Navigant, Baptist Health South Florida form revenue-cycle management joint venture

Navigant and Baptist Health South Florida have created a revenue-cycle management joint venture to help providers improve their billing, scheduling and administrative tasks, the companies announced Tuesday.

The new endeavor, which will initially serve Baptist Health South Florida, aims to leverage machine learning and artificial intelligence to boost revenue and cash flow while lowering the cost of bill collecting, executives said. The joint venture, slated to launch this summer, will also provide new jobs, they said.

“We are committed to improving the patient experience and developing more consumer-friendly systems,” Brian Keeley, president and CEO of Baptist Health South Florida, said in a statement.

Coral Gables-based Baptist Health South Florida includes 10 hospitals, 50 outpatient and urgent-care facilities, a medical group and 40 physician practices. The not-for-profit has nearly 20,000 employees and more than 3,000 affiliated physicians.

The health system reported total revenue of $2.48 billion in 2017, up 4.4% from $2.38 billion in 2016. But it had an operating loss of $31.3 million on the year.

Part of the financial pressure stems from late or unpaid bills. Baptist’s provision for doubtful accounts increased 34.4% in 2017 to $410.1 million.

Navigant, which is primarily a consulting firm, also has its own revenue-cycle management platform Cymetrix, which is used by more than 100 providers.

“By relying on the services provided by this new venture, health systems will have the ability to direct their focus where it is needed most, on their patients and the health of their communities,” Julie Howard, chairman and CEO of Navigant, said in a statement.

Reducing no-show appointments and collecting payment have been a major focus of providers, especially as consumers shop around as they are expected to shoulder more of their healthcare costs.

Many hospitals and health systems have looked to partnerships or outsourcing to get a better grip on revenue-cycle management, which can lower labor costs and provide a quick return on investment compared to other strategies involving clinical operations or management changes.

Both Intermountain Healthcare and Presence Health are outsourcing revenue-cycle services to R1 RCM, which has financial ties to Ascension. Quest Diagnostics also outsourced its revenue-cycle services to UnitedHealth Group subsidiary Optum in 2016.

Outsourcing these services to a specialist can fill gaps in providers’ customer service and technical proficiency in billing matters, said John Behn, president of Stroudwater Revenue Cycle Solutions.

“I don’t think it’s a trend that is going to stop,” Behn told Modern Healthcare in January when discussing the Intermountain move. “Outsourced groups that are taking these services on are becoming far more customer savvy and responsive to clients.”

A recent study by Research and Markets revealed that the demand for revenue-cycle management products will exceed $90 billion by 2022, compared with about $51 billion in 2017.

That surge is reflected in a Black Book survey of more than 4,000 hospitals across the country that found that around 35% of small hospitals, 15% of large hospitals and 14% of community hospitals planned to outsource their revenue-cycle management. Ninety-four percent of hospital chief financial officers listed revenue-cycle management as a top priority, given the growth in value-based reimbursement. More than 90% of survey respondents said they were also looking for revenue-cycle management solutions that helped them address population health and alternative payment models.

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