Posted February 14, 2018 by nextgen in articles

Understanding the Relationship between EHR and RCM


A properly-deployed electronic health records (EHR) platform can promote better patient outcomes and streamline the revenue cycle management process. To better understand the connection between EHR and RCM, consider the following.

The Power of Modern EHR Systems

Not too long ago, EHR was an innovative characteristic of cutting-edge practices. With the introduction of MACRA, however, EHR has become a must-have for all but the tiniest healthcare providers. In addition to making a practice eligible for Medicare reimbursement dollars, EHR has become an engine that drives efficient and effective healthcare delivery. At the same time, it’s also become a critical cog in the revenue cycles for modern providers who know how to use it.

Some of the key factors that directly affect revenue in a practice include patient volume, provider productivity, fees for services, collections, insurance claims and patient payments. A high-performing, fully-integrated EHR system can help with all of these. At the same time, it can also positively impact the quality of patient care.

While it can often be difficult to visualize the link between patient care and business efficiency, they are really two sides of the same coin. Because RCM generates the resources required to support clinical activity, patient care is linked to its success. In this sense, it’s clear that a provider can improve the overall quality of patient care by improving the efficiency of its RCM. Invariably, this is best accomplished through EHR.

A properly-integrated EHR system can do a lot of things to streamline revenue cycle management: It can improve the efficiency of billing practices; eliminate tedious paperwork; and reduce the number of treatment denials. It can also indirectly influence a provider’s RCM by promoting more accurate clinical notation.

Medical errors are believed to cost healthcare providers billions of dollars every year. They also result in lost productivity and liability issues, when mistakes cause grave consequences for patients. With computerized physician order entry (CPOE), healthcare providers are able to mitigate the risk of medical errors. They are also able to leverage clinical decision support (CDS) to access person-specific information, intelligently presented at appropriate times, to enhance patient care.

Moreover, because an efficient EHR platform unchains healthcare providers from time-consuming operational tasks, they are able to spend more time with their patients. Effective EHR will also allow practices to successfully report on the many key performance measures, required by the Medicare Access, CHIP Reauthorization Act (MACRA).\

Streamlining the Revenue Cycle

Although many provider organizations have spent countless dollars modernizing their IT infrastructures, a lot of revenue cycle technology still consists of several stand-alone databases and software applications that are all pieced together through a complicated web of legacy or home-grown interfaces/manual processes.

As the healthcare industry moves to value-based reimbursement, payers will be shifting reimbursement from a fee-for-service model to pay-for-performance. In turn, healthcare providers will need to focus on optimizing their RCM operations by incorporating efficient technology that can gather data and drive analytics for improved clinical outcomes.


Allen Plunk-Senior Vice President, RCM Services NextGen Healthcare

Allen Plunk joined Quality Systems/NextGen Healthcare as senior vice president, RCM Services in March, 2017. He drives the growth strategy and business transformation of the NextGen Healthcare RCM and Financial Solutions organization. Allen is a certified public accountant with more than 25 years of experience delivering global technology and technology-enabled services. He was the chief operating officer for Optum360 for six years, helping Optum build their RCM practice after CareMedic Systems was acquired by Optum in 2009, where Allen served as chief financial officer and chief operating officer. Allen began his career with Coopers & Lybrand, followed by various finance and operations leadership roles in start-up and venture-backed technology companies.


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