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For independent anesthesia practices, achieving financial stability and having a consistent revenue cycle has become more complex and challenging.
Fremont, CA: According to the American Society of Anesthesiologists, many anesthesiologists are being pushed out of networks when private insurers terminate their physician arrangements with little or no warning (ASA). The proposed Medicare reimbursement rule aims to raise payment rates for some services, which would entail reductions in the Physician Fee Schedule in other regions, including those most commonly used by anesthesiologists. Anesthesia procedures are up against one of the biggest public health crises of the moment, COVID-19, on top of all this.
After the pandemic's height earlier this year, societies are resuming regular activities but returning from a dramatic amount, and consequently, sales declines for independent practices will be tough. In reality, financial stability and profitability are still realistic expectations for activities.
Optimization of revenue cycle management is critical for addressing the financial and organizational difficulties caused by COVID-19 and other healthcare industry incidents, such as abrupt terminations of payer contracts.
The leverage of data analytics and automation to simplify revenue cycle processes and improve performance is crucial in the optimization process. The revenue cycle is still a mostly manual operation, despite many technological advances in healthcare.
One way to optimize the data is to search for changes in staff utilization and operating room productivity. In addition to high surgical turnover, a well-managed operating room often results in decreased postoperative complications and enhanced patient-centered outcomes.
By reviewing operating room data and designing methods to maximize the most common delays, groups may make major performance improvements while assessing physician transparency, streamlining processes, strengthening interdisciplinary collaboration, and gathering detailed data.
Software technologies automate critical functions of sales cycle management, such as coding, payer follow-up for claims, and patient statement generation, improving top-line revenue while reducing costly labor costs and the likelihood of human error.
Although optimization of revenue cycle management will promote realistic measures to retain financial stability, leaders of practice should also focus on the future of healthcare-increased consumerism and patients as the new payer.
To protect practice revenue, revenue cycle management optimization can prioritize patient experience while patients handle higher out-of-pocket expenses and expect more from providers' financial knowledge. If Medicare chooses to reduce further reimbursement rates for services typically billed by anesthesiologists, this may be extremely significant.
Patients are finding more convenient, digital ways to communicate and pay medical bills with their providers. Practices should invest in consumer-facing solutions that patients can use to assess expected care costs, pay medical bills, and link providers with questions to thrive in the current landscape.
Through approaching the patient early on with financial expertise, these strategies may also automate and optimize front-end processes. More front-end changes lead to fewer headaches and delays down the road for claims.