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The Strategic Importance of C-Suite Participation in the Evaluation of RCM Partners
April 8, 2024
In the fast-paced world of healthcare, where technology plays an increasingly critical role in operations and patient care, selecting the right enterprise revenue cycle management (RCM) platform and partner is paramount. However, the process of evaluating and purchasing such systems can become cumbersome and inefficient, leading to suboptimal outcomes.
Healthcare providers should establish a well-thought-out evaluation and decision process that enables them to remain nimble while adhering to procurement governance, program management office (PMO), and change management best practices. This process should also consider the project scope, budget, resource availability, priorities, IT integration requirements, timeline, and risk mitigation. This blog delves into the essential principles for a productive RCM partner evaluation.
One of the fundamental principles of establishing an effective purchasing decision process is ensuring executive engagement and oversight from the outset. Too often, the responsibility for vendor evaluation is delegated to departmental leaders, which creates the risk of a myopic focus on operational details rather than strategic alignment. Key stakeholders, including the CEO, CFO, CIO, Chief Revenue Officer (CRO), and senior representatives from relevant departments, including the PMO, must actively contribute to the evaluation process. This ensures that strategic objectives, such as growth strategies, compliance, and patient and client engagement, are considered from the outset. When evaluating a new RCM technology solution or outsourcing arrangement, the RCM leader plays a vital role but must be guided by the executive team.
Effective change management is critical when considering a new RCM solution or outsourced services partner. Transitioning to a new RCM solution impacts cash flow and other key financial metrics, so organizations need to choose a technology partner with implementation expertise and processes that minimize these risks. While the RCM team may be intimately familiar with the current processes and workflows, their focus on operational details can drive recommendations that may resist real change and not align with broader strategic objectives, such as reducing labor costs. From a leadership perspective, engaging the team in the evaluation process is critical, as is strong executive governance, which places guard rails around the procurement process and the timeline so it does not get stalled or off-track.
Healthcare providers should seek strategic partnerships that align with their long-term objectives instead of viewing vendors as mere service providers. This requires vendors to demonstrate a deep understanding of the organization’s unique challenges and priorities, including security and compliance requirements. Provider organizations can cultivate long-lasting partnerships that drive innovation and mutual success by prioritizing strategic alignment and shared goals.
The composition of the evaluation team should include a select number of individuals with a comprehensive understanding of the organization’s long-term needs and objectives. While departmental expertise is valuable, it is equally important to have cross-functional leadership representation to provide diverse perspectives and insights. Including senior finance, IT, and operations stakeholders ensures that the chosen solution aligns with the organization’s broader goals and priorities.
The evaluation process must, of course, include input from the people closest to the work, but at the right level of detail and in line with pre-determined time limits. Choose evaluators who are change agents and who will ask the right questions without getting bogged down in how things might differ from the current approach. People resist change, even while they want their work processes to improve. For an evaluation process to successfully conclude in a purchasing decision, the team must keep the core business objectives front and center and use criteria that consider the organization’s needs cross-functionally. The evaluation team also needs to focus on why they want to change. Is it to increase revenue collected per test, to reduce days sales outstanding (DSO), to improve profitability, or another measure? Be sure to structure the evaluation process to specify how select team members closest to the work will report their feedback to the leadership stakeholders and in what timeframe to facilitate making a decision.
Within the evaluation team, it is essential to define clear roles and responsibilities to avoid duplication of efforts and ensure efficiency. While select team members may be vital in evaluating specific features and functionalities, ultimate decision-making authority should reside with the executive leadership team. Delegating certain aspects of the evaluation process to designated team members ensures that each stakeholder can contribute their expertise effectively without getting bogged down in seemingly important but often unnecessary details that do not align with the criteria set by the executive steering committee.
Selecting an enterprise RCM solution does not end with the initial purchase. Instead, the most successful healthcare providers adopt a mindset of constant evaluation and optimization to ensure that the chosen solution evolves with their changing needs. This may involve regular performance reviews, user feedback, and proactive engagement with the software or services partner to address emerging challenges and opportunities. If you choose to outsource, the focus shifts from process to outcomes.
Creating and managing an enterprise RCM evaluation and purchasing process requires a strategic approach prioritizing executive engagement, cross-functional collaboration (without getting bogged down into the minutia), and effective and timely change management. By adhering to best practices in evaluation and change management, healthcare providers can ensure that the chosen solution aligns with their long-term objectives and drives tangible benefits, such as increased revenue per procedure and improved profitability. Executive oversight, collaboration with those closest to the work, and remaining nimble while managing a structured procurement timeline are essential to securing an RCM technology or services partner to support the organization’s evolving needs and facilitate innovation in healthcare delivery.
By leveraging these principles, the XiFin team has developed strong strategic partnerships with many enterprise clients. We have a structure in place that supports even the most complex integration and interoperability needs. Our expert implementation and technical teams apply the due diligence, complete the gap analyses, and provide the system demonstrations during the assessment process to mitigate risk, even for the most sophisticated engagements. Our team also has experience collaborating with global consulting firms that often support these types of comprehensive initiatives.
Additional Resources
Want to hear more from XiFin Chief Commercial Officer, Harley Ross? Read the recently published whitepaper, The Executive’s Guide to Molecular Diagnostic Market-Share Expansion, for insights and strategies for navigating the complex and rapidly growing molecular diagnostics industry.