For an ambulatory surgery center to be financially healthy, it requires that data, analytics and reporting tools be set in place to monitor the success of certain key performance indicators (KPIs) that allow the center to be in total control of the revenue cycle.
If an ASC does not have visibility of these KPIs via a real-time management console or analytics tools, no one might realize that there is a problem within the revenue cycle, which could ultimately cause significant revenue and timing challenges.
Signs an ASC is not financially healthy
There are a few tell-tale beacons to watch for to determine your center’s financial health:
- A monthly decline in revenue
- A monthly increase in A/R days
If these changes occur, a center must immediately begin to examine the root cause of the issues and formulate a plan of attack to regain consistent performance and overall financial health.
Improving an ASC’s financial health
Ultimately, successful financial health comes down to this: Revenues exceeding expenses. On the cost side, you should examine business office staffing costs to determine if they’re optimized with the right people in the right roles. On the revenue side, you should look at revenue per case as well as the revenue per contract. Each contract should be uploaded into the management information system (MIS), and every revenue cycle specialist should have an intimate understanding of each contract. This ensures that the correct reimbursement is being received.
To begin to understand your center’s financial health status, you can take a proactive first step and complete a business office audit to determine what issues exist, where the issues are and where changes need to occur.
Once you recognize the need to improve your ASC’s financial health, the center has two options: Keep RCM internal or outsource RCM.
To make this decision, it’s best to objectively analyze your center’s capabilities and strategies. If your center has the resources, expertise, technology and performance to not only sustain a healthy revenue cycle but improve upon it, you can implement internal changes. However, if this is not the case, then outsourcing RCM to an organization that’s dedicated to each piece of the revenue cycle may be the best top line and bottom line approach.