Patient Accounting | 5 MIN READ

Unlock Higher Productivity and Improved Collections

Tina Mishol
05/08/2019

What’s the best way to set productivity targets for a back office in terms of revenue cycle management? And how do you motivate staff to reach those goals? Good questions! There’s no one-size-fits-all answer across healthcare provider organizations. But you can’t go wrong if you focus on identifying and rewarding revenue-generating activity.

That’s the key take-away from a discussion with 7 revenue cycle leaders from organizations including Sharp HealthCare, Dignity Health, and University of Colorado Medicine, about how they measure productivity and incentivize the back office to collect more revenue at lower cost.

In this post, I’ll share best practices for establishing a productivity measurement model that’s right for your healthcare organization to unlock higher levels of staff productivity while ensuring quality outcomes.

Focus on results, not activity

Many organizations start with an activity-based goal for productivity, say 40 or 50 transactions a day. But setting an activity goal of “X” amount higher can be traumatic for teams and create tension from groups who claim their work is harder than others.

An even bigger problem with this approach, however, is that you’re focused on the wrong thing. Instead of an arbitrary activity-based goal for productivity, identify tasks as revenue-generating vs. non-revenue-generating and focus on those that support the highest collections.

This requires some legwork to understand which tasks are most meaningful in terms of revenue collection. For example, would you rather have staff collect 30 invoices for $100 each or focus on a single $10,000 invoice? The desired outcome is maximizing collections. Work back from there to assign tasks and goals to your staff, adjusting workflows as needed to prioritize the higher value work.

Gain visibility into your revenue cycle

Identify which outcomes SHOULD impact collections, and then track that activity all the way through to see if the expected outcome is being achieved.

Commonly in healthcare organizations, some steps in the revenue cycle are not visible or not currently tracked. A deep dive into your data can help you tackle this issue. Running reports can pull information out of the system and give you a full picture of your revenue cycle management workflow.

One of the organizations we work with used their data to establish a gold standard workflow, which they now use to measure employee performance.

Automate and streamline workflows

Since your new productivity model isn’t going to reward busywork, get rid of it. Identify easy, repetitive tasks and automate them. Dive into your metrics to look for common trends and identify where you can use automated scripting.

While you’re at it, de-clutter your workflows. Take away tasks that don’t add value. Are staff being given information that doesn’t help them do their jobs? Get that noise out of their work queues.

Wait until you have optimized workflows and automated before adding any more staff.

Account for the difficulty of tasks

All tasks are not created equal. Some tasks truly are more difficult and time-consuming. Your productivity measurement system should recognize this and incentivize accordingly.

How you carry this out depends on how your teams are structured. For example, at academic medical centers that organize by specialty, there may be different expectations for the surgery team compared to the OR or anesthesia teams. At organizations where teams are grouped around tasks, productivity targets might be different for eligibility denials vs. documentation denials.

Another approach is to categorize tasks into three tiers of difficulty and set higher activity targets for easier tasks. It often works better to set productivity standards for related types of tasks.

Measure performance and hold staff accountable

There’s nothing more motivating than being told “This task lives and dies with you.” Make it clear to employees that they are expected to resolve the tasks, not simply move or reassign to another work queue. Measure for completed outcomes, not the number of touches to a task.

Provide team-level and individual-level visibility through reporting, such as sending daily team reports with individual standings. Having leadership share reports and give frequent feedback helps employees stay motivated.

Even better is real-time reporting. Giving employees in-the-moment feedback is a key element of a “gamification” strategy adopted by an innovative healthcare system in San Diego. The company developed a game-like application to monitor performance in revenue cycle management (RCM). Employees and management use it to track RCM performance in real time. Monitors around the office show which team is on top at any given moment.

Reward success and address problems

Employees who hit targets for collection-related (revenue-impacting) activities can be recognized in staff communications or monthly pizza parties. Regular reports and recognition can build friendly competition and a sense of pride and ownership.

To incentivize employees and make work more fun, San Diego’s leading healthcare system is applying components of gameplay (scoring, rewards, competition and rules of play) to its revenue cycle activities. The company sees real-time feedback, recognition and rewards as the most effective methods to motivate employees, especially millennials.

If task outcomes aren’t achieved, this is a signal to management to review training, workflows and technology to understand what their employees need to be successful. Data analytics can help identify troublesome trends, for example denials. Once you identify the root cause, you can address the problem. Read more about how Sharp HealthCare is empowering and engaging staff with gamification.

How are you boosting productivity in RCM? I invite your comments.

Andrea: Do we want to quantify the # of organizations? Possibly list some, such as: ‘Sharp HealthCare and CU Medicine were among the organizations we consulted.’

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