In the business of healthcare, money is necessary to facilitate the exchange of high-quality goods and services – and administration's goal is to make more of it while minimizing spending. Though your entire team may be mindful of profitability, there are a few individuals within your business whose responsibility dictates they care a bit more than typical about cash flow. These key stakeholders not only sit on the board of directors and make major strategic decisions, but they also put money into the facility and want to maximize their investments, which is why they expect you to present them with information that keeps them tuned into the center's revenue cycle health.
To understand exactly who these people are and what motivates them, you first need to know a little about what makes them unique. Let's break down three types of outpatient centers and the key stakeholders invested in each one.
1) Freestanding Physician/Provider-Owned Facility
In this scenario, the key stakeholders are the providers themselves, often physicians in an ambulatory surgery center (ASC) or physical therapists in a rehabilitation clinic. They're also likely to be board members with a vested financial stake in the center because they put their own money on the line to create it. As an investor, they're 100 percent engaged in how money is coming in and going out. However, as they are also providers, they're responsible for the care and procedures performed in the center, so maintaining their personal and professional reputation is important.
2) Center/Clinic Run by a Management Company
The management company may have financial ownership of the center with a voting seat on the board. Regardless of ownership – full, partial or none – they're highly concerned with revenue cycle management because their job is to maximize profitability. As with a provider-owned facility, they also want to promote the highest level of care, as they rely on meeting quality outcomes for reimbursement, and because a good reputation is important to attract referrals and keep patients.
3) Joint Venture with a Hospital
In this case, which you'll find more often with an ASC, there will be a third entity seated on the board: the hospital representative. That person serves as the eyes, ears and voice of the hospital and acts to represent the hospital's financial interest. So though they may not be personally invested, the money still matters, and they need to see that a partnership is giving them a competitive and financial advantage through things like market expansion and operating efficiency.
How do you approach these stakeholders?
With each type of facility, the stakeholder effect on revenue cycle management directly relates to the amount of their ownership or their voting rights. Regardless of whoever is on the board of directors, they want to know that you have effective processes in place for a healthy revenue cycle while also providing the highest level of care. Managers need to be able to prove this through consistently tracking agreed upon Key Performance Indicators (KPIs), demonstrating good record keeping and reporting transparency. Here are a few tips to do that:
- Proactively keep stakeholders abreast of all monetary information – good or bad. Hiding a bad situation only creates distrust.
- Understand the numbers. Any investor will be concerned with the financial side of the business, so being able to "talk the talk" with them is key.
- Focus on patient engagement and satisfaction. As we move to value-based reimbursement, your reputation for quality care and outcomes will depend on it.
Remember that open communication is key no matter the level of stakeholder investment. As the industry shifts to a value-based model, the exchange of clinical, financial and operational information will be critical to discuss revenue cycle goals and collaboratively develop strategies to achieve them.
How do you present revenue cycle information to your key stakeholders?