Healthcare leaders should re-envision the revenue cycle as a driver of value

The way we frame our professional roles can make all the difference in how we fulfill them.

I was reminded of that recently when I read an interview in the May issue of Leadership with Brian Unell, Piedmont Healthcare’s vice president of revenue cycle transformation and integration and a presenter at HFMA’s 2019 Annual Conference. Unell prefaced a discussion of Piedmont’s consumer-focused revenue cycle initiatives by saying, “I see revenue cycle as a strategic, value-added function, not a cost-focused transactional function.”

From B2B to B2C

Unell’s perception of revenue cycle reflects an important shift in mindset that is only starting to spread throughout healthcare circles. In the B2B era, revenue cycle was basically a series of transactions between providers and health plans. But times have changed.

With higher deductibles and increased cost sharing, patients are responsible for paying more of their own healthcare expenses. And the calls for increased price transparency are unending. The business practices that providers and health plans had developed for conducting transactions with each other have little relevance to interactions with patients and members in their roles as consumers.

Cost center vs. value driver

When revenue cycle is viewed as a cost center, management decisions understandably revolve around minimizing operating costs. But that’s the wrong framework for an era of consumerism, when interactions with revenue cycle staff can affect not only revenue but also the patient’s attitude toward the provider and toward healthcare in general.

When revenue cycle is viewed as a value-added function, it empowers leaders to:

• Think creatively about ways that revenue cycle can add value. (Piedmont, HFMA’s MAP Award winners and HFMA’s Patient Financial Communications Best Practices Adopters are all doing that.)
• Engage with revenue cycle customers — i.e., patients.
• Elevate revenue cycle roles by providing training and opportunities for career advancement.

Tangible and intangible returns on investment

There is a dollar ROI to this — for example, Piedmont Healthcare is ahead of schedule in its goal to increase patient collections by $10 million over a three-year period.

But there also are other, more intangible ROIs. For one, there is a return on patient satisfaction. Within a health system, the revenue cycle team is typically both the first and last team that patients encounter in an episode of care. Revenue cycle interactions stay with patients.

Additionally, there is a return on employee satisfaction. Revenue cycle team members should feel proud of their contributions to patient satisfaction and the patient experience, in addition to their contributions to the financial health of the organization.

A seat at the table

Creating a vision of where a team is going and how it’s going to get there is an important leadership role. Revenue cycle leaders are redefining their visions for their teams. Meanwhile, healthcare leaders outside the revenue cycle can benefit from understanding the value that revenue cycle brings to the organization and viewing revenue cycle leaders as full partners in organizational leadership.

Consider this: Consumer experience is high on the strategy agenda of virtually every health system these days and typically falls under the purview of a C-suite representative. But the revenue cycle experience often is not included in consumer experience, as defined by the organization. 

If a consumer experience is wonderful from a care perspective, but the registration, communication, billing and collection processes are full of hassles or hard to understand, that could negate positive perceptions of everything else. So why wouldn’t revenue cycle be on a par with clinical care when it comes to efforts to improve the consumer experience?

Revenue cycle — it’s not just about transactions anymore.