When healthcare organizations outsource their Revenue Cycle Management (RCM), they can “potentially” experience noteworthy cost savings and improved efficiency. Nonetheless, managing an outsourcing partner and achieving desired outcomes comes with its own set of challenges and oftentimes significant setbacks in performance. There are several tactics organizations can implement to mitigate some of these risks.
To maximize a successful partnership, healthcare organizations must establish Service Level Agreements (SLAs) that are clear, measurable, and aligned with their business objectives. Periodic review and necessary revision of SLAs is pivotal to reflect changes in business requirements. There should be flexibility within the agreement to establish mutually agreed upon service levels as the relationship matures and there is a need to respond to new and/or unanticipated challenges.
Effective management of outsourcing partnership requires resources and effort from both parties. Healthcare organizations should appoint a project manager or leader to oversee the alliance, providing data access and mechanisms for consistent communication with their outsourcing partner. There may also be a need for resource allocation for data analysis and reporting to effectively monitor the performance under the agreement. Performance against the agreed upon SLA metrics must be measured and monitored.
Effective communication channels between healthcare organizations and their outsourcing partners are paramount for successful collaboration. A regular and consistent dialogue should encompass project updates, issue resolution, and a strategy for upcoming initiatives. In this context, transparency plays an essential role in delivering timely communications and fostering an effective relationship.
Establishing and monitoring performance metrics is critically important to ensuring accountability. See more on Revenue Cycle Reporting. This includes establishing a mutually agreed upon baseline performance level. Performance reviews should be recurring and aimed at identifying areas where improvements can be made towards meeting shared objectives. To ensure the outsourcing partnership runs smoothly and meets all obligations, it is imperative for healthcare organizations to conduct periodic reviews in collaboration with their outsourcing partner.
Evaluating performance, identifying areas of improvement, and addressing any issues that may arise will provide a more effective collaboration. Implementation of a robust governance structure is vital to ensure the outsourcing partnership is achieving the desired objectives. It involves defining roles and responsibilities, an escalation processes, dispute resolution procedures, and change request procedures, organizations are far more likely to have an ongoing and successful working relationship. The governance structure should be reviewed regularly to maintain relevance as the business requirements evolve and change. With the right partner Healthcare organizations can undoubtedly enhance their revenue cycle through RCM outsourcing but not without the proper considerations, structures, and controls.
In summary, to foster a successful relationship with an outsourcing partner, healthcare organizations must adhere to specific outsourcing best practices. Such guidelines include the establishment of clear SLAs, allocation of sufficient resources, maintaining effective communication channels, monitoring performance metrics against goals and baselines, conducting regular reviews, granting access to necessary data and systems, and implementing governance structures. Implementation of these procedures will enable a strong and high performing partnership resulting in an optimized revenue cycle and achievement of desired financial objectives. See more on Effective Vendor Management and Accounts Receivable Outsourcing.
At PinnacleHCA, we have an established strong track record of helping our clients optimize their outsourced environment and achieve their financial objectives. If you have any questions or concerns about your outsourcing relationship or your revenue cycle, please feel free to reach out at jmartin@pinnaclehca.com or call at 214.395.6089.
