Outsourcing Revenue Cycle Management: A Balanced Perspective

Jon Love in Infusion Magazine: Navigating the Waters of Outsourcing Revenue Cycle Management: A Balanced Perspective   

Our VP of Pharmacy Services, Jon Love, provides a balanced perspective on outsourcing Revenue Cycle Management (RCM) in home infusion pharmacies in his recent article for NHIA's Infusion Magazine. 

Recognizing diverse needs, Love discusses both the benefits and challenges to help pharmacies make the best decision in whether to outsource.  

Outsourcing RCM can be transformative for home infusion pharmacies. Key benefits include: 

  • Cost Efficiency: Deloitte reports that companies can save up to 60% on operational costs through outsourcing, due to lower labor costs and reduced infrastructure investments. This allows pharmacies to focus more resources on patient care, enhancing service quality. 
  • Scalability: Outsourcing provides flexibility to scale operations according to demand, avoiding the complications of hiring and layoffs during fluctuating periods. 
  • Access to Expertise: RCM outsourcing companies offer specialized knowledge in infusion therapy RCM, ensuring smooth and efficient financial operations. 

Despite the benefits, there are notable challenges: 

  • Quality Control: Maintaining consistent service standards can be difficult. According to the Chartered Institute of Procurement & Supply, 46% of businesses faced quality issues when outsourcing. 
  • Cultural and Communication Barriers: Global outsourcing can lead to misunderstandings and inefficiencies due to differences in language, work culture and time zones. Effective communication protocols and cultural awareness training are essential to mitigate these issues. 
  • Dependency and Control: Heavy reliance on external partners can make pharmacies vulnerable to disruptions. The COVID-19 pandemic highlighted the need for contingency plans to ensure business continuity. 

If a pharmacy does choose to outsource RCM, the factors they should take into consideration to do so successfully are:  

  1. Own the Outcome: Establish clear expectations and accountability with outsourcing partners. Regular audits help maintain performance standards. 
  2. Conduct Thorough Research: Assess potential partners' track records and capabilities thoroughly before selection. 
  3. Build Strong Relationships: Foster trust and respect through regular check-ins and open communication. 
  4. Ensure Clear Communication: Conduct regular updates and constantly communicate with your outsourced partner to prevent misunderstandings and keep everyone aligned. 
  5. Embrace Technology: Use shared dashboards, real-time reporting systems and secure communication platforms to streamline operations.

    By understanding the benefits and potential pitfalls and implementing best practices, pharmacies can optimize the advantages of outsourcing while mitigating risks. With careful planning and finding strategic partners, outsourcing can enhance efficiency, reduce costs and improve patient care. 

    For a deeper understanding of optimizing RCM outsourcing in home infusion pharmacies, refer to Jon Love's full article in NHIA's Infusion Magazine (you must be a subscriber to view), or contact Jon for his thoughts. 

Prochant is the only AI-driven reimbursement service provider in the home-based care industry. We deliver focused revenue cycle management (RCM) solutions to healthcare providers with 7 wholly-owned global delivery centers. Our expertise lies in providing end-to-end RCM for home-based care, infusion, and specialty pharmacies, consistently delivering exceptional results to some of the leading healthcare providers in the country. We harness specialized automation technology and deep industry knowledge to streamline the time-consuming and expensive reimbursement process. As a result, we help healthcare providers accelerate their collections, increase revenue, and reduce operational costs while managing risk. Prochant is HITRUST certified, the gold standard for HIPAA security. For more information, please visit prochant.com.