Structuring a central business office to succeed in a managed care dominated environment

Integrated delivery systems have begun to consolidate the business office functions of their member facilities in response to a decline in managed care revenues and an increase in health care expenses. Many who have pursued this strategy have experienced cost reductions through staff restructuring, but have not experienced the revenue retention, cash acceleration, and other performance gains originally envisioned. This often occurs when the role of the central business office (CBO) has been limited to serving only the "back-office" functions of claims processing. In today's health care environment, the viability of a CBO depends on its responsiveness to the administrative complexities of managed care. Successful CBOs accommodate extensive cross-functional coordination, achieve operational efficiencies through the use of automation, and adopt best practices for implementing managed care contractual obligations.