"I have had the privilege of working with HMI for twenty plus years and have always found their representatives to be professional and knowledgeable in all aspects of acute hospital and professional service charge master management. Additionally ongoing coding related reviews and billing reviews and associated report backs are timely and positively impact appropriate revenue capture - billing - and compliance." "I recommend HMI to be considered when choosing a partner to assist with the...
Greg Yost, PFS Director Princeton Community Hospital, Princeton WV
We have utilized HMI Corp. since 2002 for consultation services related to chargemaster review and updates and have always found their services to be professional of nature and valuable to our organization.
David Alley, CFO Athens Regional Medical Center, Athens TN
We recently transitioned to HMI from another Physician Documentation & Coding Compliance Review vendor, and the entire experience has been positive. HMI has been extremely accommodating throughout the process and has demonstrated a willingness to adapt to our workflows, leading to a seamless transition. We’ve received positive feedback from our providers about their experiences with HMI, and the Coding Hotline has been an invaluable resource. For anyone looking for a new consulting partner,...
Dawn Chrismer, RHIT, CHC, CCS-P Director of Business Services/Compliance Officer Heritage Medical Associates, Nashville, TN
HMI has been a very reliable resource for Princeton Community Hospital for many, many years. I have had the opportunity to work with many staff members and have found all to be reliable and courteous in every aspect. The staff is very flexible and provides Princeton Community with the support and coding stability needed. Thank you for the sometime short notices for coding coverage when unexpected situations arise with our staff. We thank you for your coding expertise as well as your...
Denise Moore, CCS Coding Manager Princeton Community Hospital
I’ve worked with HMI employing them to conduct audits of physician documentation and coding. They have consistently produced quality work in a very timely fashion with reports that were well written and easy to understand. Communication has always been prompt and effective. I have such confidence in their work that, over the years, I brought them from my prior location to my current location. I would recommend HMI to anyone in need of accurate and timely coding or auditing.
Robert C. Kay, RRT, MBA, MJ, CHC, CPC-A Chief Compliance Officer St. Christopher\'s Hospital for Children
“I have had the privilege of working with HMI over the past 10+ years with two different health systems. I have used HMI for hospital CDM and compliance reviews as well as physician coding reviews and education. I always receive top-notch service from the HMI team and I appreciate working with a partner that is always honest and responsive to my questions and needs. I have worked with Mary Quimby and Vickie Faler and both have proven to be very knowledgeable, accessible, and...
Rodney Adams, MMCH, Associate Administrator of Finance Williamson Medical Center
HMI has been a great partner with MedStar Washington Hospital Center now for many years. We can always count on them to provide us with support on small to very large projects. HMI delivers consistent and honest results and additionally provides very thoughtful & targeted education to our physicians.
Purvi Jani AVP Reporting and Revenue Cycle MedStar Washington Hospital Center
Having worked in healthcare revenue cycle for more than three decades, I have partnered with many vendors. My vendor of choice for CDM Review, E/M Coding Compliance and Physician Education is without a doubt HMI, LLC. Mary Quimby and Vickie Faler are not only subject matter experts, they are true partners providing that extra level of service that sets them far above others in the industry. I have worked with them for 15+ years in 5 different acute facilities, and multi-specialty physician...
MaryAnn Hastings, CPMA, Director Revenue Cycle Operations, Galen Medical Group
We have been working with HMI since 2010 and have expanded the use of their services to include CDM and ED Coding. The HMI coding staff is extremely knowledgeable and has become an integral part of our coding team. Our consultant Beth never shies away from any CDM project that comes her way. We appreciate the professionalism and teamwork we have with HMI.
Janet Willis, Director of Revenue Management, Monadnock Community Hospital
We have utilized HMI’s for chargemaster compliance and billing reviews for nearly 10-years. We have always found that their staff to be knowledgeable, resourceful and professional in all services provided to our organization.
Jessica Mayfield, Manager Revenue Management University of Missouri Health Care
Revenue Cycle Management (RCM) Trends for 2020
Revenue Cycle Management (RCM)
Revenue cycle management has experienced ups and downs in recent years. What lies ahead for revenue cycle management?
Last year, we saw the continued rise of automation and AI. We also saw battles over price transparency.
Continuing the trend from previous years, we also saw healthcare organizations contend with patient expectations, government regulations, and a growing number of technology options.
Let’s take a look at some of the revenue cycle management (RCM) trends we’re preparing for in 2020.
Continued Battles Over Healthcare Pricing Transparency
Healthcare pricing transparency battles occurred across the country in 2019. Expect battles to continue into 2020.
A Waystar survey released in August 2019 found that lack of price transparency was the biggest factor to a negative patient experience. Governments are pushing for increased healthcare transparency, and healthcare organizations are adapting.
Last year, we saw healthcare organizations implement strategies to better manage the patient financial journey. In 2020, we expect healthcare organizations to take the next step.
Some organizations have published the chargemaster online, giving patients full transparency over how much services cost. However, because chargemaster prices are not necessarily the prices charged to the patient, these resources can be difficult for patients to interpret.
In June 2019, the Trump administration signed an executive order mandating that health systems provide out of pocket cost estimations to patients upfront.
Look for increased transparency and better patient access to prices as we move through 2020.
Higher Demand for Revenue Cycle Management RCM Outsourcing
Revenue cycle management outsourcing is becoming increasingly popular among healthcare organizations – and it’s been a trend for several years.
The trend towards revenue cycle management outsourcing is expected to continue into 2020.
Revenue cycle management companies advertise benefits like sharing the risk and reward, which creates a win-win solution for partner organizations. Healthcare organizations can create a sustainable, high-performing engine while still enjoying growing cash flow.
As revenue cycle management outsourcing companies become more competitive, outsourcing is an increasingly attractive option for healthcare organizations.
More Cybersecurity Battles and Ransomware Attacks
Cybersecurity has been a priority for healthcare organizations for over a decade, and this trend is expected to continue into 2020.
Cybersecurity attacks aren’t stopping anytime soon. Healthcare organizations need a coherent cybersecurity strategy to stay competitive.
In April 2019, the United States government reported 44 healthcare data breaches, which was the highest number of healthcare breaches reported in a single month since the government started tracking healthcare breaches in 2010. The previous record was set in April 2018, when there were 42 breaches.
Ransomware attacks are particularly common. Last year, Carbon Black released a study showing that 66% of healthcare organizations experienced a ransomware attack within the last 12 months.
Higher Volumes and Patient Revenue
Hospitals nationwide ended 2019 with an increase in hospital profitability. The increase was linked to surges in net patient revenue and service volumes. Hospitals were treating more patients – and making more money from those patients – than ever, according to a report by RevCycle Intelligence.
This profitability increased despite a slight increase in supply expenses, increases in bad debt, increases in charity care, and mixed performance on expenses.
Over 800 hospitals across the country saw particularly high volumes in adjusted discharges, emergency department (ER) visits, and operating room (OR) minutes.
It was a positive trend after a tough year. The December 2019 increase was the first year-over-year operating EBITDA margin increase in six months. Hospital operating margins also increased by 171.8 basis points compared to November 2019.
Overall, EBITDA margins rose 136.9 basis points year-over-year in December 2019. It’s possible this trend will continue into 2020.
CFOs Are Becoming More Involved
The role of the healthcare CFO has been changing in recent years. 2020 might be the year it becomes even more evident.
CFOs are expected to continue taking a leading role at every level of the healthcare organization. Modern healthcare CFOs don’t just listen: they act.
Healthcare IT Leaders Revenue Cycle Lead, Larry Todd, recently recommended that CFOs go beyond listening and start implementing:
“…any implementation will affect the revenue of the organization so it’s very important for CFOs to be involved in the implementation project and to be informed of key parts of the project that could put the organization and its revenue at risk.”
In the same article, Linda Hoff of Legacy Health described how CFOs need to take a specific interest in not just financials, but also patient satisfaction and quality. All metrics are closely intertwined:
“You have a passion for what you’re doing within your facilities, how you’re interacting with patients. You have to be as interested in patient satisfaction and quality as you are in the financials. If you don’t have that passion for all those aspects, you’re really not going to land yourself in a CFO role especially today.”
Surprise Billing Will Continue to Be Attacked
Surprise billing took a beating at the end of 2019. In December, members of Congress announced the expansion of a bipartisan investigation into supress billing practice. Because of that expansion, the investigation will now look at physician staffing companies and health insurers.
That same month, a Health Affairs study found that annual healthcare spending for patients with employer-sponsored health insurance would drop by $40 billion if specialists were not able to bill out-of-network.
A Kaiser Family Foundation report released in June, meanwhile, found that one in six Americans received a surprise medical bill in 2017 despite being covered by health insurance.
As surprise billing continues to make media headlines nationwide, surprise billing practices will continue to be attacked.
Look for these trends and more to make headlines across the revenue cycle management field in 2020.