Healthcare Revenue Cycle Management, ICD-10, Claims Reimbursement, Medicare, Medicaid

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Why Revenue Cycle Must Evolve with Healthcare

By Elizabeth Snell

Read Part 1 of the RevCycleIntelligence.com St. Luke’s interview.

As healthcare continues to evolve, it only makes sense that providers need to adapt their payment systems. This includes how they get paid, but also, how they handle the billing of their patients. Dr. David Pate, CEO of St. Luke’s Health System, said that the changing healthcare environment is having a huge impact on the way that revenue cycle is managed, and that patients cannot be lost among the shuffle.

According to Pate, healthcare costs are a much bigger issue after the 2008 recession. Essentially, whatever the patient responsibility for paying might be now, it is putting more pressure on the patients than before.

“As companies have responded to escalating healthcare costs, they have shifted more costs to their employees,” Pate explained. “We’ve seen the rise of patient sharing responsibility, oftentimes through a high deductible health plan or some similar arrangement, where patients need to pay a higher deductible than they’ve historically paid.”

Patients in particular are going to be stretched, Pate said, and it means they’re going to have more interaction with their healthcare system because of the higher bill. However, with the iVinci Health options for payment systems, Pate explained that St. Luke’s is working to take off some of that pressure – for all parties involved.

Through the iVinci system, providers can predict when and how patients will pay. Additionally, providers can use forecasting tools in other areas, such as vendor management, reporting and analytic tools to manage revenues. According to Pate, the predictive tool for how patients will pay is especially beneficial, and that it works similar to how credit card companies rate users.

Credit card companies know what an individual’s record of paying is, how likely they are to pay the bill on time and how likely a person is to be overextended or not. St. Luke’s has been able to incorporate some of those elements to healthcare, Pate stated.

It’s helpful because then the provider can create a more individualized payment option. If the scoring system says that a patient always pays his patient portion on time, then where there is a bill out there for him, there is no reason to call him, Pate explained.

“It allows us to focus on those people who have worse scores,” Pate said. “They may need help, we may need to structure payment plans with them, or they might qualify for charity care.”

The patient will also benefit, according to Pate, as he can have more control over how he pays his bills. Through the iVinci system, patients can structure payments over monthly installments and keep their payment information stored in a secure place.

St. Luke’s is also currently working with iVinci to create long-term financing options, Pate explained. If a patient is not able to pay off his bill over the next four months, St. Luke’s will help set up a financing plan, he said.

“Those components give us a way to really change how we handle the revenue cycle in a way that allows us to respond better to the fact that patients bear more personal responsibility today,” Pate said, adding that the trend will likely only continue. That’s why it’s important to solve the problem now.

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