5 Changes Influencing Healthcare Reform's Effect on Revenue Cycle Management

Healthcare reform in the United States has been a hot topic for years, and the changes that the US healthcare system is undergoing now (and will undergo in the coming years) are influencing hospitals and practices as much as they are patients.  US citizens and medical organizations have been thrust into a number of debates and reform laws designed to make healthcare more accessible and better-financed, but in the meantime, hospitals are more and more frequently finding themselves in need of a better way to manage revenue and handle medical collections in order to pull together adequate funding.

The following five changes are already starting to have an influence on medical collections and how revenue is managed at medical facilities.

1. A move toward high-deductible health insurance plans.  This means that more people are paying out-of-pocket, and healthcare organizations will need to work even harder at collections before as well as after a patient’s treatment.

2. “Meaningful Use” and penalties for hospitals and practices that don’t adopt EMR.  Electronic medical records systems mean more accurate recordkeeping, and many EMRs and EHRs allow for syncing with a medical billing system for even more accuracy.

3. A general push towards technology.  More and more hospitals and practices are adopting electronic billing and collections systems.  Automation and careful review of old collections reports and revenue cycle management procedures means more collections as well as more patient questions to field.  Hospitals need to be prepared to handle patients with collections issues moving forward in 2012, especially if they’ve implemented a new revenue cycle management program.

4. Medicaid funding cutbacks.  The proposed $700 billion-dollar Medicaid cutbacks mean that providers could end up with a high number of patients without any medical coverage.

5. Accountable care organizations.  These organizations try to make themselves accountable for the quality of care that their patients receive as well as the cost.  The payment system is designed to both reduce cost and improve the quality of medical attention that members receive.  With this type of system, providers are actually responsible for improving healthcare for their patients – and revenue managed is being used to constantly change the system.