8 NOVEMBER 2023IN MY OPINIONFew physicians understand a hospital's revenue cycle. Practicing physicians top priority is patient care, as it should be, and most have little concern how their practice impacts hospital finances. In the era of cost containment, cost consciousness, price transparency and accountable care, physicians need greater awareness of the hospital revenue cycle and healthcare finances in general. Patients are becoming increasingly savvy and their physicians need a basic understanding of hospital finances in order to communicate with them intelligently.When it comes to hospital based revenue cycle and finances, physicians have the greatest control over assigning admission status and diagnosis related group t. Though Utilization Management (UM) and Clinical Documentation Integrity (CDI) departments follow criteria and rules regarding these areas, the physician's orders and documentation still drive these decisions. In the last ten years, physician and other healthcare providers are becoming more accustomed and comfortable with this but there is still a large knowledge gap for most providers and institutions. For this reason, it is imperative for intimate physician leadership in the UM and CDI processes. Assuring this will increase physician knowledge of and skill in revenue cycle and decrease the distance between revenue cycle and the bedside.This concept of decreasing the distance between revenue cycle and the bedside is an important one as it seems many areas of healthcare management are increasing the distance from the bedside. That is tolerable for some areas but for UM and CDI, it is not. Physician leadership in revenue cycle can take many forms and one form is not necessarily better or worse than another. This involvement can be a chief medical officer position to a medical director or can take the form of dedicated or even part time physician advisors. This leadership structure will depend on the needs of the institution, its size and resources as well as the talent available to it. Some health systems may have an internal candidate capable of fulfilling this role while others may need to seek an outside candidate. Whatever this model looks like, physicians involved in the revenue cycle process should be intimately involved in the following domains.IMPORTANCE OF PHYSICIAN LEADERSHIP IN REVENUE CYCLE MANAGEMENTBy Anthony Muni, Chief Medical Officer, Utilization Management & Clinical Documentation Integrity, University Hospitals
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