Colpas Phil
Health Manag Technol. 2013 Jun;34(6):8-11.
If there's one aspect of healthcare that's omnipresent - that is connected in some way to virtually every component of the medical trade - it's the revenue cycle; and vendors' solutions to manage it are as varied as the experts we queried on this topic. The revenue cycle actually touches on nearly everything related to healthcare - from the time a patient books an appointment with a healthcare facility, until the patient and insurance company provide final payments for services rendered to the healthcare provider. Over the past several decades, software programs and computers have replaced ledger books and calculators. And while the goal of revenue cycle management (RCM) remains essentially the same, healthcare reform will make this process infinitely more complex, due to reduced reimbursements and the onset of ICD-10 in October 2014. Additionally, reimbursement will be tied to quality, rather than quantity. According to an Information Week article by Ken Terry, outsourcing of billing and collections continues to grow, "because hospitals and physician groups are not very good at these non-core tasks." Think writers and math: I know a great many writers, including yours truly, who possess truly weak math skills. Granted, both skills involve opposite brain hemispheres - different parts of the brain. But what may be even more important is the fact that math is not generally an integral component of the main function of writing. A similar situation exists in healthcare facilities; just replace writing with providing care for people. A 2012 Black Book Rankings survey states 96 percent of organizations are in the process of acquiring several crucial accountable care organization (ACO) data solutions, including clinical decision support, RCM, health information exchange (HIEs), electronic health records (EHRs), e-prescribing, data center security and storage solutions, business intelligence and care coordination management. So it's clear that RCM will continue to remain a top-of-mind issue as we see how healthcare reform plays out. Here's what our select group of experts had to say about how automation helps to steer the revenue cycle process.
如果说医疗保健领域有一个无所不在的方面——它在某种程度上与医疗行业的几乎每个组成部分都有联系——那就是收入周期；而供应商管理收入周期的解决方案，就如同我们在这个话题上咨询过的专家一样多种多样。收入周期实际上涉及到与医疗保健几乎所有相关的事情——从患者预约医疗设施的那一刻起，直到患者和保险公司为医疗服务提供商提供的服务支付最终款项。在过去几十年里，软件程序和计算机已经取代了账本和计算器。虽然收入周期管理（RCM）的目标本质上仍然相同，但由于报销减少以及2014年10月开始实施的ICD - 10，医疗改革将使这个过程变得无比复杂。此外，报销将与质量而非数量挂钩。根据肯·特里在《信息周刊》上的一篇文章，计费和收款的外包业务持续增长，“因为医院和医生集团在这些非核心任务方面做得不太好”。想想作家和数学：我认识很多作家，包括我自己，他们的数学技能真的很差。诚然，这两种技能涉及大脑的不同半球——大脑的不同部位。但也许更重要的是，数学通常并不是写作主要功能的一个组成部分。医疗保健机构也存在类似的情况；只需将写作替换为为人们提供护理。2012年《黑皮书排名》调查显示，96%的机构正在获取几种关键的 accountable care organization（ACO）数据解决方案，包括临床决策支持、RCM、健康信息交换（HIEs）、电子健康记录（EHRs）电子处方、数据中心安全和存储解决方案、商业智能以及护理协调管理。所以很明显，随着我们看到医疗改革如何展开，RCM将继续是一个首要问题。以下是我们挑选的一组专家对于自动化如何帮助引导收入周期流程的看法。
