Leveraging Analytics in the Revenue Cycle Management Maturity Journey

By Thomas Thatapudi & Matthew Bridge

September 7, 2023

As healthcare organizations progress in navigating the roadmap toward revenue cycle management (RCM) maturity, the effective use of analytics is a key driver of success in the journey to improve operational excellence, achieve greater efficiency, and maximize financial performance. Previous articles in our revenue cycle maturation series have discussed the importance of service delivery capabilities and the pursuit of technology and interoperability within the AGS Health revenue cycle maturity framework. Next, we highlight the significance of analytics in providing valuable insights and actionable intelligence that can transform a revenue cycle from a basic, retrospective reporting system to a strategic decision-making powerhouse.

Effective analytics enable organizations to assess their performance in real time, answering critical questions about the health of their operations, financial metrics, and collections. By leveraging analytics, organizations gain a comprehensive view of their revenue cycle, helping them benchmark performance against peers and world-class organizations to identify areas for improvement. This understanding is crucial in driving decision-making and optimizing operations.

Many healthcare organizations, particularly those in the emerging and foundational stages of revenue cycle maturity, often have limited analytics capabilities, relying on Excel spreadsheets to manage metrics and track performance. While Excel provides retrospective insights, it has limitations. Excel-based analytics lack a unified strategy, leading to fragmented and manually tracked key performance indicators (KPIs). Additionally, entering, organizing, and analyzing data via Excel is a labor-intensive process that can take staff away from spending time on other priorities. Data integrity issues can also occur due to human error and limited data capacity. To overcome these challenges, organizations need to transition from Excel-based analytics to more advanced business intelligence solutions.

Healthcare organizations in the advanced stage invest in analytics tools and processes to gain insights and make data-driven decisions. They leverage automated business intelligence solutions that bring together data from various business units, enabling comprehensive benchmarking and reporting across the organization. With system-wide metric definition and adoption, organizations achieve visibility across the entire revenue cycle workflow, from patient visits to accounts receivable closure. This cohesive story enhances decision-making, improves patient experience, and demonstrates the impact of RCM on overall organizational success.

High-performing organizations have progressive analytics capabilities that enable them to optimize revenue cycle performance, identify trends, and drive continuous improvement with analytics that are integrated, predictive, and prescriptive. High-performing organizations leverage self-service enterprise analytics to drive actionable insights across all populations. Comprehensive benchmarking against industry standards and best-in-class competitors allows organizations to continuously push the needle toward excellence. By adopting predictive analytics and implementing data literacy programs, organizations empower their teams to make data-driven decisions, unleashing the true potential of analytics in driving success.

Assessment framework - analytics layer

Assessment framework analytics layer

Analytics is a critical component in the revenue cycle maturation journey. Without the insights and understanding provided by analytics, the efficiency gains and financial improvements achieved through other means may fall short. Analytics equips organizations with the knowledge to identify bottlenecks, monitor performance against peers, and drive proactive actions. It elevates the revenue cycle from a reactive operation to a proactive, strategic function that maximizes financial outcomes and enhances patient financial experience.

As healthcare organizations strive for revenue cycle maturation, the role of analytics is key to unlocking the full potential of the revenue cycle, providing valuable insights that drive operational excellence and financial success. By leveraging analytics effectively, organizations can move beyond basic reporting, adopt proactive decision-making, and continuously improve their performance. The journey toward revenue cycle maturity is incomplete without a robust analytics strategy, making it an essential investment for organizations committed to achieving sustainable success in healthcare RCM.

A Four Stage Journey Toward RCM Transformation and Maturity

View our webinar, “A Four-Stage Journey Toward RCM Transformation and Maturity,” and watch for the final article in our series that shares practical examples and best practices.

Thomas Thatapudi B&W

Thomas Thatapudi