Department of Health Systems Administration, Georgetown University, Washington, DC, USA.
J Healthc Manag. 2012 Sep-Oct;57(5):325-39; discussion 339-41.
Effective revenue cycle management--from appointment scheduling and patient registration at the front end of the revenue cycle to billing and cash collections at the back end--plays a crucial role in hospitals' efforts to improve their financial performance. Using data for 1,397 bond-issuing, not-for-profit US hospitals for 2000 to 2007, this study analyzed the relationship between hospitals' performance at managing the revenue cycle and their profitability and ability to build equity capital. Hospital-level fixed effects regression analysis was used to model four different measures of profitability and equity capital as functions of two key financial indicators of revenue cycle management--amount of patient revenue and speed of revenue collection. The results indicated that higher amounts of patient revenue in relation to a hospital's assets were associated with statistically significant increases in operating and total profit margins, free cash flow, and equity capital (p < 0.01 for all four models); that is, hospitals that generated more patient revenue per dollar of assets invested reported improved financial performance. Likewise, a statistically significant link existed between lower revenue collection periods and all four indicators of hospital financial performance (p < 0.01 for three models; p < 0.05 for one model). Hospitals that collected faster on their patient revenue reported higher profit margins and larger equity values. For revenue cycle managers, these findings represent good news: Streamlining a hospital's management of the patient revenue cycle can advance the organization's financial viability by improving profitability and enabling equity growth.
有效的收入周期管理——从收入周期前端的预约安排和患者登记到后端的计费和现金收取——在医院提高财务绩效的努力中起着至关重要的作用。本研究使用了 2000 年至 2007 年美国 1397 家发行债券的非营利性医院的数据，分析了医院管理收入周期的绩效与其盈利能力和建立股本能力之间的关系。采用医院层面固定效应回归分析模型，将四种不同的盈利能力和股本衡量指标作为收入周期管理的两个关键财务指标（患者收入总额和收入收取速度）的函数。结果表明，相对于医院资产而言，患者收入的增加与运营和总利润率、自由现金流和股本的显著增加相关（所有四个模型均为 p<0.01）；也就是说，每投资 1 美元产生更多患者收入的医院报告称其财务表现有所改善。同样，在收入收取周期较短的情况下，与医院财务表现的所有四个指标之间存在显著关联（三个模型中 p<0.01；一个模型中 p<0.05）。更快收取患者收入的医院报告称利润率更高，股本价值更大。对于收入周期管理人员来说，这些发现是个好消息：简化医院对患者收入周期的管理可以通过提高盈利能力和促进股本增长来提高组织的财务生存能力。
