Presentation on theme: "Carolyn Milburn, President 214-890-6700."— Presentation transcript:
Carolyn Milburn, President
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 Patient Registration Patient Exam Service Coding Charge Entry Claims Submission Payment Processing Resubmission & Appeals 2 nd Claims/ Patient Billing A/R Follow-Up Collection Agency 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."
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 VP Revenue Cycle VP Managed Care/Contracting Director of Patient Access/Registration Director of Professional Billing Director of Revenue Cycle The Key Stakeholders Include: Director of Business Office Director of Patient Financial Services Manager of Revenue Cycle Revenue Cycle Analyst Practice Administrator/Office Manager Revenue Cycle Consultants
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 Survey of hospital executives indicates that revenue integrity is the most important component of the financial health of their organizations.
Typical Salary for Revenue Cycle Leaders Milburn Partners’ data based on placements from 2012-Present
REVENUE CYCLE MANAGEMENT CODING/BILLING OPERATIONS/ MEDICAL RECORDS COMPLIANCE/ RISK MANAGEMENT INFORMATICS/ DATA ANALYSIS MASTER 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 ADVANCED 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 MID LEVEL 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 ENTRY 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 trade- offs 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.
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 Market Trends
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
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. Salary, Education and Certification
Practice Settings for HIM Professionals 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 Consulting firms Government agencies Law firms Insurance companies Correctional facilities Extended care facilities Pharmaceutical Research Statistician Clinical Trials Coordinator Data Manager Information Technology System Analyst Project Manager Data Manager Medical Software Companies Software Designer Software Tester Traditional SettingsNon-Traditional Settings
Typical Salary for HIM Professionals Milburn Partners’ data based on placements from 2012-Present