A successful virtual revenue cycle workforce

Lessons for the future

By Colleen O. Hall, CPC, CPMA, CIRCC, and Rachel L. VonDielingen
| 3/9/2021
A successful virtual revenue cycle workforce: Lessons for the future

The onset of the COVID-19 pandemic required nearly all businesses to reexamine the virtual work environment. While some healthcare revenue cycle departments easily expanded existing work-from-home models, others scrambled to adopt virtual workforce policies and get their staff members up and running to conduct business operations from their homes.

While it’s unknown what “business as usual” will look like on the other side of the pandemic, one thing is sure: Organizations need to adopt successful work-from-home policies that allow for continuation of business and safety of staff if conditions, such as a pandemic or other emergency, make remote work necessary or if the institution chooses to adopt a virtual work environment.

Defining work-from-home success: What the data shows

At the pandemic’s start, revenue cycle leaders, like many executives across various industries, had concerns not only about the physical transition to a virtual work environment but also about whether and how their staff – and business operations – would thrive. They wondered how they would be able to manage their employees successfully while keeping their business productive.

Historically, healthcare revenue cycle departments have operated predominantly in person. Organizations typically have operated out of on-site business offices, with most employees working side by side with their colleagues. At the pandemic’s start in early 2020, all that changed within a matter of weeks.

While several prominent businesses in various sectors have made the news after announcing their extended work-from-home policies,1 less information has been documented about the duration of remote healthcare revenue cycle departments’ policies. Although questions remain about whether a virtual workforce ultimately will be a successful workforce for healthcare finance departments, current data provides hints about whether this model could be successful in the long term. In particular, data about accounts receivable (AR) performance and hospital volumes offers clues, and answers might differ based on the type of hospital or health system.

In an examination of COVID-19’s impact on AR performance in a sample of 1,500 U.S. hospitals, data comparing July 2019 and July 2020 AR balances shows a slight increase (0.7%) in those balances in 2020 despite a decline in hospital volume by an average of 14.4%.2 Why could this be?

Among the 1,500 hospitals studied, rural hospitals were more than two times more likely than urban hospitals to experience a 10%-plus increase in AR days. Part of this increase might be due to the fact that rural organizations were more likely than urban facilities to continue elective procedures and therefore maintain higher volumes. However, another significant factor might be that rural hospitals typically have had a more difficult time moving their workforces to a virtual environment due to technological barriers, distance among work sites, and other issues that hinder their ability to work accounts successfully and efficiently.

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Lessons for the future: 3 key areas for consideration

All organizations – regardless of their size or market – can learn from those facilities that made the shift to remote work more successfully. Specifically, organizations that have had strong virtual work performance have focused more heavily on the following three areas.

1. Automation

For the past few years, the value of automation has been increasingly emphasized in the healthcare field. Prior to the pandemic, however, use of automation in the healthcare revenue cycle seemed more like a long-term goal for most provider organizations. This all changed when COVID-19 hit. Increasingly, organizations have been implementing automation to streamline workflows and redistribute employees more efficiently.

Organizations that wish to incorporate automation can consider starting with repetitive, manual processes within the revenue cycle that don’t require a human touch. Automating processes such as medical records requests or other health information management- or authorization-related processes can help eliminate touch points on the claims and billing sides of the finance department, ultimately speeding up workflows and freeing up staff to handle more complicated accounts.

To prepare to adopt automation more widely within their finance departments, organizations also should consider which skill sets will be needed to support automation and even adjust hiring practices to accommodate these new skills. Revenue cycle executives also might consider identifying current team members to focus on finding specific processes or accounts that could be automated.

2. Technology and infrastructure

After making the rapid transition to a virtual work environment, many healthcare organizations are now rethinking their future investments in infrastructure. Organizations today are more closely analyzing what they might need in the future in terms of office workspace and the costs they might save by downsizing their physical work environments.

Healthcare leaders also might benefit from analyzing how funds saved from reducing infrastructure costs can be reallocated to investments in technology and other resources that will help workers succeed in the virtual work environment.

3. Organizational structure and performance metrics

The emotional well-being of staff is critical to the success of a virtual work environment. When determining what type of organizational structure will work best for their staff, organizational leadership should consider where their individual employees work most comfortably – and where they thrive. Though some organizations have moved to fully virtual workplaces, others might decide more flexible arrangements, in which staff are able to choose whether to work virtually or on-site, are more appropriate for their workforce. Creating a well-defined “where to work” policy is an organizational must in these times.

No matter which type of work-from-home structure the organization ultimately implements, with some or all staff working virtually, leadership should consider redefining “productivity” and adding more productivity measurements. With new metrics, for example, organizations might be surprised to find that some staff work more efficiently at home without distractions, ultimately completing more work at home than they would on-site.

In addition, it’s important that organizations measure and share information about not only productivity but also outcomes. Measurements tied to core organizational metrics are critical, especially when staff is working remotely. When staff members are brought into the organization’s focus and shown how their work is driving overall organizational success, it can positively affect employee engagement.

It is also critical for leaders to focus on enhancing connections among workers – many of whom were used to the team environment of a physical workspace. Examples of how leaders might help their team members connect while working virtually include setting aside time for weekly video sharing touch points, providing continuous transparent communication about organizational and team metrics, and encouraging staff members to share their own ideas for connecting. Some of the best ideas regarding frequency and type of connection can come from staff (lunch hour video calls, anyone?).

Be prepared for what’s next

Making sure that employees working from home are successful – and happy – can help organizations achieve improved revenue cycle performance and contribute to the overall financial health of the organization. In an environment marked by many unknowns, today’s healthcare organizations must be prepared to be able to work efficiently and effectively outside traditional, in-person workspaces. By focusing on success factors in the areas of automation, technology and infrastructure, and organizational structure, organizations can better position themselves to support their staff while investing in the right technology solutions to help their people – and their businesses – thrive.

1 Gillian Friedman and Kellen Browning, “July Is the New January: More Companies Delay a Return to the Office,” The New York Times, Oct. 13, 2020, https://www.nytimes.com/2020/10/13/world/july-is-the-new-january-more-companies-delay-a-return-to-the-office.html
2 Aggregated data from a Crowe study of 1,500 hospitals.

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Colleen O. Hall
Colleen O. Hall
Managing Principal, Healthcare