- ORLANDO - With over 40,000 healthcare stakeholders milling around Orlando’s Orange County Convention Center for HIMSS17, big and small vendors were eager to show off the latest and greatest products in healthcare revenue cycle management.
Revenue cycle management solutions and demos at HIMSS17 responded to a changing healthcare landscape. Healthcare organizations sought a range of solutions to manage value-based reimbursement models attempting to overshadow fee-for-service and the prevalence of healthcare consumerism as high-deductible health plan enrollment increases.
From claims management to patient collections, selecting a healthcare revenue cycle management solution may not be as straightforward as installing one system. But most launches and demos at HIMSS17 presented providers with solutions that targeted certain aspects of the cycle.
Here is a look at some of the healthcare revenue cycle management solution launches and news coming from the latest HIMSS conference.
Zirmed announces 2 RCM products for claims reimbursement maximization
The Kentucky-based healthcare revenue cycle management vendor, Zirmed, announced on the first full day of the conference that it plans to expand its Charging Integrity product. Through the solution, healthcare organizations engage with a predictive analytics system to explore the charging practices of facilities and employed providers in their system.
The solution will now be able to “integrate professional charges to uncover coding and charging discrepancies between hospital and professional billing,” according to Zirmed.
The vendor also made its mark at HIMSS17 after announcing their payer contract management solution a day later. The cloud-based solution aims to help healthcare organizations to develop and maintain government and private payer contracts to ensure that claims reimbursement revenue is being maximized.
Using the product, healthcare organizations will also be able to analyze “what-if” scenarios to better evaluate payer contracts. Zirmed intends for the function to allow healthcare organizations to optimize future payer contracts through better insight into existing arrangements.
Recondo uses APIs to optimize healthcare revenue cycle management
HIMSS17 attendees had the opportunity to demo Recondo’s new application program interfaces (APIs) that target revenue cycle management data. The company designed the suite of APIs to get payer information into the hands of healthcare organizations without having to use multiple health IT systems or analyzing incomplete payer data.
Recondo explained that the payer data presented through the APIs could help healthcare organizations to update existing workflows for patient eligibility checks, medical necessity verifications, prior authorizations, and pre-service patient collections.
The revenue cycle management solution aims to prevent revenue leakage by aligning workflows with payer requirements for claims reimbursement. The company also designed the product to boost patient collections by getting financial information to the healthcare organization earlier.
Change Healthcare showcases patient-friendly collection solutions
At the HIMSS17 Interoperability Showcase, Change Healthcare offered a scenario in which healthcare organizations can use data analytics and health IT to improve the patient collections experience.
With healthcare consumerism becoming more prominent, the company aimed to show healthcare organization leaders how existing and future health IT solutions can better engage patients not only with their care delivery, but with their patient financial responsibility.
"Our financial responsibility as consumers of healthcare continues to rise, and the industry must overcome the many obstacles to engage consumers in health and financial decision making," stated Ian Ellis, Change Healthcare’s Senior Vice President of Strategic Marketing.
The company highlighted its data analytics solutions centered on healthcare consumerism as well as its consulting services.
McKesson launches financial, patient collections tools for RCM success
The California-based health IT solutions company, McKesson, announced several new revenue cycle management products at HIMSS17, ranging from financial, clinical, and payment products.
With about 60 percent of healthcare payments anticipated to come from a mix of value-based reimbursement structures in the next five years, according to a 2016 McKesson survey, the company wanted to design tools to help providers manage the transition.
“We can’t continue to look at revenue cycle management the same old way in an industry rapidly moving to value,” stated Rod O’Reilly, President of McKesson Health Solutions. “For example, providers cite a lack of analytics as a reason they don’t meet value-based program objectives up to 78% of the time, which is not sustainable.”
“That’s why we’re investing in a reinvention of revenue cycle management, from financial and clinical clearance to payment integrity and analytics.”
At the conference, McKesson launched the Healthy Hospital program, which provides healthcare organizations with analytical tools to benchmark their revenue cycle, as well as a payment assurance consulting program that focuses on using data to develop value-based reimbursement strategies.
The company also previewed two other solutions, including a financial clearance tool that helps revenue cycle management staff manage patient collections with data and a clinical clearance tool that aims to make medical record reviews more efficient.
RICOH brings together healthcare operations and patient experience
Many HIMSS17 attendees stopped by the RICOH booth to view the company’s new administrative product that aims to streamline the revenue cycle management process
The Pennsylvania-based company intended to help healthcare organizations bring the many aspects of revenue cycle management under one system. From patient registration, billing, and claims reimbursement, the new solution aims to unify the processes by allowing data to move from one department to another.
“Healthcare is a remarkably complex industry, which means it takes a lot of attentive and efficient handling of information to make sure administrative processes work as intended,” said Ron Nielson, Healthcare RICOH’s Vice President. “Getting information where it needs to be, when it needs to be there can prove challenging; when important information is difficult to access, it makes life difficult for patients, physicians and administrators alike.”