Depending on the response, your rural hospital may be suffering from an ineffective revenue cycle management strategy. If that's not the case, there is a severe breakdown in your revenue cycle. Typically, rural hospitals or any hospital for that matter should have GDRO in the 30s or better.
One-third of all rural hospitals operate at a loss and/or risking closure. That's scary!
Rural hospitals provide access to healthcare to 62 million Americans living rural and remote communities across the country. If one rural or critical access hospital closes, it puts the health of an entire community at risk.
Staggering financial challenges are not unique to rural hospitals but maintaining an effective revenue cycle management strategy to track, analyze, and improve profitability can be.
According to the NHRP, "The effectiveness of a hospital’s revenue cycle drives the entire hospital operation because the cycle is the source of the resources needed to maintain a successful facility." Implementing an effective revenue cycle management strategy guarantees that a rural hospital will have the resources to maintain profitability.
A successful RCM strategy for rural hospitals should include:
- Measurable ROI
The old adage "What gets measured, gets improved," it's just as true in healthcare revenue cycle management. For example, you could measure the percentage of clean claims. You should see patterns arise, find ways to improve your process to decrease the days between services rendered and getting paid.
- Improvements GDRO
By focusing on lowering your Gross Days Revenue Outstanding (GDRO) cash flow will improve, giving you the predictable revenue your rural or critical hospital needs.
- Reducing operational costs
Staffing for denials fundamentally increases costs and reduces revenue. Changing from the status quo midset to one of continuous process improvement will decrease your operational costs, allowing your rural hospital to run more efficiently.
- Denial elimination
Rural hospitals who practice denial elimination are more effective at managing a successful revenue cycle. Every denied claim costs a rural hospital $25. Denial reporting is time-consuming, wastes valuable resources and doesn't fix the problem that caused the denial in the first place. Preventing denials through tracking trends and patterns is the only way to ensure your claims get paid fast.