Revenue Cycle Presentation CMilburn 2014

Report
Carolyn Milburn, President
214-890-6700
[email protected]
www.milburnpartners.com
Milburn Partners, Inc.
• Our firm was founded in 2001 with offices in Dallas and Houston
• Clients span from the Mid-Atlantic to California, with a focus on
Revenue Cycle, Finance and Accounting, exclusively in healthcare
• We feel our Client and Candidate network is both broad and
deep
• Over half of our current searches require candidates that have
experience in Revenue Cycle
• In 2013, for example, we successfully completed 5 Vice President
of Revenue Cycle searches, in DFW alone, all in a 4 week span
Appointment
Scheduling
Collection
Agency
Patient
Registration
A/R Follow-Up
2nd Claims/
Patient Billing
Patient Exam
What is Revenue Cycle?
The Healthcare Financial
Management Association (HFMA)
defines revenue cycle as "All
administrative and clinical functions
that contribute to the capture,
management, and collection of
patient service revenue."
Resubmission &
Appeals
Service Coding
Charge Entry
Payment
Processing
Claims
Submission
CAREER PATH IN REVENUE CYCLE
Business Degree
HIM Degree/RHIT
RN Degree
Accounting Degree
Bachelor’s of Science
Finance Degree
Clinical Analyst
Financial Analyst
BOD
Mgr. Rev Cycle
Rev Accountant
Access Services
Director
Sr. Director
Vice President
C-Level
Revenue Cycle Management
The Key Stakeholders Include:
VP Revenue Cycle
Director of Business Office
VP Managed Care/Contracting
Director of Patient Financial Services
Director of Patient
Access/Registration
Manager of Revenue Cycle
Director of Professional Billing
Practice Administrator/Office Manager
Director of Revenue Cycle
Revenue Cycle Consultants
Revenue Cycle Analyst
Survey of hospital executives indicates that revenue integrity is the most
important component of the financial health of their organizations.


57 hospital executives polled, 34 were C level
1/3 affiliated with large hospitals and healthcare systems, remainder
split between critical access, community and medium-sized facilities
Among the most important financial priorities:

Receiving proper reimbursement from private payers

Complexity of reimbursement policies from government payers



Ensuring optimal reimbursements for pharmaceuticals and medical
supplies
1/2 of executives added additional staff to address revenue integrity
issues
1/4 established separate revenue integrity departments
National Salary Data
Supervisor/Manager/Director
Patient Financial Services
Education
Percentage
Compensation
Associate's degree
29%
$83,400
Bachelor's degree
Master's degree
37%
28%
$109,800
$116,100
Title
Percentage
Compensation
Supervisor
Manager
5%
28%
small sample
$72,200
Director
67%
$117,300
www.hfma.org
National Salary Data
VP Revenue Cycle
Education
Percentage
Compensation
Bachelor's degree
32%
$237,700
Master's degree
58%
$247,400
Region
Northeast
South
Midwest
Percentage
17%
35%
31%
Compensation
$276,300
$215,700
$229,600
West
16%
small sample
Organization
Percentage
Compensation
Hospital with 521 beds or less
18%
$196,600
Hospital with 559 beds or greater
18%
$268,100
System level, headquarters or regional
62%
$253,100
National Salary Data
Supervisor/Manager/Director
Patient Access
Education
Associate's degree
Bachelor's degree
Master's degree
Percentage
29%
31%
32%
Compensation
$76,700
$100,200
$102,800
Title
Supervisor
Manager
Percentage
6%
34%
Compensation
small sample
$73,800
Director
59%
$108,700
www.hfma.org
Typical Salary for Revenue Cycle Leaders
Practice Administrator/Office Manager
75,000
Revenue Cycle Analyst
75,000
90,000
Manager of Revenue Cycle
Director of Revenue Cycle
95,000
Director of Professional Billing
95,000
100,000
Director of Patient Access/Registration
120,000
Director of Patient Financial Services
130,000
Director of Business Office
150,000
Revenue Cycle Consultants
160,000
VP Managed Care/Contracting
210,000
VP Revenue Cycle
0
50,000
100,000 150,000 200,000 250,000
Milburn Partners’ data based on placements from 2012-Present
ENTRY
MID LEVEL
ADVANCED
MASTER
REVENUE CYCLE
MANAGEMENT
CODING/BILLING
OPERATIONS/
MEDICAL RECORDS
COMPLIANCE/
RISK MANAGEMENT
INFORMATICS/
DATA ANALYSIS
VP Revenue Cycle
VP Coding
Director CBO
Director PFS
Director Managed Care
Director Coding
Chief Learning Officer
Chief Knowledge
Officer
Director HIM
Regional Director HIM
Chief Compliance
Officer
VP Privacy/Security
Director Risk
Management
Chief Clinical Informatics
Officer
Director Clinical
Informatics
Rev Cycle Manager
Reimbursement &
Insurance Manager
CBO Manager
Access Manager
Consultant
Coding Trainer
MPI Manager
Meaningful Use
Specialist
Compliance Auditor
Business Analyst
Privacy Officer
Compliance Officer
Information Security
Officer
Research Development
Specialist
Project Manager
Mapping Specialist
Data Integrity Analyst
Revenue Cycle Analyst
Documentation & Coding
Specialist
HIM Rev Cycle Auditor
Office Administrator
Cancer Registrar
Health Information Tech
Transcriptionist
DRG Validator
Quality Improvement
Analyst
Clinical Informatics
Coordinator
Content Analyst
Clinical Data Analyst
Coder
Benefits Coordinator
Medical Biller
Insurance Claims Clerk
Billing/Collections Clerk
HIM Clerk
Patient Care
Coordinator
Patient Registrar
Customer Service
Can you be an effective leader?
Can you:
•
Formulate your organization's revenue cycle operations
for an uncertain future
•
Use less resources and continue to advance
performance
•
Connect financial data with clinical data
•
Improve the overall value delivered to patients and the
community
•
Think strategically and plan proactively
Working Towards C Level Status
Major changes in the industry are requiring health systems to
rethink and revamp their stratagem. What is required?
 Identify and target patient populations
 Achieve clinical integration across the network, and leverage
data from anywhere and everywhere
 Actionable insight into the financial performance of the group
and the health of the patient population
 Visibility across networks that can be influenced and acted
upon at the initial point of contact with patients
 Manage the networks/patient populations, no matter what the
payment model might be
 Harmonize
data from multiple systems (EHR, practice
management, claims)-turn it into insight which can then become
action directly in an organization’s existing workflows
The Chief Revenue Officer
CROs are accountable for all revenue-related functions - marketing, sales, customer
support, pricing and revenue management.
• Teams up with Executives to create and convey the company’s ideas and
revenue strategies across all relevant functions to ensure the right goals
are defined and met
• Regularly analyzes productivity and effectiveness to create market
positioning and competitive advantages, and determines budget tradeoffs to improve and develop sustainable results
• Recognizes the differences between marketing and sales, and creates
processes to ensure their synchronization across the full revenue cycle get
the best results
• Has a long-term, integrated perspective while striving to drive quarterly
revenue results
The Chief Strategy Officer
The best way to describe the role of a CSO? There is no clearly
defined role.
• Capable of seeing all the pieces on the board and able to see
several moves into the future. (to infinity…and beyond!)
• Some formulate strategy, others execute strategy, others do both.
• Might act as “internal consultants,” or as experts because they have
proficiency in particular areas (revenue cycle management,
managed care-contracting, patient financial services, practice
operations)
• Responsible for understanding how market forces are transforming
and how those changes will affect the services patients will need in
the future.
The Chief Strategy Officer
Revenue Cycle leaders who want to advance to CSOs will
need to be able to:
 Consolidate network revenue cycle and productivity data
 Use analytical tools that display information clearly and
accessibly
 Have actionable insight into patient financial services,
collections, referrals, denials, DAR, etc.
 The ability to easily “slice and dice” data and share
performance results
 Benchmark tracking and performance comparison by
practice, specialty, or geography
Building Your Executive Profile



Consider how these positions are changing, how else you
might be able to align your resume with those changes?
You’ll need years and years worth of learning
experiences from various managerial and director
positions. (don’t get complacent!)
Experience and demonstrable skills are the most
important things that employers look for in C-Level
Executives.
Market Trends
•
•
•
Demand for ancillary healthcare companies and
consultant roles have doubled over the past year
Centralization of processes as consolidations and
reimbursements are cut
Hospital systems are developing mini regional
offices
In Closing…
 Demand for health care, and thus the need for more health care
workers, is expected to keep growing.
 Revenue Cycle roles are the backbone of well run organizations
 Develop plans to recruit and retain the talent that will tackle the
challenges your organizations are facing
 Patiently growing the talent and skills of your team is critical
 Industry consolidation will be a great way to upgrade the
quality of your workers
Salary, Education and Certification
HIM Professionals
Health Information Technology is one of the fastest growing occupations

HIM graduates with an Associate’s earn $35,000 to $45,000 annually

HIM graduates with a Bachelor’s start at $50,000 to $60,000

In 5 years, can potentially earn upwards of $65,000 to $85,000


(RHIAs) often hold managerial positions related to these functions. In a
recent survey, AHIMA found more than half of RHIA respondents were
directors, managers, or consultants, with almost 31 percent serving as HIM
directors.
(RHITs) often specialize in coding diagnoses and procedures in patient
records for reimbursement and research. RHITs may serve as cancer
registrars or hold a supervisory position.
Practice Settings for HIM Professionals
Traditional Settings













Management, HIM (Medical Records)
Tumor registry
Coding
Trauma registry (E.R.)
Transcription
Quality Improvement
Release of Information
Patient Admissions
Compliance Auditor
Physician Accreditation
Utilization Review
Physician offices
Risk Management
Non-Traditional Settings







Consulting firms
Government agencies
Law firms
Insurance companies
Correctional facilities
Extended care facilities
Pharmaceutical Research




Information Technology




Statistician
Clinical Trials Coordinator
Data Manager
System Analyst
Project Manager
Data Manager
Medical Software Companies


Software Designer
Software Tester
Typical Salary for HIM Professionals
32,000
45,000
45,000
52,000
65,000
65,000
80,000
80,000
80,000
85,000
88,000
90,000
100,000
Clerical Support
HIM Technician
Coding Professional
RHIA
Coding Manager
RN
Practice Manager
Privacy Officer
Compliance Officer
Security Officer
Consultant
HIM Director
IT Director
Vice President
140,000
0
50,000
100,000
Milburn Partners’ data based on placements from 2012-Present
150,000

similar documents