Maximizing Revenue and Cashflow for Medical Device, DME, and Remote Patient Monitoring: RCM Quality, Service, and Value

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 3: QUALITY OF SERVICE AND VALUE

Innovations in diagnostic technologies, medical devices, and remote patient monitoring services create positive impacts for patients. These devices and services provide vital information to physicians, save time, and reduce healthcare costs. When connected medical devices and monitoring services gain traction, patient outcomes and satisfaction improve. Unfortunately, it can be challenging for the organizations that deliver this life-enhancing technology to gain market access, commercial adoption, payor coverage, and reimbursement for their services.

Medical device, independent diagnostic testing facilities (IDTFs), remote patient monitoring, and durable medical equipment (DME) companies require several specific capabilities for operational and financial success. Selecting the right outsourced revenue cycle management (RCM) partner is one important step toward ensuring access to the comprehensive set of capabilities essential for:

• Gaining market access
• Expanding commercial adoption and payor coverage
• Maximizing revenue
• Increasing cashflow
• Reducing the cost to collect reimbursements
• Decreasing AR days

Selecting the right RCM outsourcing partner can have a profound impact on a diagnostic device or monitoring organization’s operational and financial performance. It’s equally important, however, to regularly evaluate the current RCM partner’s capabilities against industry data and benchmarks to ensure it continues to be the right partner.

At XiFin, we recommend using the following five criteria to frame this evaluation:

• Innovation
• Expertise and Excellence
• Quality of Service and Value
• Security, Compliance, and Trustworthiness
• Reliability

To continue to support your organization’s operational and financial success, your outsourced RCM partner must consistently demonstrate these five core competencies. In this third post in our series, we focus on the specific capabilities related to Quality of Service and Value. If you missed either of the two prior posts, you can find them here:

PART 1: INNOVATION
PART 2: EXPERTISE AND EXCELLENCE

Quality of Service and Value are Core Principles in Successful Business Relationships

Quality of service and value are core tenets of any successful business relationship. Outsourced RCM partners must prioritize delivering products, technology, services, and experiences that consistently meet or exceed customer expectations. Quality speaks to the performance of the work itself, whereas value speaks to how customers perceive whether they are getting all of the expected benefits in exchange for the cost of the service.

Establishing and maintaining high levels of quality and value in outsourced RCM business relationships is vital to an ongoing, collaborative partnership with meaningful and lasting outcomes. By prioritizing quality of service and value, outsourced RCM providers demonstrate long-term sustainability and a commitment to meeting the unique needs of medical device and remote patient monitoring companies.

Quantifying Quality of Service and Value

One valuable tool diagnostic organizations can use to evaluate the capabilities of their outsourced RCM partner is the Black Book Market Research annual report, “Diagnostic/Laboratory/Ancillary Services Revenue Cycle Management: Outsourced & Managed Support RCM Services User Survey.” Black Book Research conducts this in-depth study to understand how diagnostic and medical device leaders evaluate outsourced RCM service providers across 18 key performance metrics. This report is based on the real-world experiences of over 2,000 survey respondents.

The XiFin team associates six of the 18 Black Book Research performance metrics with Quality of Service and Value. These six metrics are outlined below.

1. CLIENT RELATIONSHIPS AND CULTURAL FIT (Question 4, page 13)

One of these metrics that can help you evaluate Quality of Service and Value is categorized by the Black Book Market Research team as “Client Relationships and Cultural Fit.” For this metric, the Black Book Market Research team asked study participants to evaluate RCM outsourced services providers on the following statements:

• Outsourcing vendor leadership honors customer relationships highly.
• The relationship with the vendor elevates the customer’s reputation.
• Improving healthcare delivery efficiency and effectiveness is a priority of the supplier.
• Governance of engagement is neither complex for buyers nor does it require vendor management attention regularly.
• There is no regular transparency or quality issue.
• There are no culture clashes or misfits that threaten relationship’s success or client’s satisfaction.

2. CUSTOMIZATION (Question 8, page 17)

In a second performance metric related to Quality of Service and Value, Black Book Market Research asked research participants to assess RCM outsourced services providers on the following statements related to “Customization.”

• Outsourced services are customized to meet the unique needs of specific practice client purpose, processes, and hospital/provider/physician models.
• Little resistance is encountered when changing performance measurements as clients’ needs vary.
• Extraordinary efforts are made to adapt and convert client special needs into workable solutions with efficient cost and time considerations.

3. TRAINING (Question 3, page 12)

Another performance metric related to Quality of Service and Value is classified by Black Book Research as “Training.” For this evaluation, Black Book Research asked study participants to evaluate RCM outsourced services providers on statements:

• Outsourcing vendor leadership provides significant and meaningful training opportunities for internal employees and client staff.
• Leadership strives to develop technology staff, client service and customer servicing consultant employees.
• Training modules are effective and practical so that minimal post-implementation training is required on or off site.
• Regular updates are timely and require minimal additional training to implement.

4. DEPLOYMENT AND CONTRACT IMPLEMENTATION (Question 7, page 16)

The fourth performance metric in the Black Book Research study related to Quality of Service and Value asked study participants to evaluate RCM outsourced services providers on the following statements related to “Deployment and Contract Implementation.”

• Outsourcing services client deploys at a pace acceptable to the client.
• Services delivered eliminate excessive supervision over vendor implementations.
• Vendor overcomes client implementation obstacles and challenges effectively.
• Technical, organizational, and cultural implementation obstacles are handled professionally and punctually.
• The implementation time meets standard expectations.
• Implementations are efficient and sensitive to users’ specific situations, which may cause delays.

5. SCALABILITY, CLIENT ADAPTABILITY, FLEXIBLE PRICING (Question 10, page 19)

Next, the fifth performance metric covered in the Black Book Research study related to Quality of Service and Value asked participants to appraise RCM outsourced services providers on the statements below classified by Black Book as “Scalability, Client Adaptability, Flexible Pricing.”

• Outsourcing services vendor provides flexible pricing allowing the client to choose and pay for the precise functionality and services needed.
• Vendor Invests in significant infrastructure and could provide services to enterprise organizations.
• Managed services meet the changing and varied needs of the outsourcing customer.
• Pricing is not rigid or shifting and meets the needs of the client.

6. SUPPORT AND CUSTOMER CARE (Question 17, page 26)

Finally, in terms of rating RCM outsourced services providers on performance metrics related to Quality of Service and Value, the Black Book Market Research team asked study participants to evaluate providers on the following statements, which they categorized as “Support and Customer Care.”

• Account management provides an adequate amount of onsite administration and support to clients.
• There exists a formal account management program that meets client needs.
• Media and clients reference this vendor as an outsourcing services leader and top vendor correctly.
• Customer services and relationship satisfaction is manifested through significant flagship clients as well as smaller and newest customers similarly.
• A vendor provides an appropriate number of accessible support and customer care personnel.

Medical device, remote patient monitoring, and DME leaders must look for these important operational and financial factors related to quality of service and value when evaluating existing—and potential—revenue cycle management (RCM) outsourcing partners. Outsourced RCM service providers that rank high for these six performance metrics clearly deliver the Quality of Service and Value that medical device, DME, IDTF, and remote patent monitoring providers need to achieve their financial and operational goals.

Objective industry data and benchmarks, such as the Black Book Market Research report, help these diagnostic providers quantitatively determine whether they have partnered with the outsourced RCM services provider that can deliver the capabilities needed to help them maximize market access, commercial adoption, payor coverage, and cash flow, as well as accelerate time to collection, and optimize return on cash.

The next post in this series focuses on the final two categories of core RCM services capabilities, “Security, Compliance, and Trustworthiness” and “Reliability.” Download the 2023 Black Book Market Research report to see how your outsourced RCM service partner stacks up.

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