Can the EHR system do everything? 3 stats to consider in revenue cycle management strategy

Just how much an EHR system can do became quite clear when Becker’s Hospital Review asked CIOs to discuss their most exciting EHR projects. From enabling massive COVID vaccination clinics, to automating more paperwork processes to increase bedside time with patients, CIOs and their teams provisioned EHR systems to do pretty incredible things in a quick span.

To that end, building on and continuing to optimize EHR strategies are big priorities for CIOs through the rest of 2022. In Stoltenberg Consulting Inc.’s annual Health IT Industry Outlook Survey, CIOs identified “getting the most out of existing IT purchases, like the EHR system” as the biggest financial goal for the year, followed by maximizing value-based care reimbursement, improving and sustaining the speed and accuracy of financial reporting, and reducing claims denials and speeding up patient payments.

Each year, the CIO mandate to push their EHR system to do more becomes both harder and more critical because of the many complex pressures surrounding the healthcare industry. Revenue cycle management is one area where this is certainly true.

But can the EHR system do everything? And, perhaps more importantly, should IT be expected to make it do everything?

We had this question in mind as we looked at some of the results of a study we commissioned with Forrester Research. In our Total Economic Impact report, completed earlier this year, we wanted to see how customers benefited from using our software. But it also gave us some insight on how the EHR system can be optimized.

The common denominator across the four health organizations surveyed was that prior to implementing Flywire, each used their electronic health record (EHR) systems in conjunction with an assortment of homegrown self-payment modules and manual business processes to bill and collect patients’ post-service outstanding balances. The revenue cycle leaders interviewed said these systems were not as effective as they could be in collecting payments owed. How did they know? Patients would call to pay bills instead of paying online. Patients complained of getting multiple bills for a single visit, and rarely understood the amount paid by insurance and what balance remained for them. And patient call volumes were high, and patient satisfaction scores were low.

The data below makes the case for considering how best-of-breed revenue cycle management software fits into EHR optimization plans. The numbers are specific to Flywire, but provide guidance in what metrics can be considered.

  1. Bad debt write-off reduced from 5.5% of net present revenue to 4%

    In 2020, hospitals in AHA’s annual survey provided $42.67 billion in uncompensated care – the sum of the hospital’s bad debt (care it expected payment for but never got) and financial assistance (which includes care it never expected payment for). Over the past 10 years, hospitals have delivered $745 billion in uncompensated care.

    Those surveyed as part of our TEI report said that they reduced bad-debt write-off, and that translated into a 29% increase in collections. Having more ways to reach a patient to notify them about bills – as well as the ability to design payment plans that fit best with their financial realities – helps increase self-pay in the face of falling insurance reimbursements. One vice president of revenue cycle management said in our TEI report that patients are twice as likely to pay a bill, twice as likely to return for service and five times as likely to refer the hospital to a friend.

  2. $310,911 saved in paper billing present value over three years

    An average paper bill cost 80 cents. When you consider one estimate that a typical 500-bed hospital will produce about 35 million pages a year – that’s quite a lot.

    After implementing Flywire digital payment capabilities, the composite organization witnessed 10% of its Balance After Insurance (BAI) and self-pay populations individually shift from paper bills to digital payment plans. With 10% more calling into call centers and accepting aided digital payment plans, the amount of paper statements mailed was reduced by 20% – a good thing when many factors are coming together that may contribute to prolonged shortages of paper itself.

    Paper isn’t just costly when it comes to bills. By one estimate, some 75% of providers use paper and manual processes for collections, and 82% issue refunds via paper check. An IDC study showed that incompatibility between systems was a major reason for paper use.

  3. Patient calls drop, 30% of staff reallocated to other tasks

    Your healthcare organization may have several instances or even different systems altogether for managing accounts receivables. One of the benefits pointed to by CIOs is bringing together the data from these different systems into a single portal. Before Flywire, interviewees spoke of using printouts from EMR systems that just showed the total owed, and expected patients to call into call centers and pay. In some scenarios, the same organizations had multiple EMR systems and patients couldn’t understand the bills.

    “Something that we never struggle with is the lack of people to call. Before, we couldn’t get to all our phone calls. We could only load so many calls in the phone system per day, and between certain hours. With these saved FTE hours, we can now get to more patients,” one interviewee said.

    When bills are hard to understand, patients can spend as much as 40 minutes on the phone – tacked on to 20 minutes spent waiting to get a person on the phone in the first place. And when bills are easier to understand, patients pay them faster. Data supports this: 74% would switch providers for a better payment experience.

    With a single view of data from multiple A/R systems, providers can design payment plans and push bills to customers over integrated digital channels – including online, email and text.

A less quantifiable stat is the impact on your people. Limited IT bandwidth is real. In finding the expertise needed to configure and customize the EHR system, you’re competing against a white hot industry and a limited pool of people with specialized EHR knowledge. In IT as a whole, the demand for software developers is projected to grow 22% by 2030, according to the Bureau of Labor Statistics, and is among the occupations with the most job growth. For hospital CIOs, staffing is a major challenge, Becker’s Health IT recently reported, as they compete with other industries for top IT talent.

If you’re thinking about how to optimize your EHR system when it comes to revenue cycle management, get a complete look at Flywire’s TEI report here.