Maximizing Your Home Care Agency’s Performance with Revenue Cycle Management

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Home care and I/DD agencies continue to be faced with new challenges – mandated costs that need to be managed, the Electronic Visit Verification (EVV)™ mandate, value-based care and payments, consumer-directed care, provider consolidation, and increased payer diversity, just to name a few. However, if you look at these challenges from a different perspective, they are also all significant opportunities. Developing strategic plans that focus on these challenges and opportunities, and executing them timely and completely, is more critical than ever for home care agency success.

But you also have to continue “minding the store” while you’re out strategizing and executing, and hopefully growing your businesses…all while continuing to provide excellent patient care. You don’t want to get stuck in the day to day, only to learn that you missed the boat!

With the thin margins and ever-increasing costs in your home care business, revenue and cash flow are especially critical. Is your revenue cycle performing at its optimum? Are you billing for all the services that you provide? Are you getting paid as quickly and completely as you should? If your state is transitioning to managed care, are you building the revenue cycle processes to get paid? How much of your agency leadership’s time is spent managing this function? Is this the best use of that time?

From an executive vantage point, you can’t determine if your processes are working correctly unless they’re being measured.  Just like in medical and automotive diagnostics, having key metrics is crucial.  Having the right metrics allows you to leverage your time to maximize efficiency and effectiveness. This is where Revenue Cycle Management can take your home care agency to a new level of growth and efficiency.

There are two approaches Home Care and I/DD agencies can take to Revenue Cycle Management:

a) identify an internal or external resource to pull a large list of metrics together, analyzing them and creating a really comprehensive look at your entire revenue cycle,  or
b) concentrate on a few metrics, identify and address anything that needs attention, and expand from there.

If you opt for (b), pull together these six to start:

  • Revenue vs cash receipts vs cash applied by month for the past 12 months
  • Comparative aging trend by bucket for the past 6 months
  • Days Sales Outstanding by Payer
  • Dollars billed vs collected 120 days after billing
  • Unbilled (held) claims
  • Unverified hours (if using electronic visit verification)

Investigating anomalies in these figures will reveal opportunities for improvement in your revenue cycle. Make changes, then run the numbers again. Ensure that updated figures are reported to you regularly so your organization stays on track. Then expand to new metrics.

Alternately, you can look for a Revenue Management Software that provides revenue cycle outsourcing and support services to home care and I/DD agencies, allowing your management to focus on providing excellent patient care while navigating the opportunities and challenges in our industry. Sandata offers full-service revenue cycle management as well as data collection and process consulting projects that maximize your revenue, cash flow, and operational effectiveness.

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