Top 5 RCM Challenges for Healthcare Executives in the COVID-19 Era and Beyond

Brian Robertson, CEO at  VisiQuate , There have been many memorable “where were you?” events since the 21 st century began. But few can match the COVID-19 pandemic, at least from a healthcare perspective. 

The effect on healthcare (and healthcare executives) has been particularly profound since our industry is in the center of everything. From the search for personal protective equipment (PPE) to setting up secure wings and field hospitals to instantly redeploying nurses from other floors to the emergency department (ED), the changes have been profound. 

Yet it’s not just the front-line care areas that have experienced these challenges. They’ve also extended to the core operational functions, such as revenue cycle management (RCM) and business intelligence. 

If there is a silver lining to all the trauma it’s that the pandemic has turned up the volume on the need to remove administrative waste and long-held assumptions. Many in healthcare have been far too comfortable for far too long saying “healthcare is 10 years behind other industries” in terms of business and operational technology. The pandemic has shown us the folly of that sentiment. 

We have the opportunity now to take what we have learned and are constantly discovering and apply it to make hospitals and health systems data-driven paragons of efficient operations. Here are five RCM challenges healthcare executives are currently facing and how the industry can improve on them moving forward. 

1. Allowing some employees to work from home

Prior to the COVID-19 pandemic, work from home was mildly embraced by some and driven more by increasingly expensive and/or unavailable office space.  Many hospital and health system executives believed that RCM personnel were best managed and supported when together in the same building or campus as their managers. As such, few had plans in place to enable a real work-from-home option. 

Then came the pandemic, and the options became A) allow work from home or B) cease RCM activities until the clinical side sounded the “all clear.” 

While there were certainly challenges on the mechanical side, many healthcare organizations quickly discovered that their RCM staff was capable of performing most of their duties effectively while at home.   

As they consider continuing work-from-home options, at least for those who want them, healthcare executives will need to be able to measure the productivity and effectiveness of their RCM staffs. This means they will need to get very good at workforce performance analytics. 

The best analytics will be about performance versus activity and will enable them to gain an auditable, objective measure of the value-based performance of each employee and the department as a whole. They will then be able to set incentives and take a more practical look at workloads and what people can do. For example,...