Lean Processes Enhancing Revenue Cycle Management

Claudia Maiorana, Director – Account Management

How many different journeys is your organization taking to get to what you think is a shared destination? People within organizations are frequently travelling different paths – certain they are working towards the same goal, but when asked, that is often not the case. Aligning team members to meet the organization’s most important goals is an active process that requires lean thinking. Sometimes associated with manufacturing, most notably Toyota, lean processes are used across industries, including healthcare, to ensure each step is valuable and optimized, while maximizing resources.

Methodology around focus and process is crucial. We know this from our revenue cycle management (RCM) experience working with a multitude of healthcare organizations, making sure they receive the highest reimbursements allowed in the shortest timeframe possible. A lean process approach places focus on a particular process and maps it out, looking for ways to gain efficiencies and better meet our customers’ needs. This is such a critical factor that lean process improvement is one of the five major elements of Meridian’s Revenue Acceleration Program.

Meridian utilizes the 4 Disciplines of Execution® approach to lean processes by FranklinCovey. The goal is to understand what you can control and then look to improve a key indicator, such as days in A/R. The four disciplines outlined within this method are:

  • Target a Particular Goal – Select and focus on one critical objective for your In this approach, every goal must have a demonstrable measure of X to Y by when. An organization may identify reducing days in A/R by two before September or improving the cash collection rate by five percent in two months as one of these goals.
  • Identify Tasks that Deliver Results – It is said that 20 percent of activities produce 80 percent of results. Discover what those tasks are and track them using weekly measurements. For the examples above, what activities impact your days in A/R and cash collections most, and how do we improve them? Maybe this includes net collection rate, work denials within one day of notice or another factor.
  • Visibly Track Progress – You can’t know where you are headed if you don’t know where you are. Show the progress made in a simple, highly visible display. Make sure it encompasses the main measures and immediately communicate whether or not the team is on target. Keeping the entire team informed of where you stand in meeting goals will keep everyone on the same page and motivate them to move forward.
  • Establish Accountability – In order to succeed, everyone needs to be accountable for the goals set. At Meridian Medical Management, we participate in a quick weekly meeting that highlights successes, analyzes failures, and course-corrects, if necessary. These sessions briefly report on the prior week’s commitments, review and updates the progress made, and then set new targets for the upcoming week.

These steps will help you meet goals that further your organization’s overarching objectives, although sometimes things come up that make it more difficult to devote time to this process. Understand that billing operations, like other roles, always have urgent topics as part of the day job. These will always occur and will need to be handled. It is important, however, that the team have a focus on a goal outside of the daily crisis and devote time to meeting it. This will keep you progressing in the right direction.

Utilizing the 4 Disciplines of Execution is not about just getting the data – it is implemented to create actionable, informational steps. Instead of just addressing the top to denials, for example, identify if any of them are preventable. Fixing the root cause will keep these denials from reappearing in the future and save time in the long-run.

Beginning the process is not easy. It requires you to translate vague strategic intent into a clear, specific formula for improvement. Focusing on the greater goals without being distracted by smaller ones takes discipline. Once completed, however, it will empower the rest of your team to execute better and meet objectives.