As the behavioral health sector grapples with a workforce crisis, the dire shortage of qualified professionals continues to increase workloads and burnout among existing staff. This shortage not only impacts the quality of care but also exacerbates financial strains as claims denials skyrocket. 

At the intersection of workforce and revenue cycle management exists a critical point at which these two areas can work synergistically to address today’s challenges in the behavioral and mental health space. 

During a recent live webinar, “Happy Staff, Happy Patients: How to Drive Satisfaction Through Revenue Cycle and Workforce Management,” senior executives discussed the top priorities of healthcare leaders in these areas, how leaders can work cross-functionally to achieve shared goals, and the pivotal role technology plays in empowering patient-centric care experiences and building a more resilient behavioral health system. Here are the key takeaways.    

Top priorities for healthcare leaders

The behavioral health sector is facing unprecedented challenges that impact both workforce and financial sustainability. At the heart of these challenges lies a growing demand for services coupled with a shrinking workforce, creating a perfect storm for providers.

Workforce management (WFM) challenges

• Severe staffing shortages across all levels of care
• High turnover rates and burnout among existing staff
• Difficulty in recruiting and retaining qualified professionals
• Increasing patient acuity requiring more specialized skills
  

Revenue cycle management (RCM) challenges

• Rising prevalence of claims denials, impacting cash flow
• Missing or inaccurate claims data leading to reimbursement delays
• Lack of proper documentation affecting medical necessity claims
• Balancing quality care with financial sustainability
  

In response to these challenges, Chief Nursing Officers (CNOs) and Chief Financial Officers (CFOs) are aligning their priorities to create more resilient and efficient operations.

Top priorities for CNOs 

1. Transparency in scheduling: Implementing tools that provide clear visibility into staff schedules
2. Flexibility in workforce management: Treating scheduling as an art rather than a mere task to meet staffing needs appropriately
3. Accountability: Building a culture where staff are accountable to each other and the organization
4. Strategic staffing: Focusing on skill mix and experience levels to ensure the right staff are in the right roles
   

"I've learned how critical it is to have the right tools in place in order to ensure that you have the right staff in place to take care of your patients. So, any type of tool that can provide visibility, transparency into what's going on is a top priority of mine." – Dr. Michelle Spurlock, System Chief Nursing Officer, Acadia Healthcare

Top priorities for CFOs

1. Managing labor expenses: Optimizing the largest cost center for behavioral health hospitals
2. Addressing claims denials: Maximizing reimbursements from payers and improving staff workflows
3. Supporting staff retention: Recognizing the link between staff satisfaction and financial outcomes
4. Cross-functional collaboration: Working closely with clinical teams to improve documentation and coding practices
   

"Retention for us is huge because we’re at a point now where we cannot lose people. We need to be pulling people in, not having people walk out the door." – Gordon Dixon, Chief Financial Officer, Smokey Point Behavioral Hospital

Collaborating cross-functionally to achieve shared goals 

Cross-functional collaboration is essential to achieving leadership priorities. While WFM and RCM are distinct functions, they are interconnected and can significantly enhance the overall effectiveness of healthcare delivery when aligned properly.  

The integration of WFM and RCM is crucial in addressing the challenges faced by behavioral health providers today. By aligning these two areas, organizations can enhance patient-centered care, ensuring that the right staff are available to meet patient needs while managing financial sustainability.

WFM focuses on optimizing staff allocation and ensuring that skilled professionals are scheduled appropriately to handle varying patient acuity levels. Strategic staffing not only improves patient outcomes but also fosters staff satisfaction. Conversely, RCM addresses the financial aspects, streamlining billing processes and reducing claims denials, which are often exacerbated by a lack of or inaccurate data in the revenue cycle process.

Working cross-functionally enables CNOs to collaborate with CFOs to ensure adequate staffing levels and manage labor costs, while CFOs focus on maximizing reimbursements and minimizing denials. This partnership enhances communication across clinical, nursing, and billing teams, ultimately leading to improved operational efficiency and better patient care.

Looking ahead to a resilient future‍

Healthcare leaders should be optimistic about the future. Leveraging technology to boost efficiency, enhance patient care, and gain more visibility with data-driven insights paves the way for a more resilient and effective behavioral health system. CNOs and CFOs have the opportunity to work together to optimize staffing and resource allocation while maximizing reimbursements and streamlining scheduling and financial processes across their organizations. 

Cross-functional collaboration powered by the right tools can build strong teams through transparency, accountability, and genuine appreciation. Leaders can better understand staff needs, balance schedules effectively, and foster a supportive work environment while engaging both staff and patients. The integration of workforce management and revenue cycle management tools can make this happen. 

By embracing innovative solutions and prioritizing staff satisfaction alongside financial sustainability, healthcare providers can better meet the growing demand for behavioral health services while delivering high-quality, patient-centered care.

Join us at Empower, Inovalon’s annual data-driven healthcare summit, this October for an in-depth discussion about how strategically leveraging data enhances patient outcomes, streamlines operations, and fosters equitable practices in healthcare.

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