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Crafting a Secure RCM Plan Amid a Surge in ACA Enrollees

Posted: 01/24/2018 at 1:00 AM   /   by   /   comments (0)

A couple getting health insuranceThe open enrollment period of Affordable Care Act’s (ACA) is over. But anyone eligible can still obtain health insurance in 2018 by qualifying for the special enrollment period, or through Medicaid or the Children’s Health Insurance Program (CHIP). With extra period and opportunities to enroll for the ACA, what does this mean to healthcare providers?

Here’s what decorm.com and other reliable online resources found out:

Enrollment overflow

ACA aims to make health insurance more affordable, reduce the number of uninsured individuals, and lower the cost of healthcare. In 2016, about 2.1 million plans were chosen from the marketplace. Exactly a year after, 2.8 million signed up for the ACA. With more in line after the open enrollment period, the demand for affordable health is increasing.

Healthcare caveat

With the increasing demand, healthcare providers are facing countless opportunities to take in more healthcare demand and, in effect, a business boom. A U.S. Department of Health and Human Services report showed that over 90% of Medicaid enrollees are satisfied with their health plans. However, a looming pressure exists for revenue cycle management (RCM) services.

Developing a secure RCM plan

Healthcare providers must strengthen their RCM services by looking for better systems and procedures that would meet the demand for ACA. To develop a sound and secure RCM plan, they must consider the following:

  1. Planning must involve all stakeholders and decision-makers.
  2. Current technologies must be evaluated and improved.
  3. Accelerating (or liquidating) outstanding receivables should be used to preserve financial health, especially during strings or periods of denials.
  4. Educating patients about their billing also helps them pay their bills in a timely manner.
  5. Staff must be educated as well, particularly with the RCM strategy and healthcare reform issues.

As enrollment plateaus after the additional enrollment windows, the real work begins in ensuring that the RCM strategy is sustainable and secure enough for the business’s future.