In today’s challenging environment, many providers are looking for smart ways to realize cost efficiencies, reduce spending, and address value-based care initiatives. They are also looking for opportunities to work with industry experts who can help them succeed while they focus on patient care. One way agencies can address these issues is through medical billing outsourcing.

According to a recent study by The Market Reports, the global healthcare medical billing outsourcing market is expected to increase at a compound annual growth rate (CAGR) of 11.9% from 2017 to 2023. It notes that outsourced RCM helps providers focus on core tasks by freeing time and resources. It also improves revenue. Additionally, a new Black Book survey states that approximately 80% of hospital leaders were vetting or considering outsourcing their revenue cycle management (RCM) by 2019. In fact, demand for full medical billing outsourcing has increased 86% between 2015 and 2019. While this statistic pertains to acute care, the benefits that hospitals see from outsourcing can also be realized by post-acute providers.

Let’s talk about the benefits of medical billing outsourcing. Why are so many industry leaders considering this solution?

Medical Billing Outsourcing Advantages

Medical billing outsourcing gives home health and hospice agencies the advantage of specialized expertise to manage your full revenue cycle. Not only does this including billing, but also coding, OASIS review, and billing recovery. Providers can focus on care delivery while fully utilizing the RCM vendor’s skillset and expertise. While outsourcing medical billing is often due to a lack of internal resources or skill, it has become a popular way to maximize reimbursement. Outsourcing often reduces administrative overhead expenses, encourages consistent coding and billing practices, improves compliance, and optimizes productivity.

Reduced RCM Costs

“As reimbursements come under pressure and costs keep rising, provider CFOs will face unparalleled pressure over the next year to preserve financial solvency, increase productivities in care delivery, implement regulatory mandates and reduce RCM [revenue cycle management] expenses associated with getting paid,” said Doug Brown, Managing Partner of Black Book. This has led to many home health and hospice agencies looking for cost effective alternatives, including outsourcing their medical billing.

You may be thinking to yourself, “My agency can’t afford to outsource my home health and hospice revenue cycle management!” Medical billing outsourcing can actually be more cost effective. This is achieved through reductions in salary, benefits, training, and overhead.  Increases in revenue from improved collections are also seen. And because specialized RCM vendors have an efficient, productive system in place, they spend less time on coding and billing. Claims are often submitted sooner allowing you get paid more quickly.

Preparation for Value-Based Care

Value-based care models aim to make home health and hospice providers more accountable for the services they provide. They are designed to shift payment models from quantity-based payments to quality-based payments. To transition to value-based reimbursement, agencies must refocus their RCM strategies to include better coding and billing operations.

It can be challenging for agencies to balance the need to provide high quality patient care with solid RCM operations. Working with a third party company helps agencies focus on patient care while leaving their billing and coding to the experts. Additionally, through services like OASIS review, home health agencies can benefit from expert chart reviews for accurate and complete documentation.

Revenue Integrity

Agencies need to be concerned about their revenue integrity. That is, making sure that services are accurately documented in a patient-specific way, are properly coded, are appropriately billed, and that the reimbursements received are correct. Gone are the days where your RCM was strictly transactional. In the era of value-based care, much more care must go into every component of your RCM. This helps you to be compliant and helps your patients get the best care possible.

A medical billing outsourcing company enables you to actively engage in patient care while they take on the burden of RCM. They have the expertise and knowledge needed to submit clean, accurate claims. You won’t have to worry about the risk of denials, underpayments, audits, or takebacks. And because they have extensive experience in addressing problems that could affect your financial health, they quickly overcome obstacles. This helps you get paid more quickly.

Comprehensive Revenue Cycle Insight

According to the market report, RCM analytics is gaining traction because, “Analytics is helping in delivering insightful results and streamlining operations as well as improving patient collections, workflows, and patient care.” The best RCM companies offer robust financial analytics to complement their services. HEALTHCAREfirst, for example, includes real-time financial analytics tools which enable customers to see updates of their Medicare claims data. They can see current trends, including where they are losing money and where they are doing well.

Successful agencies know that outsourced home health and hospice revenue cycle management reduces costs, accelerates reimbursement, and facilitates compliance. If you are interested in learning more about how HEALTHCAREfirst‘s coding and billing services help our customers succeed, please let us know.

The HEALTHCAREfirst Difference

Home health and hospice agencies across the country trust HEALTHCAREfirst to meet their revenue cycle management needs, knowing that while they focus on patient care, we are focused on coding and billing clean claims.

Contact us to learn more.