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Strategic Revenue Cycle Management as Ambulatory Volumes Increase

01 Strategic Revenue Cycle Management

Experts predict healthcare outpatient volume will surge soon, with more facilities investing in ambulatory care each year. Studies project an 18% increase in outpatient volume in 2024, reaching 109.5 million by 2033

While skyrocketing demand for outpatient care presents growth opportunities for facilities, it also requires leaders to streamline their healthcare revenue operations — including around patient engagement and payments — so they can make the necessary investments to stand apart from the competition. 

An effective revenue cycle management strategy can help your organization meet these demands. Advanced technologies allow you to focus less on administrative tasks and more on patient care. 

What’s Driving Demand for Outpatient Care?

The demand for ambulatory care services has increased in recent years, likely due to aging populations, technological advancements and a shift in patient preferences. An aging population requires more care, with the population of people 80 or older projected to reach 426 million between now and 2050. Providers must adjust to rise to the challenges. 

Additionally, technological advancements like early detection and minimally invasive care options are shifting services into outpatient settings, including small ambulatory care centers near patient neighborhoods. As a result, ambulatory care is generally more convenient for patients while being less capital-intensive than traditional large hospitals, which can reduce the costs of running your operations.

RCM Challenges and Growth Opportunities for Providers

While ambulatory volume increases can lead to challenges for your RCM team, it also presents chances for technological growth and innovation. When you switch to a centralized platform for payments and other critical administrative tasks, you free up time to focus on patient care and less on the operational challenges of meeting outpatient demands. Below are some concerns and growth opportunities associated with the increased volume of ambulatory care.

  • Operational efficiency: Managing increasing care volumes can strain resources and workflows. However, implementing RCM platforms and technology solutions can streamline your billing processes, reduce errors and optimize revenue collection. Ensuring that RCM solutions are scalable is also a benefit; as ambulatory care centers are added to your system, standing up RCM operations is easier with solutions that scale to meet fluctuations in patient volumes. 
  • Financial stability: Your organization may also struggle to balance the revenue generated from ambulatory care with the costs of providing these services. However, technology-driven solutions can help optimize RCM, saving money by automating your non-clinical tasks, improving accuracy and streamlining reimbursements.
  • Patient engagement: Increased outpatient care demands also open opportunities for improved patient engagement. RCM platforms can help you increase patient satisfaction and loyalty with transparent billing practices and online payment options. From there, you can expand your service offerings and reach more people through ambulatory care facilities.

By capitalizing on growth opportunities through RCM platforms and strategic initiatives, you can manage the increasing volume of ambulatory care services while ensuring financial stability and high-quality care. 

Strategies for Effective Revenue Cycle Management

Outsourcing RCM processes allows you to leverage scale and expertise with innovative tools, software and knowledge. Here are six tactics you can implement for a more effective RCM.

1. Use Technology

The following technologies can significantly enhance your RCM.

  • RCM software: Comprehensive RCM platforms will automate your insurance verification, estimates, billing and payment processes, streamlining your workflow.
  • Electronic health records: Integrating a comprehensive RCM platform with your EHR allows you to capture patient data, document services and offer billing in one place, which can dramatically speed up your team’s coding and billing processes.  
  • Artificial intelligence and machine learning: AI and machine learning-powered systems analyze large volumes of data to find patterns, predict revenue outcomes and collect more patient payments. 

2. Enhance Claims Denial Management 

Proactively managing your claims denials means determining the root causes, taking corrective action and monitoring trends to prevent future problems. You can also adopt digital patient intake technology to improve patient data accuracy, enable precise payment estimation, and verify and update insurance information to reduce denials. 

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3. Improve Patients’ Financial Experience

A choice of flexible digital payment options and a user-friendly payment portal will improve the patient experience and reduce routine administrative work. Payment options might include:

  • Online and mobile payments
  • QR code statements
  • Payment plans
  • Text-to-pay options

Being transparent about billing prices and providing costs upfront can promote trust and loyalty among your patients.  

4. Provide Staff Training and Education

Education is a vital component of an effective healthcare revenue cycle strategy. Train all revenue cycle staff members on coding guidelines, compliance regulations and best practices to reduce errors and timely reworks. Cross-department collaboration coordinates your clinical and non-clinical operations, aligning your revenue cycle goals with patient care objectives. 

5. Monitor Key Performance Indicators

To track your RCM performance, you’ll want to establish KPIs for your organization, such as days in accounts receivable or collection rate. Having insight into your facility’s big-picture view can inform decisions and growth areas. Use data and analytics to optimize your revenue cycle performance, meet outpatient demand and maintain a solid cash flow. 

6. Leverage External Partnerships 

While efficient RCM is critical to your facility’s operation and finances, it can be daunting, especially for smaller organizations. Partnering with an experienced RCM provider can be the ideal solution amid staffing shortages and increased demand for ambulatory care. These experts understand healthcare is ever-changing, and they have the technology and resources to optimize your RCM so you have more time to spend with patients. 

An end-to-end digital platform can help your facility grow alongside industry changes. A unified solution, that offers the right balance of technology, services, and intelligence, will reduce the burden of billing and administrative tasks on your staff while improving financial results and boosting patient engagement and satisfaction. 

Partner With Millennia to Optimize Ambulatory Care Revenue 

While increased demand can create challenges for the administrative functions of your organization, it doesn’t have to. Millennia’s solution can help you grow in this changing industry. Our technology and digital tools help streamline critical RCM tasks, improving your workflow and patient revenue. Use a centralized platform to manage insurance verification, payment processing and analytics so you have time for other initiatives. 

Request a consultation to see how our digital solution can support your organization’s growth. 

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