The sexy side of revenue cycle management

OK, maybe using the term "sexy" to describe anything related to revenue cycle management is a bridge too far. Or perhaps I'm just health-IT-enthusiast enough to go there.

Healthcare revenue cycle management is experiencing a revolution with the latest automation and remote work trends. A recent panel discussion with leaders from Banner Health, New York University Langone Health, Indiana University Health, and Luminis Health discussed the challenges and opportunities in revenue cycle management.

Here's what the most esteemed leaders in healthcare had to say about the hottest trends in healthcare revenue cycle management.

Staffing challenges

One of the biggest challenges faced by healthcare organizations is staffing. Finding and retaining qualified staff is difficult, expensive, and time-consuming. For example, senior-level revenue cycle positions can take more than 200 days to fill at nearly $6,000. Even entry-level positions can take more than 80 days and cost north of $2,000.

"The volatility of change is enormous in healthcare," said Christina Harney, Vice President of Access Management at IU Health. "At the end of the day, the team you have around you drives how successful you are."

Then there's the wrinkle of remote work. For some, it's a challenge. For others, a benefit. On the one hand, it provides workers with more opportunities, making recruiting and retaining talent difficult. But, on the other hand, adopting a work-from-home model allows leaders to pull from a larger pool of qualified candidates.

Becky Peters, Executive Director of Patient Access at Banner Health, found that allowing remote work has helped her team hire more qualified people across the country. "Since we opened up our hiring model to other states, we have seen an increase in being able to keep those staff," said Peters.

A hybrid approach seems to be working well for Sheldon Pink, Vice President of Revenue Cycle at Luminis Health, who reported that although their employees returned to the office quickly, they recognize that "there are other places where the work can be done."

Allowing employees to work from home, either part-time or permanently, seems to help improve morale and retention.

Automation poised to strike

Who would have thought that one of the sexiest opportunities in 2023 lay in automating revenue cycle processes?

And yet, it may turn out to be.

Automation is also poised to play a significant role in healthcare revenue cycle management. Harney reported that IU Health has already implemented automation to simplify scheduling algorithms, which allows access center agents to schedule appointments faster and more accurately. Patients can also "self-schedule appointments for primary and specialty care." Harney says automating preregistrations for hospital and physician visits is also a game changer.

Harney says IU Health has already implemented Experian Health's registration accelerator product and has done "a tremendous amount of work with bots." The game changer? Automating preregistrations for hospital and physician visits. Automatically conducting quality checks registrations and alerts them if an issue is detected.

The bots often resolve issues independently, without the registrar's involvement. By the end of 2022, she guesses they will have done over 100,000 registrations.

Goodbye manual processes

Then there are the other manual processes automated tools set to replace, like verifying a patient's coverage, which will reduce denials on the back end. Harney says they've already seen their first pass eligibility denial rate "go down significantly" and that the benefits have worked their way through the revenue cycle.

They've also implemented automation to simplify scheduling algorithms, which allows access center agents to schedule appointments faster and more accurately. As a result, their patients can now "self-schedule appointments for both primary and specialty care."

Another significant benefit of automation is providing good-faith estimates and achieving compliance with the No Surprises Act. Automation also helps reduce denials on the back end by verifying a patient's coverage.

Harney says they use a tool to send printed estimates through the mail for their self-pay patients. Now they're looking to automate even more, making it easier for patients to make informed decisions and pay their liabilities while helping staff to collect.

Increased revenues via automation

Now we get to the really sexy part: Money.

Peters rolled out an initiative shortly after joining Banner Health four-and-a-half years ago. It is called "revenue cycle modernization," and involves implementing automation in 26 projects between all areas of the revenue cycle.

"We saw a huge increase in our point-of-service collections, registration accuracy, and productivity," said Peters.

One of Banner Health's top operational goals for 2023? Increasing revenue.

"It's really about cash," said Peters. "Making sure we are financially strong, making sure our metrics are where they need to be. So, continuing to optimize all the tools we have and automating as much as possible."

Healthcare trends wrap-up

Staffing changes. Automating revenue cycle processes. Increasing revenue.

Can we really call them the sexy sides of revenue cycle management?

Well, let's put it this way:

In the context of a looming recession, decades-high inflation, and the effects of higher interest rates rippling through the economy, we think focusing on what matters — building the right team and strengthening efficiencies — might turn out to be the best decision healthcare innovators can make to lay the groundwork for years to come.

Overall, workflow automation is estimated to save the U.S. healthcare system more than $16 billion. If that's not sexy, I don't know what is!