Revenue cycle management (RCM) is a complex, cyclical part of home care operations. A crucial process to perfect in order to maximize your bottom line.
Here are some top trends to keep an eye out for, so that you can stay ahead of the competition—and your revenue.
Here is a preview of what we’ll go over:
Claims management and auditing require a lot of attention to detail and intricate steps that need to be followed. Whether you or someone in your office handles billing, odds are, things will come up and snag your RCM processes along the way, whether it’s the wrong billing code or Medicaid ID number.
With proper best practices in place—and documented—you can utilize artificial intelligence and automation to free up time in your team’s week to focus on other, higher-level priorities.
AI and automation tools can help you:
Predictive analytics and data can help you and your team plan ahead for hospitalizations, client discharges, risks, and help you anticipate how many clients you need to bring on in order to meet and maintain financial goals.
Beyond predictive analytics dashboards, you and your team can work together to create your own, manual dashboard outside of technology systems based on qualitative client and caregiver knowledge. No one knows your clients the way that you do, especially with detailed notes from caregivers during their visits.
With that information in mind, you can build out a whiteboard or an Excel spreadsheet that helps your team to realistically manage expectations on client longevity. Having those numbers and figures in front of you can help inform your marketing efforts and what referral sources are the most fruitful for you.
This helps to not only ensure that your caregivers have consistent hours, but also ensures that your revenue doesn’t deviate too far from your projected financial goals.
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Many key stakeholders inside and outside of the healthcare space are realizing the value and potential of value-based care arrangements. Rather than getting the same rate across the board, your home care agency has the potential to earn more than your competitor if you provide better care and a better quality of life to your clients.
What’s the relevance to your revenue cycle? If your reimbursement rates are contingent upon client outcomes, this places more importance on higher-quality caregiver-client compatibility, satisfaction rates, continuity of care, and more. This gives you the bandwidth to do your job exceptionally well, and it pays off on the backend.
Better care. Better rates. As you evaluate and participate in this model, your team is incentivized to do more, do better, and overall, just do their job well.
One of the biggest, yet modifiable factors impacting agency revenue today is overtime. Labor has been a long-standing issue for home care agencies, and this trend will continue.
As you evaluate your hiring practices and patterns, make sure that you account for how much overtime is eating into your revenue and profit margin. Assign a cap to overtime, and make sure that your team sticks to it.
And, of course, have your team work on an incentivized OT reduction plan to ween workers off of overtime and onto a regular 40-hour schedule (as consistently as possible). Beyond overtime, a few practices that you can incorporate to better manage your home care workforce:
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Every piece of your home care agency’s operations touches revenue in one way or another. By getting each of these pieces of the puzzle together, you can find meaningful ways to maximize your revenue beyond effective claims management. This gives each of your team members an important role in maintaining and safeguarding your bottom line.
If you want to improve your claims process and maximize reimbursements moving forward, let’s talk. CareTime is here to help.