Category: Thought Leadership
August 2 2017
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Sept. 1 will mark a year since I joined Cerner, and what a year it has been. Over the past several months, I’ve had the pleasure of forming relationships across our associate and client base and collecting feedback to ensure we are providing solutions and services that meet the evolving business needs of our clients and the industry we serve. While the very nature of our business requires change and agility, I believe our solutions and services have made tremendous progress in the first half of 2017.

Last December, I announced our plans for 2017 on behalf of more than 3,000 associates that form our revenue cycle management (RCM) organization at Cerner. These plans center around three core advancements: code improvements, advanced associate expertise and an improved delivery infrastructure.

As we press forward into the second half of the year and in the spirit of transparency, I’d like to share the progress we've made so far. It is also important to reinforce our focus areas as we look ahead to 2018.

Preparing for tomorrow, today: revenue cycle management

Most of our clients are now familiar with the term clinically driven revenue cycle, which describes how our integrated solutions and services are designed to bring clinical, financial and operational data together to optimize performance, guide decision-making and reduce costs across acute and ambulatory venues. As we look to the future, our RCM portfolio should not be driven by clinical information alone. Increasing expectations of the patient and our broader population compel us to deliver solutions and services that are consumer- and statistic-driven.

A consumer’s experience begins and ends with the revenue cycle. One could argue that RCM is just as important as the clinical experience to overall consumer satisfaction, given it’s the first and last interaction with a provider. Our strategies focus on innovation to help providers meet consumer expectations so they can better understand and manage their own financial information. For example, recent enhancements in self-service scheduling and walk-in workflows contribute to a better experience at check-in. At the same time, we’re developing new scheduling functionality to help front-end staff and consumers better manage future appointments.

We also understand that access to data on a granular level drives decision-making and efficiency in the revenue cycle. Analytics plays a crucial role in compliance with alternative payment models, which threaten reimbursement if data-driven and evidence-based workflows are not in place. A 1 percent reduction in reimbursement could cost millions of dollars, which most organizations cannot afford to absorb. That’s why we’re committed to embedding analytics and statistically driven workflows within our solutions to present meaningful information that guides care coordination while preventing unnecessary costs.

To deliver results across solution enhancements, our work is motivated by four guiding principles: make decision-making easier, timely and more efficient while leveraging analytics. Ultimately, all of our efforts in RCM roll up to helping our clients increase yield, accelerate cash and decrease costs. We can achieve that together through an integrated experience that is not just clinically driven but designed around the consumer with meaningful, statistical data. Here are some of the results we’re seeing so far.

Code improvements 

Innovation and development continues for both Cerner Millennium® and Cerner Soarian® RCM solutions. Leveraging best practice functionality in both platforms allows us to move faster in developing new enhancements and solutions for the benefit of all our clients.

Earlier this year, clients that use our revenue cycle solutions in either acute or ambulatory care venues had the opportunity to take recent code enhancements designed around the six focus areas below. Additionally, future development efforts revolve around these six areas to enable long-term improvement:

  • Optimize the user experience: Guided scheduling presents a series of questions based on patient data and symptoms to better determine the most appropriate time, frequency and resource allocation for appointment scheduling. Future development includes optimized workflows across patient access designed to reduce clicks and streamline user experience.
  • Financial clearance with Experian Health integration: With Experian Health, near real-time eligibility verification is integrated within a single patient access workflow. Financial clearance checklists present rules-based, encounter-level tracking that shows which tasks need to be completed during registration, reducing the likelihood of claim denials and corrective work downstream. Future development continues to improve Experian Health integration and financial clearance functionality.
  • Patient and consumer engagement: Self-service scheduling enhancements provide additional search options, and walk-in workflows with our patient kiosk enable a simpler check-in process. Future development includes near real-time appointment reminder integration.
  • Contract management: Cerner Soarian contract management engine is now generally available for both Cerner Millennium and Cerner Soarian clients. Future development includes contract modeling in aggregate or by facility to better forecast payments from payers. 
  • Alternative payment models: Ability to link claims together from multiple sources in one submission to bundled payment programs. Future development includes a more automated process for linking claims to improve efficiency, reimbursement calculation through Cerner Contract Management, and incorporation of current and future value-based reimbursement methodologies. 
  • Analytics and reporting: Variety of metrics available, including total cash collections, case mix index, DNFB, total AR days and more, to help RCM leaders manage their business. Future development includes reporting around registration, scheduling, cost accounting, case management, HIM and process intelligence. 

Advanced associate expertise

It is an exciting time for revenue cycle at Cerner. Today, our teams are supporting RCM implementations in acute and ambulatory facilities across the world. That growth requires talent and continuous education. 

Cerner continues to invest in advancing the credibility of our associates. The Cerner Revenue Cycle Certification Program (CRCP) ensures that our RCM associates have a thorough understanding of the entire revenue cycle and the necessary level of solution expertise to help our clients manage successful projects. CRCP is required not only of new RCM hires, but we’re also enrolling our existing associates. The program delivers role-specific education about our industry, the design of our solutions and how they work together, so teams are prepared to guide our clients in making the best solution build and integration decisions for their organizations. All of our RCM associates are also credentialed through the Healthcare Financial Management Association, which helps arm them with the industry insight and knowledge they need to effectively support the financial outcomes of our clients.

To date, more than 400 associates have either graduated or are scheduled to complete the program within the next few months. More than 100 unique client organizations have benefited from CRCP expertise so far. 

Improved delivery infrastructure

We’re solidifying our delivery infrastructure with the Cerner Model Experience, our methodology for providing subject matter expertise and solution best practices and standards to guide implementation, testing, training and communication across our client base. It also serves as a continuous loop through which Cerner adopts lessons learned, client feedback and enhancements to sustain continuous improvement. 

Going forward, our focus is to elevate our recommendations to deliver both system and operational expertise because an implementation is not just an IT project, it’s a cultural transformation. Through the Model Experience, we can help our clients optimize their existing solutions, implement new technology and adopt the necessary training, resourcing and process flow to help them utilize technology to its fullest potential in the management of their business.

Through Cerner RevWorks, the services arm of our RCM portfolio, we provide service offerings that integrate people, process and technology to help improve workflow efficiencies, meet organizational metrics and control the cost to collect. In 2016, RevWorks growth climbed over 130 percent. Black Book ranked Cerner No. 1 for physician practice managed services, No. 3 for standalone hospital managed services (200+ beds) and No. 4 for standalone community hospital managed services (101-200 beds).

RevWorks is comprised of four offerings that support a variety of client business needs across acute and ambulatory venues:

  • Transition services allow clients to focus on winding down legacy AR while we support their Cerner RCM implementation by proactively identifying and preventing potential issues, proposing recommendations and migrating staff to the new system.
  • Targeted projects are flexible and support projects based on client need including shrinking old AR, aging issues, training, resourcing and staffing needs.
  • Business office management engages our RevWorks associates who collaborate and work as an extension of the client's billing department to help them manage billing operations.
  • Full outsourcing enlists a team of dedicated RevWorks associates who fully manage a client's RCM operations, allowing them to solely focus on care delivery.

Regardless of the business need, RevWorks operates on three fundamental principles: a scalable RCM platform through Cerner Millennium or Cerner Soarian, processes that leverage our Model Experience recommendations and a financially bound agreement in which we share accountability for goals and risks with our clients and work together toward improved financial outcomes.

It’s also important to call out that our RevWorks associates operate on Cerner solutions. This gives us deeper insight into how our solutions operate on a daily basis within a client’s environment. More importantly, we can take action to improve or correct specific functionality and always search for innovative ways to solve business problems while advancing our solutions at an accelerated pace.

From adapter to shaper

We’ve made significant progress on our 2017 plan. Still, there is work to do across our three core advancements to deliver an improved RCM experience for our clients that connects clinical, consumer and statistical data within one platform. 

Fortunately, through avenues like the Model Experience and Cerner RevWorks, we collaborate with our clients to meet their needs while continuously improving our solutions and services. This builds a mutual trust and shared goals that nurture a long-term relationship far more meaningful than a simple transaction. When health care organizations need help in the revenue cycle, we want them to think of Cerner.

Cerner is known for being a visionary company that works to anticipate the future of health care. Over the past several years, we’ve moved from reacting to industry changes to managing them. As we prepare for the next era of value-based care, Cerner is focused on moving from an adapter of change to becoming a shaper of the future. Together with our clients and industry partners, we have a tremendous opportunity and responsibility to influence the changes on the horizon to benefit our communities and our industry as a whole.

Jeff Hurst,Sr. Vice President, Revenue Cycle Management and President, RevWorks

Jeff Hurst Sr. Vice President, Revenue Cycle Management and President, RevWorks Cerner

@jhurst_rcm

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