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Hospice RCM Challenges: How Your Agency Can Improve Efficiencies and Cash Management

HCHB Visiting Nurse Health System Scalable RCM

At a time of tremendous opportunity for growth, many hospice agencies are caught in a bind. They’re struggling with staff shortages, pandemic challenges, and the prospect of new payment models like VBID. Every change increases the need for back office staffing and training. Billing errors cost money: even a small mistake can delay payment and invite increased regulatory scrutiny.

Agencies need to be proactive now in order to meet the hospice RCM challenges that accompany rapid growth and more diverse payor mix. A recent webinar sponsored by Hospice News and HCHB highlights how HCHB’s RCS team helped Visiting Nurse Health System (VNHS) manage back office operations more efficiently and meet KPI targets.

Growth Opportunity = More Patients, More Payors, & More Measurements

CMS and other payors want to reduce acute care utilization, which presents an opportunity for hospice agencies. A proposed CMS rule will increase hospice payments by 2.3% ($530 million) for FY2022 – but only for those hospices that meet quality reporting requirements. Hospices that fail to meet those targets will face a 2% decrease in payments.

“CMS also said it is committed to addressing consistent and persistent inequities in health outcomes by improving data collection to measure and analyze disparities across programs and policies that apply to the hospice program.”

Agencies need to consider process adjustments and workflow updates that help them meet these new requirements, streamline back office operations, and manage cash flow. Hospice challenges in these areas include:

  • Staffing: The 2021 Hospice Trends Survey listed staffing challenges as the greatest non-COVID-related challenge for 2021. Staffing and retention is more difficult for smaller agencies because they can’t offer comparable salaries and growth opportunities as larger hospice providers.
  • Training: Each regulatory change, new contract, and software update may require additional training and/​or workflow changes. Changes may also highlight internal process deficiencies that need review and modification.
  • Technology: Regulatory and contract changes, workflow updates, quality measurements, etc. all require software configurations. Agencies need to stay on top of this to make sure their process and contract changes are reflected properly in their software programs, so their technology works for them, not against them.
  • Payor relationships: Payor source management has a direct impact on agency cash flow. Agencies must work with CMS, private insurance, and (in some areas) Medicare Advantage plans.
  • Quality measurements: The proposed CMS rule will increase the amount of data reporting for additional quality measurements. Agencies must be ready to support the new digital information reporting requirements.

It’s no wonder that hospice agencies find it hard to grow while balancing cash flow, people, and processes. Small to medium-sized agencies particularly struggle with these hospice RCM challenges. Many find value in outsourcing back office operations to an experienced hospice RCS partner.

Mission vs. Margin: A Hospice RCM Partner Can Help Your Agency Maintain Healthy Growth

A revenue cycle management partner can help you cope with rapid growth and changing payor expectations. When an agency is growing quickly, it’s easy for the operations side to outstrip the billing/​payment side, resulting in cash management problems and falling KPIs. An RCM partner focuses on the ​“margin” part of the business, allowing you and your staff to focus on patient care. With the right partner, many daily worries and hospice RCM challenges fall away, including:

  • Scheduling: It’s hard enough to find and train qualified back office employees, but then you have to juggle schedules, sick leave, and training time. An RCS partner always had a full team ready to go. They’re still part of your team, but not your responsibility.
  • Expert guidance: A full-service revenue cycle partner has dedicated staff to monitor regulatory changes, update processes to reflect changes, and help you meet payor expectations.
  • Analytics: Most hospice RCM challenges revolve around data management. Analytics help you monitor your KPIs and track important benchmarks.
  • Payor Management: RCM suppliers have existing payor relationships, which can help you comply with individual contract requirements and provide clear visibility into what the payor expects.

During the webinar, Roger Hiles, VP of Finance at VHNS described how his agency’s partnership with HCHB helped him manage many of his hospice RCM challenges during a time of industry upheaval and agency transitions: ​“Honestly, it takes so many worries out of my day. Cash flow is at the top of my list all the time, and knowing that there is a really good team behind me is really important to a finance guy. Since moving to HCHB Revenue Cycle Services, we’re a lot more in tune with our KPIs and billing status.”

Watch the webinar to learn more about HCHB’s Revenue Cycle Services helped VNHS leverage technology to successfully meet its KPIs and other metrics.

Tame Your Hospice RCM Challenges with Homecare Homebase’s RCS Team

Hospice management in this evolving healthcare landscape can be tricky – particularly if you’re trying to go it alone. A revenue cycle partner can help transform your hospice RCM challenges into opportunities for success.

Our Payor Source Management module is the backbone of HCHB’s Revenue Cycle Services (RCS). Our experts use it to classify by payor sources, set up workflows that match payor requirements, define revenue codes at the payor level, and more. With billing audits and compliance built into the system, our team can often catch coding or billing errors before payors do.

HCHB RCS is focused on creating relationships. Talk to use about how we can ease your workload, increase productivity, and streamline your billing and payment services. Our success measurements include:

  • 99% first pass clean claim rate
  • 2.5% denial rate
  • Guaranteed new collection rates of 97% for Medicare and 93% for non-Medicare

Contact us today to learn more about how we can help your agency manage your hospice RCM challenges, improve KPI measurements, and handle your back office operations more efficiently.