Revenue Cycle Management Strategies and Financial Performance of Profit Making Private Hospitals in Nairobi City County, Kenya
Loading...
Date
2022
Authors
Njau, Mwaura James
Abdul, Farida
Journal Title
Journal ISSN
Volume Title
Publisher
IAJEF
Abstract
The private healthcare sector in Kenya has
made a remarkable contribution in the
delivery of healthcare services. The
growth of the sector is spurred by
deteriorating performance in the public
hospitals and lack of resources. However,
their demonstrated significance in
actualization of development goals,
sustainability of private hospitals has been
put to question, threatening the socioeconomic status of both developing and
emerging economies. These organizations
struggle with ensuring that debts are
collected while not pressuring the patients
so much that they seek care at other
facilities. There are however strategies
advanced to ensure that the poor people
have proper access to medical services in
the private sector but its implementation is
far from being effected due to the costs
that are involved. This study sought to
establish the effect of revenue cycle
management strategies on financial
performance of profit making private
hospitals in Nairobi City County, Kenya.
Specifically, this study focused on the
effect of communication strategies
between medical providers and billing
staff, implementing payment strategies,
billing strategies, and accounts receivable
management strategies on financial
performance of profit making private
hospitals in Nairobi City County, Kenya.
This study was anchored on the
Transactions Cost Theory, Contingency
Theory and Trade-off Theory. The study
adopted a descriptive research design. This
study targeted the private hospitals in
Kenya. The unit of analysis is 47 profit
making private hospitals. The unit of
observation was the 780 respondents
comprising of senior management. To
determine how the sample was distributed
among the targeted respondents, the study
selected the respondents using the
purposive sampling technique. Selfadministered questionnaires were used to
collect primary data. Data was analysed
using Statistical Package for Social
Sciences (SPSS Version 25.0). Descriptive
statistics included mean, frequency,
standard deviation and percentages was
used to profile sample characteristics and
major patterns emerging from the data. In
addition to measures of central tendencies,
measures of dispersion and graphical
representations were used to tabulate the
information. Content analysis was also
used in processing of this data and results
presented in prose form. Inferential data
analysis was done using regression and
correlation analysis. Cross sectional data
was presented in tables and graphs while
qualitative data analysis was presented in
prose form. The research found that
hospitals provide reminder calls to patients
and include discussion regarding patient
balances and point of service (POS)
collection policies. The research also
found that the hospitals assist uninsured
patients by scheduling a meeting with
financial counsellors to complete financial
assistance applications. The study also
found that the hospitals use concurrent
coding to improve medical necessity
documentation. The research found that
was not certain whether the hospitals hold
weekly nursing and health information
management (HIM) team meetings to
discuss medical necessity documentationand charge capture opportunities. The
study concluded that communication
strategies between medical providers and
billing staff had the greatest effect on the
financial performance of profit making
private hospitals in Nairobi City County,
Kenya, followed by accuracy of billing
strategies, then consistent accounts
receivable reviews while Implementing
payment strategies had the least effect to
the financial performance of profit making
private hospitals in Nairobi City County,
Kenya. The study recommends that the
timeliness observed in billing service at
profit making private hospitals should be
upheld in order to achieve its effectiveness
and efficiency and consequently result to
customer satisfaction. The study
recommends long-term initiatives captured
in a communication plan to enable
conceptualization of dealing with complex
issues such as conservation and to provide
time for diverse functions including
consensus building and forming networks.
Description
Article
Keywords
Healthcare, Communication Strategies, Implementing Payment Strategies, Billing Strategies, Financial Performance, Profit Making Private Hospitals
Citation
Njau, M. J., Abdul, F. (2022). Revenue cycle management strategies and financial performance of profit making private hospitals in Nairobi City County, Kenya. International Academic Journal of Economics and Finance, 3(7), 296-316.