Tips for Home Care Agencies to Improve Their Revenue Cycle

One area that home care agencies may want to think about rebooting in the new year is their revenue cycle management. Not every strategy for improving a revenue cycle will work for every home care agency, but finding one that works can help maximize the overall bottom line.

The revenue cycle of a typical home health agency refers to all administrative and clinical functions that a home care agency is responsible for for each patient, and has a number of components from intake through reporting. Within each step there are common issues that arise which can make or break an agency’s success, Michael Freytag, managing director of BlackTree HealthCare Consulting, said in a Home Health Care News webinar Wednesday, sponsored by Optima Healthcare Solutions.

One way to think about revenue cycle management is by focusing on these three domains: the people within the agency, the process the agency is using and the technology.


“All three areas are equally important to having a successful revenue cycle,” Freytag explained. “Technology is often blamed and in reality the EMR [electronic medical record] is a very important aspect and can definitely cause inefficiencies, but the people as well as the process are equally as important.”

Tackling staffing issues

Difficulties with employees can come up at multiple points during a revenue cycle, but a few are in scheduling and patient management, Freytag said.


Within scheduling some struggles that agencies encounter include a high number of clinicians missing visits and a large percentage of staff working overtime.

“If turnover is an issue you have to take a look at the root causes, because you can see a correlation between overtime hours and turnover numbers,” Freytag said. “A solution to staffing could be a systematic approach to utilizing EMR for scheduling or even look into centralizing or switching to a self-scheduling model.”

In terms of the patient management portion of the revenue cycle, issues that Freytag has seen among staff include lack of education as well as under- or over-utilization of certain technology platforms.

To combat these issues, agencies can implement weekly conferences to go over cases with clinicians as well as upgrade the continuing education program within the agency, Freytag said.

Collaboration and staff structure

Oftentimes utilizing technology and staffing issues go hand in hand, but if the two areas are managed properly, the revenue cycle has the potential to become seamless.

The OASIS completion step in the revenue is where many problems can come up and slow the cycle down, Freytag explained.

To make the process smoother, agencies could utilize weekly revenue cycle meetings to check in on OASIS completion and make sure there is a healthy amount of collaboration between the clinical staff and the finance staff, he added.

For almost all issues within a revenue cycle, if a solid structure is put into place by the leadership team every other specific issue will seem a lot less stressful.

“Leadership needs to ask themselves if they have the right structure in place and the right staff on a day to day basis and hold themselves accountable for following that,” said Freytag. “There is a fine line between micromanaging and holding your staff accountable and you have to walk that line.”

Written by Alana Stramowski

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