Making the Right Choice: Evaluating Outsourced Revenue Cycle Services Vendors

You are George Jones, MHA, FACHE, Chief Executive Officer, Spotsville General Hospital (25 beds), located in an unincorporated rural area in Northwest Texas. The hospital has an ongoing problem with revenue cycle management and, currently, has over 31% of its total accounts receivable aged beyond 120 days. In the rural environment it is extremely difficult to recruit experts in medical billing. Your options are to continue operating with a negative revenue stream or outsource the process. You have assigned, Lucy Rogers, Chief Financial Officer, to prepare a brief, one page or less, analysis of the situation and make a recommendation to either outsource or continue managing the process in-house. Be sure to use references to support your position. The case cannot exceed one page.

Focus your analysis on:

• How do you know when to bring in outside help?
• What differentiates one out sourced service from another?
• What anticipated impact will each approach have on the bottom line.