When it comes to integration, commitment is not the same as readiness. Before starting down the path to integrated operations, organizations should assess their current state and determine whether revenue cycle integration is even a good strategy. 

The Revenue Cycle Integration Continuum Criteria tool consisting of 24 questions in six categories assists organizations in assessing where they are along the integration journey and where they want to go. Each question is worth one point. 

The self-assessment consists of questions in the following areas. 

Leadership. Do the organization’s leaders (direct supervisors vs. top-level leaders) oversee staff performing integrated revenue cycle functions?

System integration. Are core revenue cycle systems integrated, or are there tools (i.e., bolt-ons) to support functional integration? 

Process and staff integration. What functions are integrated (e.g., access and registration, coding, accounts receivables management, call center)? 

Culture and legal structure integration. What is the state of cultural readiness and legal structure implications?

Patient interaction integration. Are patient interactions and receivables integrated?

Finance (budget and expense management) integration. Do finance leaders have expense-management responsibilities for integrated revenue cycle functions? 

To fully leverage this tool, organizations must carefully consider their current state and answer the questions, scoring one point for each answer. Note that the number of questions in each section varies across the sections. The sum of the total points will indicate an organization’s progress toward integration and readiness for future work. For example, a score of 17 out of a possible 24 would indicate that the organization has already begun integrating and is ripe for further efforts. Conversely, a score of 8 out of 24 would demonstrate an interest in integration, but it also points to the need for improvement efforts to move the organization toward full integration. 

Once an organization completes the self-assessment, it will have a better sense of where it should focus its efforts. 

Kevin M. Lockett is vice chair, revenue cycle, Mayo Clinic, Rochester, Minn., and a member of HFMA’s Florida Chapter.

Publication Date: Monday, March 03, 2014

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