Revenue Cycle Optimization: Investing in People and Tech

A large nonprofit health system modernized its processes and technology and invested in leadership development to drive revenue improvement and continue its journey to create an efficient, high-performing revenue cycle organization.

With payor challenges growing, employee burnout increasing, and an operating model shifting to accommodate remote work, a large health system set out to transform its revenue cycle operations to enhance performance, cost, and engagement.

A more efficient, standardized financial model and an operational structure to support the new model were needed to supplant the organization's outdated technology and decentralized revenue cycle environment. Recognizing that revenue cycle leaders would benefit from coaching to effectively lead their people through the change, the division leader sought to provide training and development to elevate the team’s skills.

Huron worked closely with the organization’s revenue operations leadership team to drive net revenue improvements across the health system’s revenue cycle and design a future-state operating model to sustain the transformation and optimize costs.

Core elements of the project included:

Increasing net revenue: In a revenue cycle assessment, Huron identified the opportunity to increase the organization’s recurring net revenue in excess of $48 million. To derive the financial benefit and drive performance improvement, the team implemented front-end workflow technology, process standardization, improved reporting analytics, and a robust accountability structure.

The teams also worked together to develop a comprehensive clinical documentation improvement (CDI) program, which included standardizing processes across facilities and improving coding, yielding an additional financial benefit for the organization.

Modernizing technology solutions: Recognizing that outdated technology was inhibiting efficiency and performance improvements, Huron worked with the health system to transition the organization to a customized revenue management platform. The new technology enabled the teams to create automated workflows to improve staffing efficiency and generate data-driven insights through real-time reporting.

Expanding visibility and accountability: Prior to implementing revenue cycle improvements, a governance structure was developed to ensure that proposed and future design decisions would include input from all impacted stakeholders. The teams customized leading practices to fit the organization’s culture and unique environment, which included establishing a meeting cadence and structure and regular metric reviews to promote accountability and continuous improvement.

Leadership training and development: With significant changes occurring across the organization’s revenue cycle, Huron and the health system identified an opportunity to coordinate leadership development and functional training. Focusing on employee engagement, change management, and effective communication, Huron analyzed leaders’ performance and designed a scalable online development solution with personalized learning paths tailored to leaders’ functional roles. Leadership coaching along with training on new workflows and technology supporting performance improvements were essential to helping leaders increase engagement and influence change.

Designing a future-state revenue cycle operating model: To support the organization’s journey to creating a high-performing revenue cycle, Huron analyzed the health system’s cost structures to design a more efficient, centralized operating model. The proposed model includes a new organizational structure that moves the revenue cycle function under a single accountable leader, enabling cost savings through a more efficient workforce structure and functionality to adapt to industry trends and market changes.