According to Susan DeVore, president and CEO of Premier, Inc., a healthcare improvement company, today’s healthcare providers are being judged on more than the amount of payment for a procedure and the effectiveness of their billing and collection process. They’re also being increasingly evaluated based on their quality, creating a need for “total quality management.”
Building a Quality Management Cycle in Healthcare Operations
In a new op-ed published in the Wall Street Journal, Devore notes that, in today’s health-care industry, “the quality of care is just as important to a hospital’s revenue as making sure claims are paid properly.” Additionally, federal programs requiring hospitals to publicly report their outcomes, as well as rewards or penalties as a result of these outcomes, put pressure on hospitals to perform well. As a result, understanding how to measure performance is essential to a hospital’s success.
“Much like the revenue cycle process, hospitals need to be able to keep track of and manage the quality cycle of care to determine the most important areas of focus and consistently meet high-performance measures,” she writes. “If we take some of the best practices from the revenue cycle, we can implement a quality cycle management process that aligns and focuses firmly on the specific elements of performance that produce continuous quality improvement, and in turn, a healthier balance sheet.”
In the article, Devore notes that these “best practices” include “a clear cadence, metrics with targets, a firm culture of accountability and… deep executive engagement to generate change.”
“Yesterday’s revenue cycle management is today’s quality cycle management,” she says.
Nearterm sees quality metrics of revenue cycle management for hospitals as a subset of the overall mission that hospitals embrace which is to deliver quality care in a sustainable way. Quality cycle, in our opinion, is as much among the objectives of RCM as it is also among the objectives of Nursing Services, Supply, and other operational areas of care.