Data integration and predictive analytics are important tools for healthcare revenue cycle professionals to see and make informed decisions about financial health and market changes.
Data analytics involves using advanced technology to collect, analyze, and interpret large sets of data. In healthcare, this could mean examining patient information, billing records, and reimbursement rates to identify trends and patterns. Informed revenue cycle management can evaluate strategies and implement tactics to stay ahead of the curve.
Statistics and predictive analytics is the branch of mathematics that when applied to the revenue cycle can identify a trajectory and prescribe other paths to a desired outcome. The process involves collecting, analyzing, and interpreting enterprise-wide health system data. Healthcare revenue cycle professionals use statistical analysis to gain insights into financial data, such as identifying trends in patient volumes or predicting the likelihood of reimbursement denials.
Together, data analytics and statistics help healthcare revenue cycle professionals to better understand their organization's financial performance, identify areas for improvement, and develop strategies to optimize revenue cycle management.
Challenge
Healthcare providers face rising costs, long revenue cycles, bad debt, and increased claims write-offs. At the same time healthcare is becoming even more complex with the shift to Evidence-Based Medicine (EBM), Pay for Performance (P4P), Diagnosis-Related Groups (DRG) and Consumer-Directed Health Plans (CDHP). Providers have reason to fear the higher costs and lower reimbursements that accompany these emerging models. And coupled with the reality of too many providers either losing money or just breaking even - the need to speed up revenue while reducing collections cost has never been greater.
Solution
QlikView and the partner community have built a number of ‘QlikView Apps’ to help healthcare organizations like yours take control of your entire revenue cycle, so you can seize every opportunity to improve profitability. Using the QlikView Business Discovery platform, healthcare CFOs, financial analysts and accounting professionals can:
Gain visibility across processes affecting cash flow, net cash, bad debt, and cost-to-collect
Improve workflows for patient admissions, claims administration, denial management, fraud detection, and insurer contract management
Profile costs and revenue by facility, practice, physician, procedure, etc.
Real-time monitoring of cost controls, actual spend versus budget across all departments to stay in constant control of bottom-line financial performance
And healthcare finance departments can use QlikView to:
Automate planning, budgeting, and forecasting tasks
Increase cost capture during care delivery
Decrease insurance claims write offs
Increase charge capture
Reduce time and cost to collect reimbursements
Reduce time and cost of financial compliance reporting (IFRS, SOX, etc.) as well as P4P and DRG tracking, reporting, and cost accounting
