Hospices Reshape RCM in a Remote World

As the business of hospice turns more virtual during the coronavirus pandemic, leaders are increasingly looking ahead at the long-term impacts and sustainability of remote operations. Accountability measures and efficient technology will be key as hospices seek new ways to reshape remote revenue cycle management (RCM).

Telecommuting has been on the rise in several industries, including health care. The U.S. Bureau of Labor Statistics reported that an estimated 31 percent of workers across the nation had switched to remote capacity by the beginning of April following the outbreak of COVID-19. The virtual workforce is expected to grow, according to a Gartner, Inc., survey of chief financial officers and financial leaders, with nearly 75% of respondents leaning toward a permanent shift to remote work.

The ability to provide telecommuting options became vital for hospice organizations to maintain a healthy workforce during the COVID-19 pandemic. Providers nationwide restructured and reevaluated policies to bolster remote capacity as they worked to protect staff and high-risk patients.


Concerns among hospice leadership abound over the long-term capacity to run smoothly in a remote workspace. With a pandemic-driven recession looming overhead and upcoming new payment models coming in 2021, enduring the financial waves of change will take an increased focus on revenue cycle management. In addition to the intricacies of evolving insurance billing policy changes amid an economic downturn, hospice providers are challenged with navigating a new normal in the tele-workspace landscape.

“Productivity is probably one of the biggest concerns going into remote work,” said Matt Zabolotny, vice president of revenue cycle services for Net Health in a recent Hospice News webinar. “Even though it could save organizations money to move staff remotely, there is worry about control and productivity. You want to make sure everyone is being held accountable, and the best way to do that is to consistently collaborate with one-on-one and team check-ins to make sure there’s an avenue for communication.”

Pittsburgh-based software company Net Health shifted to an entirely virtual workforce, having closed a number of their physical locations due to the pandemic’s spread.


“As the leader of the organization, if you’re dialed in on a mindset of accountability and setting clear expectations, you’re going to have a lot more success,” Zaboltony commented. “Communicate those expectations a lot, both in writing and consistently in recurring supervisions. Train, trust, and supervise and clearly define everyone’s roles and responsibilities. [A] culture of accountability starts from the top and flows down. There are a lot of platforms out there that allow you to collaborate with remote employees using strictly technology.”

Hospice leaders can instill accountability in remote staff with consistent touchpoints, especially as the pandemic’s storms reach into their bottom lines. Riding out the sea of unknowns will hinge in part on the ability to effectively communicate with staff in billing and collections. Revenue cycle management has largely become dependent on an organization’s technology capabilities, with compliance and data tracking key.

“HIPAA compliance has really put a number of organizations at risk by having folks work remote,” said Zaboltony. “You want to make sure that you set in a policy that [staff] wireless routers need to have strong password protection and encryption so there’s no loss of data, or no one is able to hack into their home router. You want to provide your team with encrypted and password-protected hardware that comes from your office and was set up by your IT department. Avoid having remote employees using any type of home computer. They’re checking claims online. That protection is so that the HIPAA compliant data can be sort of containerized within the device, and if the person should leave or lose their device, you can wipe that information from it and you’re protected from a breach.”

Despite the price tag that comes with technology, having compliant and data-driven systems in place could have greater potential for the unfolding value-based care models in the hospice space. Tracking claims status and patient care costs could give hospices planning to participate in the Medicare Advantage Value-Based Insurance Design (VBID) Model a competitive advantage in the ability to demonstrate their value proposition to payers.

Expanding remote work options could also broaden talent pools and encourage retention, giving hospices the ability to recruit nationally beyond the geographic limitations of their service areas, according to Zaboltony. With staff retirement and limited training opportunities leading factors of hospice workforce shortages, redesigning career paths remotely could attract a younger and more diverse base with long-term potential.

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