Designing Revenue Integrity for Value and Efficiency

The 2024 NAHRI Leadership Council zeros in on the keys to optimizing and focusing revenue integrity programs.

Designing an effective, efficient revenue integrity program is a balancing act. Leaders must determine the program’s focus, size, and structure based on their organization’s facility and service line
mix, the volume of charges and claims its departments generate, the payers it works with, the EHR and other technology it uses, and other factors. These needs must be balanced against the resources available to support the program. Done right, the organization will reap the rewards of complete, compliant, and audit-proof revenue.

This report, based on data gathered from the 2024 NAHRI Leadership Council Research Survey: Revenue Integrity Program Structure and Staffing, provides key into program design and staffing models from across the country, including reporting structure, key responsibilities, program focus, and more.