Revenue1 Cycle Management Strategies1 and1 Financial Performance1 of Profit Making Private1 Hospitals1 in1 Nairobi1 City1 County, Kenya
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Date
2023
Authors
Mwaura, James Njau
Journal Title
Journal ISSN
Volume Title
Publisher
Kenyatta University
Abstract
The1 private1 healthcare1 sector in1 Kenya has1 made1 a remarkable1 contribution1 in1 the1 delivery
of healthcare1 services. The1 growth of the1 sector is1 spurred1 by deteriorating performance1 in1
the1 public hospitals1 and1 lack of resources. Declining health service1 use1 in1 Nairobi1 due1 to the1
COVID-19 has1 huge1 implications1 for their profitability as1 most capital hospitals1 are1
recording reduced1 patient numbers. Other factors1 affecting the1 financial performance1 of
private1 hospitals1 in1 Nairobi1 County include1 the1 revenue1 cycle1 management process1 in1
healthcare. Most of the1 private1 hospitals1 cannot be1 able1 to increase1 their bed1 capacity1
despite1 the1 high demand1 of health care1 due1 to financial constraints. This1 study sought1to
establish the1 effect of revenue1 cycle1 management strategies1 on1 Financial Performance1 of
profit making private1 hospitals1 in1 Nairobi1 City1 County, Kenya. Specifically, this1 study
focused1on1 the1 effect of communication1 strategies1 between1 medical providers1 and1 billing
staff, implementing payment strategies, billing strategies, and1 accounts1 receivable1
management strategies1 on1 Financial Performance1 of profit making private1 hospitals1 in1
Nairobi1 City1 County, Kenya. This1 study was1 anchored1 on1 the1 Transactions1 Cost Theory,
Contingency Theory and1 Trade-off Theory. The1 study adopted1 a descriptive1 research design.
This1 study targeted1the1 private1 hospitals1 in1 Kenya. The1 unit of analysis1 is1 47 profit making
private1 hospitals. The1 unit of observation1 was1 the1 780 respondents1 comprising of senior
management. To determine1 how the1 sample1 was1 distributed1 among the1 targeted1 respondents,
the1 study selected1 the1 respondents1 using the1 purposive1 sampling technique. Selfadministered1
questionnaires1 were1 used1 to collect primary data. Data was1 analysed1 using
Statistical Package1 for Social Sciences1 (SPSS1 Version1 25.0). Descriptive1 statistics1 included1
mean, frequency, standard1 deviation1 and1 percentages1 was1 used1 to profile1 sample1
characteristics1 and1 major patterns1 emerging from the1 data. In1 addition1 to measures1 of central
tendencies, measures1 of dispersion1 and1 graphical representations1 were1 used1 to tabulate1 the1
information. Content analysis1 was1 also used1 in1 processing of this1 data and1 results1 presented1
in1 prose1 form. Inferential data analysis1 was1 done1 using regression1 and1 correlation1 analysis.
Cross1 sectional data was1 presented1 in1 tables1 and1 graphs1 while1 qualitative1 data analysis1 was1
presented1 in1 prose1 form. The1 research found1 that hospitals1 provide1 reminder calls1 to patients1
and1 include1 discussion1 regarding patient balances1 and1 point of service1 (POS) collection1
policies. The1 research also found1 that the1 hospitals1 assist uninsured1 patients1 by scheduling a
meeting with financial counsellors1 to complete1 financial assistance1 applications. The1 study
also found1 that the1 hospitals1 use1 concurrent coding to improve1 medical necessity
documentation. The1 research found1 that was1 not certain1 whether the1 hospitals1 hold1 weekly
nursing and1 health information1 management (HIM) team meetings1 to discuss1 medical
necessity documentation1 and1 charge1 capture1 opportunities. The1 study concluded1 that
communication1 strategies1 between1 medical providers1 and1 billing staff had1 the1 greatest effect
on1 the1 financial performance1 of profit making private1 hospitals1 in1 Nairobi1 City1 County,
Kenya, followed1 by accuracy of billing strategies, then1 consistent accounts1 receivable1
reviews1 while1 Implementing payment strategies1 had1 the1 least effect to the1 financial
performance1 of profit making private1 hospitals1 in1 Nairobi1 City1 County, Kenya. The1 study
recommends1 that the1 timeliness1 observed1 in1 billing service1 at profit making private1
hospitals1 should1 be1 upheld1 in1 order to achieve1 its1 effectiveness1 and1 efficiency and1
consequently result to customer satisfaction. The1 study recommends1 long-term initiatives1
captured1 in1 a communication1 plan1 to enable1 conceptualization1 of dealing with complex
issues1 such as1 conservation1 and1 to provide1 time1 for diverse1 functions1 including consensus1
building and1 forming networks.
Description
A Research Project Subimitted1 to the1 School of Business,
Economics and Tourism in1 Partiall Fulfillment for the1 Award1
of Degree1 in1 Master of Business1 Administration1 (Finance1
Option) of Kenyatta University
Keywords
Revenue, Cycle Management Strategies, Financial Performance, Private Hospitals, Nairobi City County, Kenya