How health systems have utilized outsourced RCM services to meet their overall business objectives
With new reimbursement models, significant healthcare regulatory changes, and the rise of consumerism, today's revenue cycle management operations have become even more complex for hospitals, health systems, and other providers. These complexities require a strategic approach, and one such approach is partnering with an outsourced vendor.
Access Healthcare recently sponsored a featured session at Becker's Health IT + Revenue Cycle Management Virtual Forum, where panelists shared how their organizations benefited from outsourcing RCM services. Paul Reda, Director of the Healthcare Industry Group at Alvarez & Marsal, moderated the discussion and the panelists included:
· Desmond Jackson, Senior Director at Johns Hopkins Health System
· Sean O'Rourke, Vice President at Holy Name Medical Center
· Kumar Shwetabh, CEO of Pacific Global, an Access Healthcare company
Here are five key takeaways from the session:
The need for technical expertise and staffing drove Johns Hopkins and Holy Name to look at partnering with an outsourced vendor. Both organizations were somewhat averse to working with an offshore vendor, rather than keeping the work in their communities, and they went through the process of analyzing the costs and potential challenges involved. But Mr. Jackson and Mr. O'Rourke said their respective organizations ultimately decided to partner with Pacific Global because of its domain expertise, service capabilities, and technology.
After selecting Pacific Global as their outsourced partner, Johns Hopkins, and Holy Name both faced challenges during the implementation process. For Johns Hopkins, it was putting the right international policies in place to govern an offshore partner, and for Holy Name it was the process of forming a truly comprehensive, integrated partnership. Meanwhile, Mr. Shwetabh, said Pacific Global had to ensure staff at the central business office of the organizations were comfortable with outsourcing, and that there was no decrease in revenue for the client during implementation.
Holy Name has experienced many benefits in partnering with an outsourced vendor. For example, Mr. O’Rourke said, “Pacific Global has helped Holy Name keep up with its growth over the last five years, from about 50 providers to more than 270. We would have never been able to keep up with the pace in terms of trying to build this on our own, given the number of practices we brought on…so they've been a great extension of our team."
Outsourcing has also been beneficial for Johns Hopkins, including gaining economies of scale, according to Mr. Jackson. He said: "We can flex up, flex down in our staffing needs as we need. And we can look at technology as another bridge to where we need to go in the coming years." He said the partnership with Pacific Global also provides the ability to look at automating more processes and removing waste from them.
Overall, Mr. Shwetabh sees the future of the RCM industry as a technology-based manpower-augmented industry, and he projects a growing RCM outsourcing market. "If you take Pacific Global and our parent company, Access Healthcare, as an example, look at the amount of technology, artificial intelligence, and machine learning tools, which we have developed," Mr. Shwetabh stated. "So, we have spent millions of dollars on all these tools. And I'm sure that in the future, more and more companies will be investing in automation, artificial intelligence, machine learning tools, and eventually, automation will play a major role in the revenue cycle."
If you are interested in learning more about this featured session, please register for the On-demand session here.
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