Top 6 Considerations for Outsourcing vs. Insourcing Revenue Cycle Management

The revenue cycle management (RCM) market is projected to experience a 12 percent uptick in growth through 2021, according to a MicroMarket Monitor report. With this projected growth on the horizon, many ambulatory surgery centers (ASCs) are grappling with the decision to outsource RCM.

While not all ASCs need to outsource revenue cycle management, a pair of primary market forces are impacting the final decision to outsource: Value-based care’s emphasis on improving quality while reducing costs, and the increased complexity that comes with a more accountable organization. As ASC leaders recognize the need to make RCM more transparent and predictable, outsourcing the function may increase cash flow, cut costs and stabilize their centers’ revenue cycle.

The following are reasons a surgery center might decide to outsource RCM:

  1. Expertise. From repealing and replacing the Affordable Care Act to Medicare and Medicaid payment bundling, the revenue cycle landscape is changing at a rapid pace. Ensuring optimal results while keeping up with the latest opportunities related to revenue cycle require specialized expertise. Outsourcing revenue cycle allows ASC leadership to focus on patients.
  2. Best-in-class technology. With tighter margins, and priorities favoring patient care over improved billing resources, ASCs are often not equipped to excel at managing the revenue cycle in-house. By outsourcing, centers can take advantage of economies of scale and gain access to best-in-class technology.
  3. Smart staffing/no succession planning. For ASCs, an experienced billing and coding staff with built-in redundancies is now a necessity. Cutting corners by hiring inexperienced staff can cost an ASC hundreds of thousands of dollars per year, not to mention direct impact on workflow and efficiencies. Outsourced revenue cycle providers have the resources to attract experienced staff because they pay well, provide comprehensive benefits, and situate themselves in desirable locations. In addition, because outsourcing revenue cycle is their specialty, these professionals know how to find and hire the best of the best, and often have a pipeline of qualified applicants.
  4. Transparent reporting. While ASCs often lack the necessary expertise, technology, resources, or time needed to devote to transparent measurement and reporting, outsourcing these processes offers access to the tools and expertise needed to analyze the data and track changes in financial performance. Proficiency with third-party reporting software allows revenue cycle experts to pull specific reports to find the root cause of a problem.
  5. Keep up with rules and regulations. Never has it been so important to stay abreast of healthcare laws and regulations. Centers have competing priorities, and new regulations can fall through the cracks. Outsourced revenue cycle vendors, by the nature of their business, proactively keep tabs on industry laws and regulations.
  6. Save space to enhance revenue. Outsourcing revenue cycle management can create additional physicalspace within a facility, and the extra square footage can be used to enhance value-added aspects of the business. For example, found space could house more testing equipment, enabling services that create revenue.

Considering outsourcing revenue cycle management to improve results? The team at Regent RCM is available to answer questions. Please call (708) 492-0531 today.