Amidst Regulatory and Compliance Shifts, Proactive Approaches Lead to Long-Term Dividends and Enhanced Patient Outcomes for Healthcare Organizations

In an era where the U.S. healthcare landscape is rapidly transforming due to evolving legal and economic factors, hospital and healthcare system leaders, particularly CEOs and CFOs, find themselves at a crucial juncture. The imperative is clear: adapt swiftly to safeguard and enhance your organization’s financial health. LBMC, a premier accounting and business consulting firm nationally recognized for its expertise, offers guidance for hospitals and healthcare systems. By fortifying revenue cycle services and staying ahead of the curve in regulatory, compliance, and AI advancements, leaders can not only navigate these changes successfully, but also set the stage for substantial long-term benefits. These strategic moves are more than financial decisions; they are key to driving superior patient outcomes and positioning your organization at the forefront of healthcare excellence.

“Given the complex payor environment and ever-evolving regulatory and compliance landscape, leaders of health care systems should proactively review their revenue cycle management strategies,” advises Lane Jackson, shareholder and practice leader of LBMC’s revenue cycle service line. “Working with a revenue cycle expert will help healthcare providers protect their long-term solvency, ultimately supporting what they do best, taking care of patients.”

Here are four ways revenue cycle management services can help healthcare organizations improve performance and stay in compliance.

4 Ways Revenue Cycle Management Services Help Healthcare Companies

1. Improve Revenue Cycle Operations

As most providers and healthcare systems have razor thin margins, a disruption to the revenue cycle can be problematic. Revenue cycle management services help these organizations enhance each aspect of the revenue cycle by improving people (organizational structure and resource allocation), processes, and technologies. These experts can also help organizations get their revenue cycle in order. This becomes extremely important during the normal course of business or before potential transactions whether on the buy or sell side. By assisting in maximizing EBITDA prior to transactions, they can ensure that products have been appropriately valued and also identify any compliance or regulatory concerns.

2. Streamline System Implementations and Optimize Processes

As healthcare leaders already have a large span of responsibility, layering on an EMR, billing platform, claims vendor, or eligibility tool implementation to their day job is a constraint on their already full plates. Revenue cycle experts can off-load that burden while helping ensure effective and efficient implementations. Additionally, in more complex scenarios such as integrating newly acquired entities, advisory support from a team that has deep technical expertise and experience is critical.

“Having an experienced implementation partner can help drive organizations’ ability to adopt new technologies,” advises Matt Wallace, Director at LBMC’s Healthcare Advisory Services. “Project management along with operational and financial guidance from a trusted advisor that serves as the liaison between implementors and operators is crucial to keeping technology implementations on time, on budget and with defined and measured success outcomes.”

3. Address Staffing Issues

Revenue cycle services can also help providers and healthcare systems balance the ongoing challenge of staffing. Retention is a chronic issue across the industry, primarily in the clinical space with nursing shortages at the forefront. Providers are compensating by reducing overall bed space capacity or other ancillary services. A revenue cycle team can ease some of that burden by providing interim leadership and resource support.

4. Navigate Artificial Intelligence

While no industry is immune to the impact of artificial intelligence, AI is of particular significance to the healthcare industry. Not surprisingly, most healthcare organizations are beginning to consider the impact of AI – both in the short and long term. A revenue cycle team of experts can help address questions such as how AI should be used, the governance and controls needed, the primary risk areas, and how much to invest in these tools.

As healthcare organizations navigate challenges such as misaligned incentives between payors/providers, reporting and incentive-based relationship reliance, consolidation pressures, and traditional budget and performance expectations, a healthy revenue cycle can be elusive. Working with an expert that fills the holes and provides the full range of advisory services can make the difference. By choosing a consultant that has the breadth of expertise – including transaction advisory services, operational/financial/compliance due diligence, tax, business intelligence, healthcare consulting and revenue cycle services – is key to a robust revenue cycle for these organizations.

To learn more about navigating the challenging healthcare landscape, contact Lane Jackson, lane.jackson@lbmcstage2.webservice.team or Matt Wallace, matt.wallace@lbmcstage2.webservice.team.

About LBMC

LBMC is a 2023 Forbes Best Tax and Accounting Firm, one of the Southeast’s largest accounting and business consulting firms, and an Accounting Today Top Firm in the Nation serving approximately 11,000 clients with diverse needs across a spectrum of industries. Primary client groups include privately-owned middle market companies in the healthcare, manufacturing, technology, and private equity space. LBMC has more than 900 team members, with offices in Nashville, Chattanooga, and Knoxville, Tennessee; Louisville, Kentucky; and Charlotte, North Carolina. A four-time national certified Great Place to Work, LBMC was also named 2023 Best Workplace in Consulting & Professional Services. Founded in 1984 as a traditional accounting firm, LBMC today is an industry leader in financial, human resources, technology, cybersecurity, and wealth advisory services for businesses and individuals. For more information on LBMC’s experts and comprehensive services, visit our website or call 615.377.4600. LBMC is growing, and job opportunities can be found on our careers page.