The landscape of health care revenue cycle is changing rapidly. As the regulatory climate changes through Medicare Access and CHIP Reauthorization Act (MACRA) and ICD-10, providers are increasingly looking to shift risk models and revenue cycle management (RCM) to trusted third-party vendors.
"It's often a capacity issue for our clients; Managing reimbursement on top of regulatory changes creates a business challenge," said Caleb Anderson, vice president ambulatory sales at Cerner.
Since 2012, hospital acquisition began popularizing and adding new physicians and clients into existing billing structures increased work-load for office staffs. Facilities of any size may find themselves struggling to keep updated on industry practices.
“There was a concern that facilities and clinics wouldn’t be prepared, either from the technology perspective or from the staffing perspective, to be trained adequately in regulatory changes,” said Doug Brown, managing partner of Black Book Market Research. “We’re seeing what was once considered a stopgap measure is now being seen as a long-term strategy in terms of being able to address such particulars as losing staff or finding adequate consulting services available to follow through with an end-to-end strategy in business office services.”
Cerner Business Office Services (BOS) is a partnership billing solution that uses Cerner ambulatory and acute practice management solutions to manage many front- and back-office tasks. BOS staff members remotely coordinate administrative functions, including data entry, charge and claims management and client patient statements.
"People tend to think software and technology services when they think of Cerner," said Anderson. "BOS is different from our traditional core. It's more focused on managing the client's business office, and it's one of the fastest growing segments in the industry."
“Of a survey of 200 new medical school graduates starting practices on their own, 100 percent were opting for business office solutions to be out-sourced. They weren’t even considering building an in-house business office staff.” Brown said. “That speaks a lot to the new-wave thinking of physicians wanting to spend their time in direct patient care and not wasting time with business office services.”
“A physician’s job isn’t to worry about revenue cycle,” Brown said. “The answer is to out-source. You know what your margins are going to be, there are a lot of certainties of these services, and as we see more providers looking for an end-to-end solution, we see a lot of competitors scrambling to get those front-end pieces into place. Cerner already has those in place and is addressing these concerns.”
Cerner BOS was ranked first by Black Book Research based on 18 performance indicators. Marks for highest client experience and provider satisfaction helped make Cerner BOS the top end-to-end Physician Revenue Management outsourcing services vendor.
Doug Brown is president and co-founder of the Outsourcing Management Institute. Brown is co-author of The Black Book of Outsourcing: How to Manage the Changes, Challenges, and Opportunities. He has served in senior operations management and executive business development positions in Fortune 500 corporations and startup ventures alike, particularly in the health care and information technology industries.