Optimizing specialty practice revenue in the midst of changing payer models

Changes in payer models have placed providers at the front lines of efforts to control healthcare costs. Payer initiatives, combined with a sharp increase in patient self-pay, pose significant challenges to provider revenue cycle management (RCM). These changes are impacting virtually everyone in healthcare.

The increasing popularity of high-deductible health plans, where patients pay lower monthly premiums in exchange for higher out of pocket expenses, has made it difficult for patients to meet their financial obligations. Many now face annual deductibles of $2,600 and maximum annual out-of-pocket expenses of $13,100 for family coverage. As a result, bad debt and collection costs are rising – and the chances of collecting payment are reduced by 62 percent once the patient leaves the office. These changes pose significant challenges to a practice’s RCM – and, if not carefully addressed, can threaten the patient-provider relationship.

In this challenging climate, specialty practices need to find new ways to optimize RCM performance and decrease expenses. Following a few RCM best practices will not only help you collect more revenue at the point of service but also help ensure your practice is patient-centric and keeping the needs of your clients front and center.

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e-eligibility, EMR software, Nextech, provider revenue cycle management, RCM, specialty practice


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