Business Office Staffing Issues Solved: A Long-Term Solution

According to the results of a recent HFMA survey commissioned by AKASA, one in four healthcare finance leaders reported at least 20+ vacancies within the revenue cycle.

When asked to select those vacancies most in need of staffing, Billing Specialists and Follow-Up staff ranked 2nd and 3rd on the list–topped only by the need for Registrars.

Impact of Staff Shortages on Revenue Cycle

For smaller organizations in particular, these vacancies can have a profound impact on cash flow and cost-to-collect. Moreover, the need to devote additional resources to staff recruitment, training, and retention is placing more stress on an already-strained system.

Over time, the costs of hiring and maintaining staff members in an understaffed department begin to pile up. The hard costs obviously include things like salaries, benefits, space, and equipment. The “soft” costs, however, are harder to identify and quantify.

The following are examples of soft costs:

• Lost productivity resulting from unfilled positions
• Accounts Receivable performance metric volatility 
• Compounded stress on existing team members
• Increased resource & time spend on recruiting/interviewing unqualified candidates

Even after qualified candidates are found, hospitals that lack a formal, structured training process tend to struggle to onboard new staff members and get them to an optimal productivity level. These challenges–coupled with the fact that turnover rates remain high–ensure that business office staffing will continue to be a point of tension for revenue cycle leaders.

Outsourcing Business Office Functions

To disrupt this cycle, some healthcare leaders are ending staffing challenges for good by outsourcing business office functions. “Low onboarding success rates and high turnover are industry-wide problems,” Laura Koziol, Human Resources Director at OS inc., explains. “While revenue cycle management vendors like OS inc. certainly aren’t immune to staffing challenges, we have systems and processes in place that make us experts.”

By working with a business partner that specializes in billing for critical access and rural hospitals, smaller organizations in particular can reduce the amount of time, money, and staff resources spent on recruiting, hiring, training, and maintaining staff. Additionally, clients working with OS inc. experience decreased A/R days and improved business office performance overall.

For example, a critical access hospital in Iowa with net patient revenue of $27 million decided to outsource portions of its business office when maintaining appropriate staffing levels became too much of a challenge. Additionally, the continuous cycle of hiring and training new staff began to negatively impact employee satisfaction, productivity, and results.

The organization now outsources all professional billing and coding and most hospital billing to OS inc. After just four months, the organization’s hospital A/R days decreased from 42 to 38, and professional A/R days decreased from 40 to 31. Additionally, professional collections nearly doubled, hospital collections increased by over $175,000, and the need to hire and retain billers has significantly decreased.