Healthcare organizations of all sizes have long outsourced various functions within their revenue cycle to specialists capable of boosting efficiencies across their operation. Historically, functions that require scale and technology to make them more efficient and effective have been the domain of outsource vendors (e.g., medical advocacy, transcription, and bad-debt collections). However, other areas of the revenue cycle, specifically coding, have a much lower adoption rate. Coding can benefit from scale, technology, and analytics just as much as back-office and patient access functions.
In a previous blog post, I discussed the ways in which the current healthcare industry outsource coding model delivers a suboptimal result for hospitals. In that piece, I highlighted some of the underlying perceptions and realities of the traditional staffing model in comparison to a managed coding solution which I believed would provide a better way for facilities to meet their outsourcing needs. In January 2015, we launched Enterprise HIM as a solution for our clients. One year later, we have completed our first Enterprise HIM Case study which showcases the value a well-designed and executed managed coding solution can deliver to providers.
Last month, we launched the Inaugural HIM Benchmark Report which was designed to allow those in our industry to see the “big picture” in HIM. The data we gathered from over 140 HIM leadership professionals has helped us evaluate the HIM marketplace more broadly so we can better inform you about current topics and trends and provide you with a benchmark of how your department compares to others across the country in a variety of key areas.
A few months ago I described why the current industry outsourced coding model delivers a sub-optimal result. The conclusion was drawn from many conversations I have had with clients over the past several years. The perception that short term engagements with multiple outsource vendors can address the ongoing needs of a HIM department is flawed given the underlying realities in the market including a fundamental shortage of coders in the U.S., increasing demand for healthcare services, and reluctance of vendors to invest resources in coder education and development with episodic staffing engagements.
As I have spoken to clients over the past several years to inquire about how they use outsourced coding, I have learned several key things which inform my opinion that the model produces a suboptimal result for the hospital.