What does the financial condition of your healthcare organization look like these days? During the pandemic, you invested significantly in people, equipment, and patients with support from government programs to ensure the viability of your organization. Coming out of the pandemic, while the spending continues, are these costs eating up reimbursement at unprecedented rates? Are volumes meeting or exceeding the plan, yet margins continue to suffer? How can you plan for capital expenditures when leading indicators point to retrenching? Even the largest and most sophisticated healthcare companies with resources devoted to accounts receivable (AR) performance tracking likely have opportunities for renewed or refreshed analysis in this area.
The application of tools such as AR cash waterfalls and zero-balance account (ZBA) calculations/analysis can be extremely meaningful and bring valuable insights to all levels of the organization around cash collection opportunities and financial reporting accuracy. To assess your level of sophistication and precision in AR & revenue valuation and analysis, and whether building or enhancing AR cash waterfalls and ZBA calculations could be helpful, the following are some considerations around this critical, risky, and subjective area:
- What might certain data points indicate about revenue cycle operations? Is cash being left on the table?
- Is there an opportunity to review revenue cycle performance and processes?
- Do meaningful revenue cycle KPIs exist? If so, are they tracked, and do cross-functional teams have visibility (including revenue cycle, accounting, managed care/contracting, and operations)?
- Who is paying attention to revenue cycle performance and who owns issues and remediation?
- Are there unusual or surprising discrepancies between what you expect to collect and what's coming in the door?
- How much visibility does everyone have into denial and short pay rates, what is the actual cash impact of these, how much of these are avoidable, and what can you change in the short and long term to get more cash (which you are entitled to) in the door?
- What could certain analyses bring to light around the strength of what's being recognized in the general ledger and financial statements for revenue and AR?
- Does your organization consistently experience higher than expected out of period revenue and AR adjustments, peaks and valleys in physician compensation calculations/accounting, and/or repeated conversations with sponsors, lenders, operations, providers, etc. around "surprise" fluctuations in financials?
- Are revenue and AR adjustments experienced during the financial statement audit, quality of earnings analyses, etc.?
How Do I Get Started?
The Ankura team of healthcare finance and revenue cycle experts can assist in efficiently and effectively building, enhancing, and analyzing data-driven AR & revenue valuation methods and tools. We frequently assist clients in creating or improving upon existing AR cash waterfalls, ZBA calculations, revenue, and AR calculations for accounting, and deploying a variety of analysis tools for leadership, revenue cycle, and others. We partner with our clients to help them manage AR performance across payors/plans, geographies, providers, and case/encounter types. We identify immediate opportunities to increase cash in the door and set up system-driven solutions to enable our clients to be self-sufficient in these areas going forward. We are deeply experienced in working with a variety of hospital and provider group EHRs, patient accounting systems, and data and reporting tools.
The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.
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