Perspectives on the revenue cycle: insights and resources for revenue-cycle leaders

Healthcare Financial Management, Annual, 2004

The turn of the millennium brought a revolution for healthcare financial professionals: we discovered the revenue cycle.

It wasn't as if we didn't always recognize the complexity of health care and the processes necessary to keep a healthcare organization financially solvent. But significant cost pressures and regulatory challenges facing providers in the past decade forced us to look more closely at those processes-with the result that we began to see them in a new light. We began to envision a greater role for healthcare financial professionals as organizational leaders charged with setting the financial and strategic course for their organizations.

In many ways, the healthcare financial executive's responsibilities have expanded exponentially with the heightened awareness of the organizationwide nature of the revenue cycle. The revenue-cycle leader must find creative ways to ensure that administrative, financial, and clinical areas work in concert with coordinated processes that account for all the expectations and requirements of patients and payers. He or she also must keep fully informed about an increasingly complex body of rules and regulations governing payment and the business of health care. With these broader responsibilities comes the need for a broader skill set and a deeper understanding of all the issues affecting healthcare organizations.

The pages that follow present tips on effective revenue-cycle leadership and management from six of the healthcare industry's leading experts in this area. The diversity of issues addressed by these authorities testifies to the broad scope of responsibilities that revenue-cycle leaders must bear in today's provider organizations.

HFMA Resources

HFMA recognizes your need to keep step with ongoing changes in the financial management of health care, because the proliferation of new ideas, concepts, and approaches can profoundly affect you, both personally and professionally, as well as your organization. To help you excel as a revenue-cycle leader, the Association has developed a broad range of tools and resources that address every phase and element of the revenue cycle, from patient access and registration to payment processing and denials management.

Here is a glance at what HFMA has to offer.

The HFMA web site includes a revenue-cycle resource page, www.hfma.org/resource/revenue_cycle.htm, containing links to a vast array of resources, including HFMA educational events, articles, publications, and e-learning resources, as well as vendor-cosponsored products and services.

The Patient Financial Services (PFS) Forum addresses issues of primary importance to the revenue cycle, including improvements, management, leadership, compliance, billing, collection access, coding, and data standardization (www.hfma.org/forums/pfsindex.htm).

HFMA's annual Revenue Cycle Strategies conference is a three-day educational event providing insight into how to lead, strengthen, and integrate revenue-cycle performance objectives. The next Revenue Cycle Strategies conference will be in October 2004 in Las Vegas, Nev.

PatientAccounts is a six-page newsletter providing feature stories, fast facts, data, quick tips, and interviews on success strategies for revenue-cycle management. The newsletter will adopt a new name in 2004 to reflect the broader interests of today's revenue-cycle leaders. (See page 32 for more information.)

hfm magazine contains articles covering the broad range of issues pertinent to the revenue cycle. Recent articles include "Six Sigma Can Meet Your Revenue-Cycle Needs," by David I. Samuels (November 2003) and "The Revenue Cycle from the Patient's Perspective," by Terry Allison Rappuhn (September 2003).

HFMA's Seminar clusters include the revenue cycle as a key topic area. Clusters in 2004 will be offered in San Antonio; New Orleans; Alexandria, Va.; and San Diego. Topics covered will include chargemaster strategies, denials management, revenue-cycle management strategies, revenue-cycle and supply-chain management, revenue and reimbursement strategies, and patient access. (See page 18 for more information.)

The PATIENT FRIENDLY BILLING[R] project is a nationwide initiative to make financial communications to patients clear, concise, and correct. HFMA leads the initiative in partnership with the American Hospital Association, the Medical Group Management Association, and other leading provider, consulting, and technology organizations (www.patientfriendlybilling.org).

Recorded sessions of HFMA audioteleconferences addressing revenue-cycle issues are available through HFMA's Media Store at www.the-resourcelink.com. (Choose HFMA from the organization list.) Offerings include:

* Diagnostic Testing and Medical Necessity Coding Isn't Just a Managed Care or Compliance Issue: It's Everyone's Issue--November 30, 2003

* Five Steps to Transform Accounts Receivable Management: Seizing the Revenue Opportunity--November 10, 2003

* Developing Key Performance Indicators for the Revenue Cycle--August 6, 2003