementing telehealth in different ways. Some are investing billions into telehealth. Others are getting left behind. 

Today, we’re highlighting the most important telehealth trends for 2021, including some of the rising and falling movements we’ve seen from telehealth in recent months. 

1) A Growing Emphasis on Preventative Health for Patients and Families 

The COVID-19 pandemic demonstrated the importance of family health. Moving forward, we’re seeing families put a renewed emphasis on protecting themselves and their loved ones. 

As the dust settles on the COVID-19 pandemic, families want to prepare for the next threat. They’re more interested in preventative medicine. They might be more careful about scheduling checkups or managing conditions. Some have lost loved ones – and they recognize the importance of preventative care more than ever.  

2) Premium Telehealth Services Are Increasingly Becoming Standard 

Telehealth services that were once considered “premium” are rapidly becoming standard. Remote patient monitoring and asynchronous communication, for example, are becoming more popular with providers. 

Early in telemedicine, remote patient monitoring and asynchronous communication were premium services implemented by few providers. Today, they’re part of the standard operating procedure at many hospitals.  

3) Patients Will Control More Aspects of Their Health Than Ever 

Patient-controlled health is the future. For decades, healthcare organizations have controlled patient data and dictated patient’s decisions. Moving forward, things are starting to change. 

With patient-controlled health, the patient makes decisions in consultation with a healthcare provider. Instead of directly following the provider’s guidance, the patient makes a collaborative decision. 

Patient-controlled health is fuelled by growing access to health technology and data. Patients have more insights into their health. They have more information than ever. With this information accessible at their fingertips, patients may take a more active role in managing their own health.  

4) Relaxed (or Clearer) Telemedicine Regulations 

Healthcare organizations face regulatory hurdles as they implement telehealth systems.  

We saw authorities relax some regulations at the beginning of the pandemic, and it’s possible we’ll see new regulatory frameworks emerge in the coming months. 

Relaxed HIPAA Regulations early in the pandemic, for example, made it easier for providers to treat patients remotely.  

As telemedicine becomes more common, providers will push for more regulatory clarity – or relaxed regulations. Regulatory clarity makes it easier for organizations of all sizes to implement telehealth systems and stay competitive.  

5) Telemedicine Visits Will Be More Common than In-Person Visits 

Eventually, we’ll reach a point where telemedicine visits become more important than in-person visits.  

Telemedicine is convenient. It works around the schedules of patients. It does not require in-person appointments or a day off work.  

More serious problems may require in-person visits, but many aspects of patient care can move to telehealth – or have already moved to telehealth.  

6) Increased Insurance Acceptance of Telehealth 

Medicare, Medicaid, and many major insurers now cover telehealth visits. It’s a big shift for the industry – and it sets the stage for rapid future growth of telemedicine. 

Expect insurers to provide further clarity on how they cover telemedicine – and what they cover. Telemedicine is going mainstream, and insurers need to keep up. 

7) Telemedicine Will Branch Beyond Basic Healthcare 

Today’s telemedicine is the tip of the iceberg. We’re just beginning to see the potential of telehealth.  

Moving forward, telemedicine will grow into spaces like mental health, providing remote psychology and psychiatry services to patients. We’ll see telemedicine deal with prescriptions (some call it “ePrescribing”).  

Providers are still figuring out how to implement advanced healthcare with telemedicine. Expect more developments in the near future.  

8) Healthcare Provider Location Will Be Less Relevant  

Telemedicine is changing the way healthcare organizations – and all organizations – think about location. Location is becoming less relevant. 

Let’s say a patient returns home after surgery. Traditionally, doctors may ask the patient to return to the hospital for a checkup. With telemedicine, patients can receive instant care at home whenever they need it, making location less relevant. 

Similarly, some healthcare providers will invest heavily into telemedicine, providing healthcare services to patients across the country from remote locations. Some providers may even maintain remote offices, distributing employees around the world. 

9) Increased Focus on Patient Data Management 

Patient data management has become increasingly important in recent years. With telehealth, patient data is increasingly being transferred and tracked online – and that means organizations need to invest in secure patient data management systems. 

Even the best healthcare organizations are one data leak away from losing their reputation.  

Expect tech companies to lead the charge. Countless tech startups are already maneuvering to become patient health data management leaders. Tech giants like Apple, Google, and Amazon may also get involved. 

What Comes Next? 

Telehealth has always been the future. 

In recent years, healthcare providers have tried to figure out remote healthcare. The COVID-19 pandemic was like getting thrown into the deep end. 

Will your organization sink or swim as telemedicine expands?  

Contact HMI, LLC today to speak with experienced healthcare consultants with proven experiencing solving complex problems.  

Top 3 Reasons Employees Leave

Healthcare employees leave organizations for any number of different reasons. However, one study found that professional development, poor work-life balance, and bad managers were responsible for most departures.
According to a study featured in Employee Benefits News, 75% of the reasons employees leave could be prevented. Here are the top 3 reasons employees leave, according to that study:
Career Development: When healthcare organizations fail to give professional development opportunities to employees, they’re more likely to leave. Thanks to several recessions, employees understand the importance of having specialized skills. If organizations fail to invest in employee training initiatives, or if organizations fail to give employees professional opportunities, employees are likely to leave for greener pastures.
Work-Life Balance: Many employees leave organizations because of poor work-life balance. Work-life balance is important among all age groups, but it’s particularly important among millennials and parents (a class that is increasingly becoming blurred). Even older adults seek good work-life balance as they seek to care for increasingly aging parents.
Management Behavior: Good employee-manager relationships are crucial to retaining talent. Training your managers to treat employees well has always been important, but it’s more important today than it has been with past generations. Employees, particularly younger employees, are more likely to stick with an organization when that organization treats them well.

Many healthcare organizations struggle to retain talent. Unfortunately, this leads to big losses.
A median turnover in the emergency medical services (EMS) space costs an agency $72,000, according to Prehospital Emergency Care.
Meanwhile, the average cost of a turnover for a bedside RN is $52,100, causing the average hospital to lose $4.4 million to $6.9 million. Some healthcare organizations spend 5% of their annual operating budget on employee turnover and related expenses.
By emphasizing employee retention and minimizing patient turnover, healthcare organizations can save millions of dollars per year.
Today, we’re explaining why employees leave – and how today’s top healthcare organizations are attracting and retaining top talent.

Rural hospitals are closing across the country. Naysayers may say it’s the end of rural healthcare as we know it. However, many hospitals are flipping this trend on its head.
America’s best rural hospitals are thriving in uncertain times by expanding care, taking advantage of telemedicine, and specializing in in-demand areas.
By taking this approach, rural hospitals have grown revenue even when dealing with aging populations, higher-than-average Medicare patient totals, and other challenges that have sunk competing providers.
Today, we’re exploring four more rural hospital success stories from small towns across the United States.

Gold Beach, Oregon Hospital Increases Services, Becomes Economic Driver for Region

Gold Beach, Oregon is a small, relatively isolated community along a picturesque section of Oregon’s southern coast.
For decades, the community was served by a small, outdated facility built in the 1950s. The facility exclusively provided acute care, meaning patients had to travel long distances to access specialized medical treatment.
Things became progressively worse for Gold Beach’s Curry General Hospital over the years. The facility could no longer meet local needs, and the building itself was not compliant with building doctors. The facility struggled to attract and retain doctors.
Things changed when the hospital received new funding. Residents of the Curry Health District approved a $10 million fund to fund construction on the facility. The hospital received an additional $20.9 million through the USDA Rural Development’s Community Facilities Program. By taking advantage of favorable interest rates and 40-year terms, the rural district was able to afford considerable healthcare spending it would normally be unable to afford.

Kalispell, Montana Emphasizes Outdoor Lifestyle to Attract Talent

Some rural hospitals have turned a disadvantage into an opportunity. Rural hospitals can be isolated – but that doesn’t mean they can’t attract talent.
Kalispell, Montana is a relatively isolated city in a picturesque corner of the state. Although isolated, the city is surrounded by world-class ski hills, Glacier National Park, multiple lakes, and considerable outdoor adventure opportunities.
By emphasizing these opportunities, Kalispell has attracted high-quality medical care to the region regardless of the remoteness.
On July 1, 2020, Kalispell Regional Healthcare opened the first floor of Montana Children’s. The $60 million facility was funded by debt, operating reserves, and philanthropy.
The opening is a big deal for the city of Kalispell. Previously, Kalispell residents needed to visit Spokane, Washington – four hours away across multiple wintry mountain passes – to get similar patient care for children. Parents of children with chronic diseases were forced to move to Spokane, Denver, and other larger cities – or face multiple harrowing drives each winter.
Now, thanks to the new opening, Kalispell residents can access quality patient care even in a relatively remote area.

North Dakota Hospital Thrives Thanks to Booming Oil and Gas Operations

In neighboring North Dakota, hospitals have faced a surge in revenue thanks to the booming oil and gas industry.
North Dakota’s McKenzie County saw its population double between 2010 and 2020, due mostly to oil and gas operations in the region. As the population grew from 6,000 to over 12,000, local legislators recognized the urgent need to expand healthcare.
Using federal and state loans, funding from the oil industry and private citizens, and a sales tax increase, the region opened the new McKenzie County Hospital in Watford City in June 2018.
Before the opening the hospital, residents had to drive 50 minutes to access surgeries and preventative healthcare services. Today, residents of the 12,000-person county enjoy high-quality healthcare even in a relatively remote, rural setting.
And, like Kalispell, McKenzie County has attracted talent by emphasizing the rural setting:
“Not everybody wants to live in a city, and not everybody should, and there are great places in America that should not have to suffer with second-class health care,” explains Patsy Levang, board chair of McKenzie County Healthcare Systems, in a statement to US News.

Mississippi Town, Population 1,600, Revitalizes Local Economy with Federal Grant

Mississippi’s Field Memorial Community Hospital (FMCH) is located in a town of 1,600 residents. While other hospitals serving similarly-sized towns close down, FMCH is taking the opposite approach.
Thanks to a federal grant, FMCH is building a new $21 million facility that will introduce big changes to local residents.
Centreville is located about 130 miles northwest of New Orleans, and approximately one-third of residents live below the poverty line.
The goal is to use FMCH as an economic driver for the region.
“A lot of times in the rural communities your health care systems are your economic drivers, and that’s true here,” explains Chad Netterville, chief executive of the Field Memorial Community Hospital, in a statement to NY Times, which covered the expansion in April 2015.
Today, Centreville has a 16-bed hospital thanks to the federal economic development program designed specifically to increase investment in low income communities. By targeting rural hospitals and expanding patient care, federal grants can revitalize local economies while contributing to higher-quality patient care.

Final Word

Since 2010, more than 100 rural hospitals across the country have closed down, according to a study from the University of North Carolina – Chapel Hill.
While times are tough for some rural hospitals, others have succeeded despite these challenges. They’ve turned challenges into opportunities, taking risks where other hospitals are not willing.
Contact HMI, LLC today for expert revenue cycle management consulting, chargemaster service consulting, coding services, and more. Founded in 1989, HMI, LLC has revitalized small and large healthcare organizations across the county.

Rural hospitals face considerable challenges throughout the country. While some rural hospitals thrive in challenging situations, others falter.
Today, we’re highlighting some of the best success stories of rural hospitals across America, including situations where ingenuity, creativity, and flexibility saved small hospitals in rural settings.

Rural Hospital in Beatrice, Nebraska Specializes in Healthcare for Older Adults

Rural areas of America tend to have older populations than urban areas. This increases challenges for rural hospitals.
It’s hard enough running a small, rural hospital. These challenges increase with older populations who have larger, more complicated healthcare needs – and who also tend to be Medicare patients.
Despite these challenges, a small hospital in Beatrice, Nebraska is thriving by implementing a seemingly obvious solution: they’ve invested in aging healthcare, allowing them to specialize in the specific areas where older adults need them most.
The average age in Beatrice, Nebraska is 6 years older than the average age in Nebraska. It’s an older, rural town with a population of 12,200 people.
To address these challenges, the Beatrice Community Hospital and Health Center (BCHHC) has implemented a range of solutions. BCHHC has continued to grow, opening a new building while doubling patient numbers since 2009.
What did BCCHC do differently? The hospital made significant investments in treating and serving the area’s aging residents. As the town’s population gets increasingly older, several nursing homes have opened in town, with BCCHC being the primary medical hub for these residents.
Today, BCHHC is the second largest employer in Beatrice. It has a 25-bed hospital employing 512 people with a payroll of $28 million. The hospital earned $100 million in revenue last year – even as other businesses are leaving Beatrice en masse.
Because of their foresight, the Beatrice Community Hospital and Health Center continues to thrive amid uncertain times for small, rural hospitals.

Healthcare organizations have many opportunities to train employees and enhance organizational revenue. By taking advantage of these opportunities, healthcare organizations can significantly improve their bottom line. From lean healthcare workshops to continuing education programs to other professional training systems, employee training opportunities can enhance organizational revenue in various ways. Today, we’re exploring some of the best employee training opportunities for small and large healthcare organizations.

Lean Healthcare Workshops

Lean healthcare workshops can singlehandedly change an organization’s bottom line. The idea of running a lean organization is nothing new in and out of healthcare – but healthcare organizations across the country are increasingly taking advantage of lean healthcare workshops to implement new techniques, philosophies, and management systems.
Some of the topics covered in a lean healthcare workshop include:
• An overview of lean healthcare practices, philosophies, and systems and how they work
• How all elements of a healthcare organization work together to create a lean organization
• Specific examples of healthcare organizations successfully implementing lean practices to rejuvenate operations
• How to identify core problems at a healthcare organization, including specific trouble spots that can benefit from a lean healthcare philosophy
By scheduling a lean healthcare workshop, organizations can discover the best practices modern organizations are using to maximize revenue while minimizing losses.

Our consultant specialist can provide case management reviews to assist physicians with the medical necessity criteria for observation and inpatient services. We also assist providers with the rebuttal process of carrier denials as well as RAC and MAC audits.

Our Nurse Auditors provide medical necessity reviews for ER physicians to ensure the patient meets the inpatient or outpatient medical necessity criterion as required by CMS.  We educate the physicians on the criterion elements to better equipment them as changes occur.

The hospital charge description master, or hospital chargemaster, communicates medical bills to payers and patients.
The hospital chargemaster plays a crucial role in revenue cycle management: it’s the heart of the healthcare revenue cycle. It’s the central point from which all billing gets sent to patients and insurers.
Organizations that fail to maintain the chargemaster face enormous problems. Poor chargemaster maintenance leads to revenue leakage. It can also lead to inaccuracies, non-competitive fees, and claim rejections.

Healthcare organizations in the United States and around the world use the ICD-10 medical coding standard. Starting in 2022, however, organizations will switch to the ICD-11 standard.
ICD-11 has four times as many codes as ICD-10. That means new challenges for healthcare providers – and new problems with missed revenue, coding errors, and denied claims.
Keep reading to discover some of the significant changes in ICD-11 medical coding, including how your organization can prepare for the release of ICD-11.

Most people assume healthcare consulting benefits the organization – not necessarily the physicians within that organization. However, that’s not true. Physicians can and do benefit from healthcare consulting.
Physicians experience actionable improvements from healthcare consulting. These improvements can benefit the organization’s bottom line, improve patient care, and make it easier for physicians to do their job.
Today, we’re explaining some of the ways physicians can benefit from healthcare consulting whether running a small practice or working for a larger organization.

When some think of revenue cycle management, they think of larger healthcare organizations with complex needs. But healthcare organizations of any size can benefit from revenue cycle assessments.
Yes, smaller hospitals can benefit from revenue cycle assessments and healthcare consulting. In fact, these assessments could have a greater proportional impact on smaller, rural hospitals.
Rural hospitals need the help. In 2016, 41% of rural hospitals in the United States operated with negative margins. As populations age, this problem is getting worse – not better.
Today, we’re highlighting some of the ways that small, rural hospitals can benefit from a revenue cycle assessment.