Insights: Taming and innovating your revenue cycle management model

In this episode of the MGMA Insights podcast, we’re joined by Taya Gordon and Kem Tolliver, colleagues, friends, co-presenters and authorities on revenue cycle management. The two recently wrote and released their first book, “Revenue Cycle Management: Don’t Get Lost in the Financial Maze.”

To purchase or preview the book – visit mgma.com/RCM.

This episode also features a special appearance by MGMA Government Affairs (GA) Associate Director Mollie Gelburd, who breaks down major changes released in the 2020 Physician Fee Schedule (PFS). To access or learn more about GA's exclusive analysis of the PFS, visit MGMA.com or find us on Twitter @MGMA. 

Don’t quite have time to listen to the entire episode? No worries. We’ve compiled an assortment of highlights for your convenience:

• (8:21) “For many, this is a hot topic, and it’s something they’re fiery about, and we completely understand that. But once you get those fires tamed down, we don’t want you to stop there. We want you to keep looking at it.” – Taya Gordon
• (9:17) “When we talk to organizations today, many times, they’re working around their technology to get results, and so it’s costing them in time. Their productivity has lowered, or they need additional staff to do what their technology typically does for them … So typically, that low-hanging fruit is really leaning on the tools that you already have in place and making them as efficient as possible to free up some of your time to go after larger projects.” – Taya Gordon
• (19:29) “I recommend before starting a practice assessment … to say, ‘Look, I’m about to do a deep dive into areas of our practice that we haven’t looked at in a while. During this process, I may uncover some things that we may not be aware of, but we all need to be on the same and be willing, ready and able to roll up our sleeves and do what’s necessary to correct those processes.’” – Kem Tolliver
• (37:29) “Yes, it does seem like a maze, and sometimes that means it’s complicated, but I really think it’s going back to understanding the impact of each of those building blocks and how you as a practice executive can use your areas of critical thinking and industry expertise to kind of tailor an approach to management of those individual sections in your practice.” – Kem Tolliver
• (43:28) “As the largest payer in healthcare, Medicare is in a position to also influence commercial payers as well, so we find that often commercial payers will adopt Medicare payment policies to some extent. So even if you don’t have a large Medicare population, this rule can be important. It’s something that we look out for every year.” – Mollie Gelburd
• (47:22) “I think what separates MGMA’s resource from others is that we created this specifically with group practice executives in mind, and the leaders of business and medicine. … This year, we included key takeaways under each policy that we summarized. And in those takeaways, we distill how we think that change policy will impact those on the ground and in actual operation. I think that’s something I don’t see in other resources that summarize the fee schedule. We really try to analyze it and break it down for folks.” – Mollie Gelburd

Here are some links and references related to this week’s show: 

• Revenue Cycle Management: Don't Get Lost in The Financial Maze (book)
• Staff empowerment essential to revenue cycle management process
• More providers outsourcing all of their revenue cycle 
• How to Improve Clinical Workflow: 50 Expert Tips 
• How to deliver effective and profitable chronic care management 
• MGMA raises alarm after CMS removes guidance that protects practices from ‘unfair’ electronic payment fees
• Medicare physician payments and quality reporting in 2020: An MGMA analysis of what to expect 

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We love hearing from listeners about the show. If you have topics you’d like us to cover or experts you’d like us to interview, email us at podcasts@mgma.com or reach out to MGMA Sr. Editor and podcast host Daniel Williams on Twitter at @MGMADaniel. 

MGMA Insights is presented by Decklan McGee, Rob Ketcham and Daniel Williams. 

Get a jump on the transition to value-based care with a new jointly created report by Humana and MGMA. To read the comprehensive report — complete with data, case studies and advice — visit mgma.com/VBCreport.