29 Mar Cerner’s point man on revenue cycle talks outsourcing options in a risk-based world
Caleb Anderson says changing payment models are likely to make hospital executives rethink revenue cycle, and consider outsourcing services to Cerner or one of its competitors, including athenahealth, eClinicalWorks, NextGen, Conifer and others.
The times are changing – not only in how care is delivered but, equally as important, in the ways hospitals, doctors and healthcare workers will be paid.
“The regulatory landscape is getting tougher,” said Caleb Anderson, who heads up the ambulatory reimbursement business for Cerner. The market for revenue cycle management is poised to grow big time – and practices and technologies are bound to change as well. “I don’t see it slowing down by any means between now and 2019.”
That’s because in 2019 the Medicare Access and CHIP Reauthorization Act will create a fundamental shift in physician reimbursement. And MACRA is poised to arrive against the backdrop of health systems getting larger via consolidation, acquiring physician practices and other partnerships.
As the health system itself changes, the revenue cycle, too, is likely to evolve.
“The fundamental business model of billing services is going to get different in the next several years as you move to a capitated payment or a risk model,” Anderson said.
As that shift happens, Anderson envisions a lot of hospital executives wanting to shift some of that risk to companies for revenue cycle management tools and practices, such as Cerner, athenahealth, eClinicalWorks, NextGen and Conifer, to name a few.