Expertise and Excellence: Essential Competencies for Maximizing Medical Device, Remote Patient Monitoring, and DME Revenue and Cash Flow

Please note: This article series addresses the unique issues and complexities that medical device, remote patient monitoring, and durable medical equipment departments face. If you’re interested in a methodology tailored for clinical laboratories or hospitals and IDN ancillary and outpatients diagnostics departments, we recommend exploring those series instead.

PART 2: EXPERTISE AND EXCELLENCE

Medical device, remote patient monitoring, and durable medical equipment (DME) companies are constantly innovating and creating new ways to have a positive impact on patients’ lives. These organizations play a vital role in the healthcare ecosystem, providing diagnostic and therapeutic data to physicians that help reduce healthcare costs.

The right revenue cycle management (RCM) partner can help these organizations gain commercial adoption, expand payor coverage, and get reimbursed for services provided. Selecting the right RCM partner can mean the difference between achieving reimbursement at a low total cost to collect or struggling to be reimbursed. This is especially important as medical device, remote patient monitoring, and DME companies not only struggle with adoption and gaining payor coverage but are also challenged by ongoing reimbursement revenue compression.

Medical device, remote patient monitoring, and DME leaders must look for several important operational and financial factors when evaluating existing—and potential—revenue cycle management (RCM) outsourcing partners, including performance in the areas of:

• Increasing cash flow
• Capturing more revenue
• Reducing expenses
• Accelerating the speed of cash collection
• Boosting return on cash

While it’s important to understand the results that a current RCM outsourced services partner delivers, for a more complete picture, you also need to consider industry data and benchmarks. We recommend using the following five categories of criteria to frame the evaluation. The right outsourced RCM services partner must demonstrate these five competencies if they’re going to help you achieve your financial and operational performance goals:

1. Innovation
2. Expertise and Excellence
3. Quality of Service and Value
4. Security, Compliance, and Trustworthiness
5. Reliability

In the first post of this 4-part blog series, we evaluated success criteria in the category of Innovation. If you missed that post, you can read it here. In this second post in the series, we’ll discuss assessment criteria related to Expertise and Excellence.

Assessing Current/Potential Outsourced RCM Partner Expertise and Excellence

How does a medical device, remote patient monitoring, or DME outsourced RCM service provider demonstrate Expertise and Excellence? You can see it when their:

• Teams clearly demonstrate their skills and perform at a high level
• Range of solutions and service offerings address the needs of their medical device, remote patient monitoring, and DME customers and align strategically with their customers’ missions
• Implemented solutions and services to meet and exceed the expected results while benefitting from ongoing development and improvement

As mentioned in the first post in this series, one valuable tool medical device, remote patient monitoring, and DME organizations can use to help evaluate Expertise and Excellence is the Black Book Market Research report, Diagnostic/Laboratory/Ancillary Services Revenue Cycle Management: Outsourced & Managed Support RCM Services User Survey.

Black Book Research conducts in-depth studies on how diagnostic leaders, including medical device, remote patient monitoring, or DME organizations, evaluate outsourced RCM service providers across eighteen (18) key performance metrics. We mapped these 18 metrics into the five categories of capabilities discussed above, and three of the performance metrics, described in more detail below map to Expertise and Excellence.

Industry expertise directly informs the solutions an RCM partner offers; if they know where your organization wants to go, then they have crafted their services to help you get there. The first performance metrics (Question 1, page 10) that can help evaluate Excellence and Expertise is based on the Black Book Market Research team asking study participants to evaluate RCM outsourced services providers on the following statements related to “Strategic Alignment of Vendor Offerings to Provider Goals & Client’s Mission.”

• Organizational structure meets the needs of stakeholders or customers.
• Stakeholder satisfaction is the most important priority.
• Outsourcing clients will likely recommend the vendor to similar-sized organizations and types.

For the second performance metric related to Expertise and Excellence (Question 6, page 15), Black Book Market Research asked research participants to assess RCM outsourced service providers on the following statements related to “Breadth of Offerings, Varied Client Settings, Delivery Excellence Across All User Types.”

• Vendors routinely drive operational performance improvements and results in the areas they affect.
• Comprehensive offerings are constructed to meet the unique needs of the client’s clinical and business initiatives.

Finally, the third metric related to Expertise and Excellence (Question 11, page 20) is based on the team at Black Book Market Research asking participants to evaluate RCM outsourced service providers on statements related to “Vendor Staff Expertise, Compensation, and Employee Performance.”

• Outsourcing vendor team is considered top in industry for professionalism and skill.
• Vendor attracts and retains high-performing staff.
• Vendor is focused on building and developing a strong employee team of producers.
• Employees act like owners/leaders.
• The company is moving towards leveraged pay at all levels.
• Vendor is using effective tools to tie performance metrics to compensation policy and compensating top leaders.

Outsourced RCM services providers that rank high for these performance metrics demonstrate the Expertise and Excellence that medical device, remote patient monitoring, and DME companies need to deliver against their financial and operational goals. They not only know their business—but more importantly, they understand yours. They help your organization excel financially in this challenging and constantly changing healthcare ecosystem. Better yet, they help influence and shape the climate.

Through objective industry data such as the information gleaned in the Black Book Market Research surveys and backed by the real-world experiences of more than 2,600 survey respondents, medical device, remote patient monitoring, and DME leaders can quantitatively evaluate whether they have partnered with the outsourced RCM services provider that can deliver the capabilities needed to help them maximize cash flow, accelerate time to collection, and optimize return on cash.

The next post in this series focuses on the third category of core RCM services capabilities, Quality of Service and Value. Until then, download the full 2023 Black Book Market Research report to see which outsourced RCM service partners can help you accelerate cash collection and increase profitability.

Download a free copy of the Black Book Report.

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