How healthcare providers can avoid the dreaded revenue plateau

As healthcare providers optimize revenue cycles with electronic health record [EHR] system implementation, they often discover a quick boost is all-too-soon followed by the disappointment of landing atop a revenue plateau.

They may wind up asking: Is that all there is? Not if they are being strategic, and they bear in mind EHR implementation is just a first step toward a larger revenue-stream optimization plan.

Accenture research reveals more CFOs at high-growth healthcare systems take a strategic approach to unlocking new value by optimizing existing revenue streams, with 83 percent employing more digital technology to that end. Already a science for many, revenue-stream enhancement is fast becoming a strategy among innovative CFOs.

Smart revenue-optimization strategies leveraging EHR go beyond plug-and-play. They focus instead on rethinking aspects of the provider’s operating model to achieve significant business impacts. These tend to develop around the following areas:

  • Reducing and optimizing spend. This can be as big as a full-scale transformation or as focused as developing some management structures around existing contracts and vendor relationships.

    A core challenge among provider CFOs, it boils down to spending wisely. Is the operating model you have in place best suited for what you need to do? Are you running three separate business offices to do the work of one?

    Robotic process automation [RPA] is a new source of revenue optimization among especially innovative providers. Specific innovations such as point-and-click robotics simplify core provider functions and free up employees for more creative, value-adding tasks.

    Potential returns gained from a reduction/optimization strategy may provide up to a 25-30 percent reduction in spend, based on Accenture experience.

  • Top-line revenue growth. As opposed to reducing/optimizing spend, where cost-cutting is emphasized, here the focus is enhancing value via improved patient access. Providers can make many adjustments in this regard, from redesigning scheduling procedures that are easier to use for patients to updating online service offerings.

    Have you ever wondered if your organization provides the best access for patients? Enabling a web portal or self-service check-in may increase the number of patients seen or even how frequently they seek preventive care. Likewise, evaluating the management of referral processes within your organization can help decrease both denials and lag in receiving insurance payments.

    Potential returns here may offer up to 10-15 percent growth in revenue. These figures are based on past experience Accenture has in implementing projects of this type.

  • Bottom-line protection. After implementing smarter spending policies and better patient access, another means of revenue growth via digital technology is putting into place due-diligence systems that enhance accountability from payers and mitigate losses from unrecovered charges.

    Optimization efforts here may add accountability to revenue-cycle activities like charge-capture timeliness and accuracy. Or they may develop a robust denial-prevention strategy by employing an interdisciplinary team in areas of overlap between patient access, clinical care and revenue cycles. Such efforts can realize fresh revenue from work already done and simultaneously offer organizations the opportunity to become truly integrated.

    Potential returns here could produce up to a 2-4 percent net income lift, based on Accenture’s work in this space.

Whether your organization is fresh off EHR implementation or the go-live is just a distant memory, don’t put off plans to build on that success. Opportunities unlocked by digital technology offer the best way to gain additional value from your initial investment, not just for your revenue-cycle departments but for your whole organization.

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Francine Dundore

Manager – Consulting, Health Provider, CFO & Enterprise Value

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