Low Value Medical Care and Revenue Cycle Management

It seems that media outlets are talking more and more about medical debt that patients are piling up. Even as our economy rebounds, the amount of money that people owe hospitals is deep. And as bad as it is to hear that patients are dealing with medical debt, it’s just as bad for hospitals: when you incur a longer-than-normal revenue cycle, it bogs down operations.

Some conducted research has been focused in low value medical care in patients with Medicare. The researchers mostly discussed specific testing and some treatment procedures when referring to low cost care. These studies show that many patients were given tests and treatments that ultimately did not help diagnose or resolve their problems.

In many of these cases, the doctor certainly knows best. However, it’s worth considering the impact that these low value tests and treatments have on revenue cycle management.

  • Consider the Long Term Effects (on your revenue cycle)

Some medicine requires quick thinking. Emergencies happen all the time, and it’s due to quick thinking that patients are able to survive. Other cases, however, don’t require immediate decisions. They can be discussions made with patients and their families.

In these situations, consider the revenue cycle. Consider having a conversation with doctors making orders. Is an MRI going to provide more specific information than an ultrasound already has? Or is it ultimately going to cost the patient more out of pocket, thereby potentially limiting the speed you’re able to close that revenue cycle? It’s not about limiting—and certainly not withholding—care. It’s about ensuring that the patient is receiving the most vital tests and treatments and ensuring that you are able to efficiently get paid. Doctors may not put much thought into the business side of a hospital, but working together is the most effective means of operating on a fiscally sound budget.

  • Help Your Patients Make Informed Decisions

Many patients don’t question what their doctors tell them. They don’t get second opinions, or do any research into their own options. They trust their doctors, which in most cases, is a great thing.

However, that can be counterproductive to patient satisfaction in the long term. New businesses are helping patients shop their medical needs around, and only patients wholly satisfied with the care they received at your hospital will come back. If they are stacked with medical debt—especially on tests they learn they may not have needed—they will be less likely to return for their next medical issue. Retaining patients means a lot in our current healthcare climate, and satisfaction is the number one retainer.

Your patients should have some opportunity to make decisions, or decide on the option they think is right for them. Providing them with information can help them.

  • Be Transparent About Procedures

Most of your patients won’t know how much procedures cost, or what their purposes are. Let them know if there are alternatives to specific tests or procedures, or if a specific test can really help you nail down what the issue is. Most importantly: if there’s a risk the procedure or test won’t do what it’s supposed to, let them know. Transparency can help keep patients happy, and happy patients are more likely to pay their bills on time.

If you have further questions about efficient revenue cycle management and some of your options, contact HCM today.


Categories: Blog