RCM outsourcing and technology have become inseparable companions in the healthcare industry. The powerful technology provided by outsourcing partnerships offers streamlined workflows, intelligent automation, and unparalleled accuracy, leading to reduced costs and increased revenue collections. This surge in benefits has fueled the rising popularity of revenue cycle outsourcing.
The latest research conducted by The Health Management Academy (The Academy) reveals that a staggering 93% of health systems now rely on strategic RCM outsourcing partners. Moreover, 36% of these systems are considering expanding their relationship to a full enterprise partnership to leverage integrated technology platforms for enhanced performance.
The growing complexity of revenue cycle management, coupled with rapid technological advancements, has rendered internally built technologies inadequate for many health systems. Recognizing this challenge, healthcare providers are seeking dedicated revenue cycle management partners who can amalgamate people, processes, and technology into a robust revenue cycle solution. Automation and sophisticated analytics are crucial factors to consider when selecting an RCM outsourcing partner. Equally important is assessing how technology can address specific challenges faced by three key stakeholder groups: health systems, patients, and staff.
Stakeholder 1: Health Systems
Healthcare administrators are all too familiar with the problem of patient referral leakage. When patients receive referrals for diagnostic tests or follow-up visits, there is no guarantee that they will choose to stay within the same health system. Healthcare Finance reports that patient leakage is a major concern for almost 90% of healthcare leaders, resulting in significant revenue losses of up to 20%.
To combat patient leakage, health systems require intelligent patient experience tools. These tools enable providers to submit referrals and signed orders electronically, facilitating faster and more consistent patient conversion. By reducing administrative burdens associated with manual referral processes, such as faxing and phone calls, staff members have more time to handle complex patient issues. Identifying gaps within a health system, such as patient leakage, provides healthcare executives with a starting point for selecting a revenue cycle outsourcing partner to improve their overall business model.
Stakeholder 2: Patients
Patients are accustomed to technology that simplifies their lives, such as online shopping and online bill pay. Although the healthcare industry has been slow to adopt patient-facing technology, the COVID-19 pandemic has accelerated its adoption. Patient-facing financial tools offer numerous benefits. They not only improve the financial experience for patients but also enhance the propensity to pay.
When evaluating an RCM outsourcing partner, it is crucial to consider patient-facing tools beyond simple payment facilitation. A comprehensive financial suite, including price transparency tools, bill consolidation options, and customized payment plans, should be part of the evaluation criteria. R1’s patient-facing technology empowers patients, resulting in high patient satisfaction scores and increased revenue performance for providers. Automation of the prior authorization process is another aspect that directly impacts patients, ensuring faster access to necessary medical care and reducing administrative burdens.
Stakeholder 3: Staff
The healthcare industry is facing a labor shortage, not only in clinical staff but also in revenue cycle management and billing departments. According to a recent survey, 90% of healthcare executives report a shortage in their RCM/billing departments, with almost half of the positions currently vacant. As a result, time-consuming administrative tasks like manual billing, coding, and insurance verification have increased, leading to potential human errors, billing discrepancies, and a negative patient experience.
RCM automation can alleviate these administrative burdens, allowing staff members to deliver higher quality patient service and focus on complex revenue cycle problem-solving. This not only benefits patients but also enhances employee satisfaction by creating growth opportunities and reducing work-related stress.
In conclusion, analyzing the benefits of RCM technology from the perspectives of different stakeholder groups offers a profound understanding of the advantages of an RCM outsourcing partnership. When evaluating or extending an RCM partnership, it is essential to conduct a thorough analysis of current processes, identifying areas for improvement. Instead of solely focusing on the technology aspect, it is crucial to assess how technology, when combined with people and processes, can provide specific benefits to all stakeholders involved.