Road Map to the Future

Transcription

1 Road Map to the Future Ron Bissetta Partner, Optimity Advisors Member, HIMSS Revenue Cycle Improvement Task Force Penny Osmon Bahr, CHC, CPC, CPC-I, PCS Director, Avastone Health Solutions Member, HIMSS Revenue Cycle Improvement Task Force Member, HIMSS Health Business Solutions Committee

2 Agenda Learning Objectives HIMSS Revenue Cycle Improvement Task Force Overview Guiding Principles Work Products HIMSS Revenue Cycle Improvement Roadmap Approach Framework Analysis Solutions Already in Place Call to Action

3 Learning Objectives At the end of this session attendees will be able to: Discuss the gaps between the current state of revenue cycle management and the Task Force's vision for the future Discuss industry activities already under way to address some of these gaps Identify at least two case studies intended to move the industry towards the realization of the Task Force's vision

4 Revenue Cycle Improvement Task Force Purpose Convene innovative stakeholders from across the healthcare industry to create a vision for the next generation of revenue cycle management business processes and tools that will keep administrative cost containment, interoperability and consumer engagement front and center. Membership Industry thought leaders from all major stakeholder groups, including physicians, hospitals, retail health clinics, payers, financial services, health plans, consultants, industry associations, and vendors. Philosophy Bring your expertise Leave your company hat at the door This is a journey of possibility thinking

5 Basic Tenet Key Underpinnings Cannot create the Patient Financial Experience of the Future without the back office functionality to support it Guiding Principles Patient Centered Transparent Pricing Efficient/Automated Non-Duplicative Bus. Processes Demonstrable ROI Standards-Based User-Friendly Inspires Change Leverage Existing/Emerging Tech

6 FY15 Brief History Developed the vision; focused on the what, not the how Created infographic based on a basic pre-planned office visit Published White Paper outlining vision

7 FY16 FY16 Expanded scenario used in infographic to include an episode of care involving multiple disparate providers delivering care in a variety of settings Issued Call for Case Studies Created microsite to illustrate this scenario Conducted gap analysis using this expanded scenario to identify potential technical gaps that will need to be addressed to realize vision

8 Road Map Approach Framework Scenarios Future State

9 Patient Financial Experience of the Future Framework

10 Scenario Started with the FY 15 Scenario which illustrated a consumer-centric financial experience for a simple, non-urgent visit to a primary care physician Complexity infused to show care coordination, multiple providers, multiple care settings, insurance information exchange, financial barriers, patient experience and outcomes Focused on the functionalities, data, and inter-connections required to support a seamless, real-time sequence of events throughout an episode of care

11 Patient Financial Experience of the Future

12 Meet Mrs. Smith

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20 Technology Innovations Currently Underway The Gap is not as big as we think. Innovation is underway in each of these areas: Patient Information Access and Exchange Patient Identification Patient Care Plan Alternative Site of Service Electronic Scheduling/Pricing/Payment Provider Selection, Payment & Explanation of Benefits (EOB) Standards A complete listing of the solutions is provided in the Appendix of the Whitepaper

21 Call to Action Make it a Reality Industry paradigms continue to shift for patients and providers, driving opportunity for partnership Enabling Technologies & Standards are needed, continue to support and advocate as an industry Join our task force payers, providers, retail healthcare, consultants, and financial institutions Share your ideas, solutions or submit a Case Study Visit our website Get Involved!

22 Join us! Thursday, March 3 Revenue Cycle Knowledge Center Best Practices to Support the Roadmap to the Future 10:00 10:30 a.m. Operating in a Value-Based World 1:00 2:00 p.m. Thursday, March 3 Interoperability Showcase Moving the Industry Forward: Revenue Cycle Management Solutions of the Future 11:30 12:00

23 Questions Ron Bissetta Optimity Advisors Penny Osmon Bahr Avastone Health Solutions