Revenue Cycle Metrics

Must-Track ASC Metrics and KPIs

 

Monitoring key performance indicators (KPIs) is an invaluable method of ensuring that your ambulatory surgery center (ASC) is protecting its bottom line and is financially healthy. In order to track these ASC metrics, you need to have sufficient analytical tools in place such as a real-time management console and software that creates customized reports.

There are numerous ASC metrics and KPIs that can be monitored, but customizing key metrics allows you to better focus on measuring and managing the critical components of your center’s revenue cycle.

Must-track ASC metrics & KPIs to monitor

Days in accounts receivable: AR days gets a lot of attention and for good reason. This ASC metric alerts your business office to the average number of days it takes your center to receive a payment. The industry benchmark is 30 days, but if your AR days start to climb to 35 or 40 days it’s a strong indicator that there may be an issue within the revenue cycle. An increase in AR days could negatively affect your bottom line, so tracking the issue to determine where it’s coming from will help you put a plan of action in place to reduce the number of days in accounts receivable.

Revenue per case: Another ASC metric you want to monitor is revenue per case. This tells you how much reimbursement your ASC is receiving from each case, and you can track trends over time. This metric can also show you how reimbursements change through time in addition to the amount of revenue coming in per case. Analyzing revenue per case can also be broken down further to look at each specialty to see if it’s profitable.

Payer mix: A third ASC metric to analyze is the payer mix. Reviewing the percent of total billed charges to single payer and percent of total revenue from a single payer, provides you with insight on how financially dependent your center is on particular payers. If charges are high but the percent of revenue is low, there might be an issue with non-payments or changes with reimbursements that you should be aware of.

Revenue Cycle Dashboard

The Benefits of Outsourcing RCM: Transparent Measurement and Reporting

 Over the course of March, we are diving deep into four key benefits of outsourcing revenue cycle management (RCM) for ambulatory surgery centers.  Last week, we examined how outsourcing RCM provides ASCs with smart staffing solutions and helps them avoid the need for succession planning. This week, we take a closer look at the importance of transparent measurement and reporting, which provides a greater insight into accounts receivable and collection trends.

With the ever-changing landscape of healthcare, including the fast approaching implementation of ICD-10, it’s imperative that ASCs have solid and transparent means of measurement and reporting to understand how the center is performing, where changes need to made and how to improve the bottom line.

Internally, ASCs may not have the necessary expertise, technology and resources – not to mention time – needed to devote to measurement and reporting. To truly track and trend change, these processes can be outsourced to a firm whose employees possess the training and knowledge needed to analyze the data and make a real difference in the center’s financial performance. Outsourcing RCM makes this entire process more efficient with better end results.

Spending time reviewing reports and analytics provides critical insight. Not only does the data offer valuable feedback for the ASC, but having this information can drive change by reducing AR days and tracking collection rate trends. However, internal employees may only have access to canned reports from which they can pull only generalized data. One of the key benefits of outsourcing revenue cycle management is that the RCM provider can develop customized reports and slice-and-dice the most pertinent information for more specified results.

Expertise with third party reporting software allows the RCM provider to pull these specific reports in order to find the root cause of a problem. For example, outsourcing RCM can allow an ASC to determine exactly when and why AR days began increasing so that the center can take steps to reverse this trend.

A management console is a useful tool for seeing various metrics change in real time. The RCM provider can customize each dashboard to display certain key performances indicators (KPIs) that alert the ASC to how well the center is meeting its bottom line.

Some of the top KPIs that can be included in the management console include:

  • Monitoring AR days
  • Collection rate trends
  • Statement lags
  • Charge lags

For each ASC, the RCM provider can set a range that falls between red, yellow and green stages in order to create a visual representation of when issues arise in real time. In some circumstances, it can be useful to compare specific KPIs to industry benchmarks, but success can also depend on the specific center. An RCM provider can determine when it’s best to judge information against these benchmarks and when it is not.