Effective Revenue Cycle Strategies for Practice Management Post-pandemic

Which RCM strategies will prove to be the most effective in 2021? Read our Q&A session with revenue management leaders to gain actionable insight that your practice can implement today.

The healthcare industry has without a doubt been adversely affected by the COVID-19 pandemic. From changes in patient volumes to expected costs, operations have been uprooted and unexpected costs have placed financial pressures on practices that no one could have predicted. What actions can practices take to gain resources, alleviate financial stressors and regain momentum? We chatted with revenue cycle management expert Bobette Flagel from TriZetto Provider Solutions about the issues healthcare professionals are facing and discussed ways they can overcome them.


Q: Let’s start with a check-in about the state of the industry. How would you describe the current healthcare landscape as it relates to small and mid-size medical practices?

A: (Bobette Flagel) The pandemic has majorly affected the lives of frontline workers and staff members, and also the day-to-day operations of medical practices. They have seen a decrease in patient volume and staff reductions. There have been many unexpected changes that led to unexpected costs for things like additional protective measures. All of this has caused practitioners to be hyper focused on their revenue.

Q: Would you say the economical toll of the pandemic has trickled down to the healthcare industry?

A: (Bobette) Absolutely. I don’t think any industries were spared, unfortunately. The shutdown in early 2020 caused a downturn in appointments that caused cash flow to decrease. Optometry, for example, was hit hard. Any specialty with services that aren’t conducive to virtual telemedicine appointments definitely suffered. An HFMA survey found that the pandemic had a negative effect on revenue for 86% of providers. Practices are looking to implement cost-cutting measures wherever possible.

Q: Are there simple ways practices can cut costs?

A: (Bobette) In many cases, you can obtain cost savings through vendor consolidation, AR backlog projects and eligibility improvements. The willingness to explore partnerships within the revenue cycle can help keep the wheels of the business turning. Combining this with powerful revenue cycle management solutions will help improve your bottom line and minimize expenses.

Q: Operational issues are also a major factor, correct?

A: (Bobette) Practices are overwhelmed and are looking for ways to alleviate the pain points. The key word of 2020 has been “pivot.” The loss of staff resources is a major issue that physicians are facing. It’s not unique to this industry; the same downsizing issues we’re hearing about on the news are also affecting medical offices. Maybe a small practice had to furlough front desk employees when in-person appointments declined, or perhaps employees had to quit because the household needs (like childcare or virtual learning) were too great.

Q: How can practitioners fill in the gaps?

A: (Bobette) Many practitioners are considering outsourcing. It’s a great option because you know your billing will never lapse when you have dedicated support. A recent survey found that respondents that elected to outsource did not see a major disruption to the revenue cycle processes. Think of it like an a la carte option. If a staff member is temporarily out caring for a sick family member, you’ll have backup. If workers have been furloughed, there simply may not be anyone to do the work. Practices may also be unable to train staff as they once would because of limiting the amount of people they’re allowing in the office at a time. That’s where we at TriZetto Provider Solutions can step in. The nice part is that we have experts on staff that have been doing this for years, long before the pandemic.

Q: What key issues can TPS help alleviate?

A: (Bobette) We’re hearing from a lot of practices that fell behind at some point this year. The office was closed or associates were working from home and did not have access to their software or data systems. Practices need the right partner. Because we work so closely with our clients, we learn the ins and outs of their business. We fit in wherever we can help. We do everything from billing claims to posting payments and really create that stability that so many practices have missed this year.

Q: What can we expect to see in 2021?

A: (Bobette) 25% of those surveyed by HFMA reported that fluctuations in patient volumes was the biggest concern for business continuity. It’s the fear of the unknown, the underlying uncertainty about what 2021 will bring. Many providers I’ve spoken with are just trying to wrap up this year and are trying to navigate this “new normal” as well as possible. No one can really predict what the future will bring so I think it’s important to have a strong contingency plan to prepare for the unpredictable.

Q: What can medical processionals do now to get ahead going into the New Year?

A: (Bobette) Although many are short staffed and are implementing new processes, I would recommend getting everything in order and then plan ahead as much as possible. That includes making sure the right resources and tools are in place to start the year off properly.

To help your practice cut costs, automate processes and improve your bottom line, visit trizettoprovider.com to explore solutions.