James McHugh, Managing Director, Revenue Cycle Business Unit Leader
The rapidly evolving healthcare space is witnessing a quick increase in revenue generation. To ensure consistency in income, healthcare providers have started deploying Revenue Cycle Management (RCM) solutions. An effective RCM system helps reduce the amount of time between providing a service and receiving payment for it by interacting with other health IT systems—EHR and billing systems— as patients move through the care process. As a result of these emerging realities, healthcare providers require more sophisticated tools and reporting systems in RCM to drive better outcomes, reduce costs, and enhance decision making to improve patient care. Irvine, Chicago-based Navigant Consulting, Inc. assists healthcare providers in reducing system inefficiencies and by providing RCM solutions and support services for effective revenue management. “We work with the clients to define support processes that coincide with the operational goals of the health system and develop system configuration updates to ensure the RCM is used to its absolute capabilities,” begins James McHugh, Managing Director, Revenue Cycle Business Unit Leader, Navigant Consulting.
By focusing on operational strategy and functional alignment of technology investments, the company enables clients to develop a roadmap to enhance yield while reducing the cost to collect. “We work with the clients to assess and improve revenue cycle performance through the use of technology investments and business process improvements,” points out McHugh. Clients get a thorough review of their organization design, EHR systems, and resource efficiency with key performance indicator benchmarking. “We provide a comprehensive review of a provider’s current systems, paired with operational interviews that are aimed at identifying technical fixes, optimization priorities, and misalignment with operational expectations.” After road mapping, Navigant allows organizations to effectively manage their revenue cycles through various services including process improvement, EHR support, organizational design, and integrated learning.
We work with clients to assess and improve revenue cycle performance through the use of technology investments and business process improvements
Alongside efficient management of revenue cycles, Navigant develops and implements integrated comprehensive revenue cycle solutions in collaboration with the hospitals. These solutions utilize best practice processes from the company’s METRIX™, a platform that allows clients to turn data into action. The METRIX™ technology platform also allows users to integrate data from disparate sources and aggregate it into one comprehensive data repository. In addition, Navigant’s VitalStats® empowers healthcare providers with the ability to convert extensive, real-time revenue cycle information, physician productivity statistics, and coding data into insightful and actionable business intelligence.
Over the years, the company has assisted a number of firms with its stellar solutions in revenue cycle management. For instance, Athens Regional Health System (ARHS) required evaluating performance improvement initiatives and stabilizing the organization due to internal crises. Navigant introduced VitalStats to ARHS enabling concurrent evaluation of physician coding practices, collections, and volume statistics. “We focused on the performance improvement initiatives that included an immediate income statement improvement of $15M during Year 1; and a stretch goal of $30M per year after Year 1,” explains McHugh.
Navigant recently acquired McKinnis Consulting Services, a firm specializing in revenue cycle assessment, strategy, and optimization assistance for healthcare providers to enhance its end to-end revenue cycle management services. The company will continue to focus on addressing challenges of underleveraged system functionality of HIS platforms. For this, Navigant has created a core group that assists clients with real-time model to charge capture problems after an EHR implementation. “We are developing more content-based solutions for the market-leading HIS platforms to provide our partners the appropriate solution that removes both redundant cost and manual processes,” concludes McHugh.