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OrboNation Healthcare RCM Blog

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RCM Outsourcing Market Analysis: 22% of Rev Cycle Leaders Outsource Outpatient RCM Services

A report entitled An Analysis of Outpatient Revenue Cycle Management Outsourcing, the result of a collaboration between HFMA and health information technology company XIFIN and reflecting responses from 157 US-based HFMA members, reveals that over one in five revenue cycle leaders handle their own inpatient revenue cycle management (RCM) operations. However, according to a study conducted…
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Healthcare M&A Generates $19B in Q2 2022

Mergers and acquisitions (M&A) are common occurrences in the healthcare market. Whether it’s consolidation of healthcare providers/hospitals/systems or synergistic healthcare technology companies advancing their capabilities to improve healthcare, M&A within the industry is seen as a major positive. Over the past decade, we’ve seen what have been dubbed “mega-deals,” including: Microsoft acquiring Nuance for $19B…
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PYMNTS.com: Healthcare Represents 20% of GDP

PYMNTS.COM leads with a jarring statistic: At more than $4 trillion, healthcare spending in the United States accounts for nearly 20% of gross domestic product (GDP), a far greater share than other Organization for Economic Cooperation (OECD) countries. There are many reasons for this disparity, but inefficiency and ineffectiveness in purchasing and payments loom large among them. Because…
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News Release: OrboGraph Acquired by Revenue Management Solutions (RMS)

Check Fraud and Recognition Solutions Business Will Continue to Run Independently Billerica, MA, August 16, 2022 – OrboGraph, a premier supplier of check processing automation, fraud detection, and healthcare payment electronification, announced today that Revenue Management Solutions (RMS), a provider of automated healthcare payments reconciliation services has acquired OrboGraph. Thompson Street Capital Partners (TSCP), a private…
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Payers & Providers Collaboration Needed to Modernize the Claims Payment Experience

According to McKinsey & Company, insurers are much closer to their vision of near-optimal claims processing in 2030 than they were just a few years ago. HealthPayer Intelligence reports that this means commercial health payers can expect the benefits of an integrated, digital claims payment process that benefits every stakeholder. A claims payment solution that…
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Healthcare IT Market Worth $821.1 Billion by 2026

According to the new market research report entitled “Healthcare IT Market by Products & Services (Healthcare Provider Solutions, Healthcare Payer Solutions, & HCIT Outsourcing Services), Components (Services, Software, Hardware), End-User, and Region – Global Forecast to 2026″ (download HERE), the global Healthcare IT market is projected to reach USD 821.1 billion by 2026 from USD 326.1…
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Report: Nearly Half of Providers Behind on Revenue Goals Amid RCM Dept. Labor Shortages

As inflation soars and pandemic-era aid comes to an end, MedCity News reports that many industries and Americans have been struggling to thrive in the post-pandemic economic landscape. The U.S. healthcare system is not exempt from this state of affairs: Kaiser Permanente recorded a net loss of $961 million in the first quarter Ascension’s net loss was $884.7…
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Update on No Surprises Act & Advanced EOBs: Over 2M Potential Surprise Bills Prevented

Early data indicates that the No Surprises Act — signed into law in 2020 and designed to protect against unforeseen charges and escalated bills, and which took effect on January 1, 2022 for most consumers enrolled in individual and group health insurance plans — is delivering on its promise in spite of significant enforcement challenges.…
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OrboNation Newsletter: Healthcare Payments Edition – June 2022

In case you missed it, over the past month, we have published incredible content on our OrboNation Blog and Modernizing RCM with AI. Review the latest OrboNation Newsletter online or via PDF download.
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AI & Machine Learning Technologies Tackling $1 Trillion in Healthcare Administrative Waste

In a recent interview with HealthCare IT News, Brian Robertson, CEO of VisiQuate, discussed the challenge of administrative waste in healthcare, particularly in a time when the healthcare industry is stretched thin for resources and experiencing a labor shortage. In the conversation, Robertson discusses how IT tools such as artificial intelligence, machine learning, and revenue…
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Revenue Cycle Leaders Facing Challenges for Second Half of 2022 and Beyond

Even before COVID, healthcare financial management was complex and challenging. The new curve-balls being thrown at us by the existence of a pandemic have made it more important than ever to seek and use information gained by others in the industry. Becker’s Healthcare marked the half-way point of 2022 by asking leaders about the biggest…
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Nuance, Health Management Academy Launch Artificial Intelligence Collaborative

The importance of artificial intelligence and machine learning deployment across healthcare has been discussed throughout the industry for some time now. We’ve seen, for instance, healthcare and technology stakeholders directly address the chair and vice-chair of the National Artificial Intelligence Initiative Office (NAIIO) via a letter asking that healthcare be included in the scope of its work to…
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How Next-Gen Automation Tech Can Improve Healthcare RCM

In an article for MedCity News, Dr. Yan Chow, Global Industry Leader for Healthcare at Automation Anywhere, explores in detail the role of next-generation automation technology in healthcare revenue management. Today, nearly every role in every industry is facing some level of disruption. We are tasked with achieving more with less – less time, less resources,…
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OrboNation Newsletter: Healthcare Payments Edition – May 2022

In case you missed it, over the past month, we have published incredible content on our OrboNation Blog and Modernizing RCM with AI. Review the latest OrboNation Newsletter online or via PDF download.
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Cerner/AKASA Partnership: Driving Automation Through AI For Better Doctor and Patient Experience

RevCycleIntelligence.com reports that Cerner, a global healthcare technology company, has announced that it is prepared to help members achieve revenue cycle automation by providing access to an artificial intelligence (AI)-driven platform through a collaboration with AKASA. “We’re excited to team up with AKASA to accelerate the adoption of advanced automation within the revenue cycle,” Steven Colucci,…
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Price Transparency Addressing Buy Now, Pay Later Model

We are watching the healthcare industry reinvent itself after being buffeted by a pandemic. In addition to problems of staffing, space, and encouraging preventive habits, paying for care has been exposed as particularly problematic. Fortunately, as reported on the PYMNTS.com website, new players are stepping up to address it. Startup Walnut announced Thursday (May 5) its $110 million…
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PwC Report: Inflationary Impact Baked Into Healthcare Costs Before It Hit the Economy

PwC, a leader in Customer Experience Strategy Consulting, released a report that examines medical costs trends in this unique period of time: The pandemic has shifted how and where Americans gain access to care, a shift large enough to influence multiple aspects of price and utilization and, thus, medical cost trend. The aftereffects of the…
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No Surprises Act Update: How Will It Be Enforced?

The No Surprises Act was signed into law in 2020, going into effect on January 1, 2022 for most consumers enrolled in individual and group health insurance plans. As discussed in this space previously, the new law addresses “surprise” medical bills in any of the following three circumstances as described by the Commonwealth Fund: An…
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OrboNation Newsletter: Healthcare Payments Edition – Apri 2022

In case you missed it, over the past month, we have published incredible content on our OrboNation Blog and Modernizing RCM with AI. Review the latest OrboNation Newsletter online or via PDF download.
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58% of Healthcare CFOs Expect Increase in Adoption of Payments Digitization

Corcentric CEO Matt Clark talked to PYMNTS about moving healthcare, insurance and financial services into the digital age. The conversation came against a backdrop in which 71% of surveyed chief financial officers (CFOs) at finance and insurance companies and 58% of healthcare and medical company CFOs said they expect the digitization of their payments processes to speed up…
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Avaneer Health CEO Stuart Hanson Talks Challenges and Trends of Blockchain in Healthcare

How serious is blockchain adoption in the healthcare industry? Consider this: $50 million in seed funding has been committed to the Avaneer Health network, funds which come from from several blue chip healthcare organizations. As reported in Healthcare IT News, the new funding comes from founding network participants that include Aetna, Anthem, Cleveland Clinic, Health Care…
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HIMSS TV Digital Check Up: Community Care Networks, AI and Blockchain Boost Value-Based Care

Bill Siwicki, feature editor for Healthcare IT News, spoke to Lynn Carroll, COO at HSBLOX, about the roles of blockchain, AI, and machine learning in value-based care. (For a refresher on the ins-and-outs of blockchain, click here.) Mr. Carroll noted that “20% of people can represent 80% of expenses.” Therefor, you try to understand where…
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2021 CAQH Index Report Reveals Progress in Adoption of Electronic

The Council for Affordable Quality Healthcare, Inc. (CAQH) recently released their 2021 CAQH Index Report, and it predictably reported that electronic claims management adoption increased in 2020 as healthcare providers shifted, whenever possible, to remote work environments in the face of COVID. RevCycle Intelligence reported, however, that the Index shows healthcare providers still leaving billions…
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OrboNation Newsletter: Healthcare Payments Edition – March 2022

In case you missed it, over the past month, we have published incredible content on our OrboNation Blog and Modernizing RCM with AI. Review the latest OrboNation Newsletter online or via PDF download.
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Retaining Patients: Successful Tech Needed in New Era of Pricing and Payments

“Patient as consumer” is by no means a new concept; however, it seems that a great many health systems are having a hard time grasping the concept in terms of engagement, according to a discussion posted on PYMNTS.com. “Health systems will tell you they’ve been financing patients for a long time,” CareCredit Senior Vice President and General…
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Identifying the Right Tech: RPA Use Cases for the Revenue Cycle

One of the many barriers the pandemic has introduced to efficient medical billing and the revenue cycle is a significant personnel shortage. RevCycle Intelligence reports that healthcare organizations are increasingly turning to automation to hit the trifecta: increase net revenue, reduce costs, and improve the patient experience. As reported in RevCycle Intelligence, Robotic Process Automation,…
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All-Star Speaker Line Up for Upcoming Revenue Cycle Industry Brief & Opportunity Analysis Webinar

OrboGraph is pleased to announce the All-Star Speaker lineup for our upcoming Healthcare Revenue Cycle Industry Brief & Opportunity Analysis Webinar! These three leading experts from Citizens Bank M&A Group, the Council for Affordable Quality Healthcare (CAQH), and Linchpin Healthcare will address ways in which the healthcare revenue cycle management market is providing opportunities for growth, transaction…
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Experian Health: Healthcare Payments Overhaul in 2022 — Focus on the Patient

“Healthcare is one of the only industries where we go get a service and don’t know what our cost is going to be until sometimes months after that service has been delivered,” Jason Considine, senior vice president of Experian Health, told PYMNTS in a recent article examining the healthcare payments overhaul that we’re seeing. That’s certainly a…
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OrboNation Newsletter: Healthcare Payments Edition – February 2022

In case you missed it, over the past month, we have published incredible content on our OrboNation Blog and Modernizing RCM with AI. Review the latest OrboNation Newsletter online or via PDF download.
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How AI is Resolving Common Coding Mistakes

Roni Berlin, BSHCM, CPC, CPB, who serves as associate vice president at ExdionRCM Solutions, opens an article at Medical Economics with the harsh reality that, if a medical student’s classes reflected the reality of practicing medicine today, “I would venture that more than half of the curricula would be focused on performing administrative work, including the…
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5 Trends Bringing Effective Intelligence into Revenue Cycle in 2022

Time for another look at what this year might bring in terms of revenue cycle challenges. Matt Seefeld, Executive Vice President at MedEvolve, created a list of reasons he is optimistic about the coming year — with the caveat that health organizations stay current in terms of evolving tech. As we enter 2022, providers with…
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Revenue Cycle Management 2.0: Key to Successful Healthcare Finance

Healthcare Economics doesn’t beat around the bush: the first line of their Revenue Cycle Management 2.0 story states clearly: It has never been more important for those in healthcare to manage their revenues effectively. This has, in turn, put greater emphasis on the need for Revenue Cycle Management (RCM) systems to enable a healthcare provider…
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OrboNation Newsletter: Healthcare Payments Edition – January 2022

In case you missed it, over the past month, we have published incredible content on our OrboNation Blog and Modernizing RCM with AI. Review the latest OrboNation Newsletter online or via PDF download.
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Kaufman Hall Research Reports 75% of Providers Experience Rev Cycle Issues

As the world continues to battle COVID-19, hospitals and healthcare systems are understandably under more pressure than any other type of organization. They not only struggle with the issues of staffing shortages, supply chain, and declines in revenue, but also need to treat the onslaught of those getting sick from the virus. Kaufman Hall management…
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Did Hospital Operating Margins Fall 80% Below Pre-Pandemic Levels in Q4?

As the healthcare industry is in the midst of recovery, Healthcare IT News spoke to Diana Allen, CEO of the SSI Group, which markets a revenue cycle management solution for providers and payers, for her expertise on how the pandemic has altered healthcare operations. One of the primary topics covered was the impact the pandemic…
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Turning Heads: R1 RCM Acquires CloudMed for $4.1B

Big news in the healthcare RCM industry comes to us via a joint press release: R1 RCM has agreed to acquire Cloudmed, a leader in Revenue Intelligence™ solutions for healthcare providers. The details of the agreement are outlined in the press release: “MURRAY, Utah and ATLANTA, Jan. 10, 2022 (GLOBE NEWSWIRE) —  R1 RCM Inc.…
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OrboGraph Recognized as 2021’s Top 10 Healthcare Interoperability Solution Company

As 2022 begins, we are proud to be included in Healthcare Tech Outlook’s list of Top 10 Healthcare Interoperability Solution Companies for 2021. As we’ve noted in both Modernizing RCM with AI and the OrboNation Healthcare Payments blogs, Interoperability continues to be a point of emphasis in the healthcare industry, particularly when it comes to revenue…
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Out of Network COVID-19 Hospitalizations Can Cost Over $100K

Adding to the various burdens that COVID-19 has placed on world economies and the population in general, RevCycleIntelligence reports that, when delivered outside of a patient’s network, COVID-19 hospitalizations can cost hundreds of thousands of dollars depending on where a patient is a treated. California was the most expensive state for out-of-network COVID-19 hospitalizations, with…
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OrboNation Newsletter: Healthcare Payments Edition – December 2021

In case you missed it, over the past month, we have published incredible content on our OrboNation Blog and Modernizing RCM with AI. Review the latest OrboNation Newsletter online or via PDF download.
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Pre-Bill Review of Docs and Coding Increase ROI 700-1000%

Enjoin CEO Dr. James Fee has some information every healthcare professional should be aware of: Bringing physicians into the mid-revenue cycle process can increase hospital ROI by 700%. In an article at Healthcare Finance, Dr. Fee says that hospitals and health systems can improve revenue through a pre-bill review prior to claims submission. His company,…
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Oracle to Acquire Cerner For $28.3B

Big news in the healthcare and technology industries comes our way via press release: Oracle Corporation (NYSE: ORCL) and Cerner Corporation today jointly announced an agreement for Oracle to acquire Cerner through an all-cash tender offer for $95.00 per share, or approximately $28.3 billion in equity value. According to the press release: “Working together, Cerner and Oracle have the capacity to…
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Season’s Greetings From OrboGraph

As the final days of 2021 wind down, we’d like to thank all our partners and clients for supporting OrboGraph in a record breaking year. Also enjoy our holiday video below! Season’s Greetings! The OrboGraph Family
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Automation – NOT Replacing Humans

If you are a reader of American Banker, you may have come across “Leaving the ‘numbing’ tasks to machines” (fear not, you can access the article free through a guest account.) The article addresses a common misconception that automation — and the underlying technology such as Artificial Intelligence and Machine Learning — is here to…
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Artificial Intelligence and Machine Learning: “It’s the Future of Revenue Cycle.”

Becker’s Healthcare notes that, given the compounding challenges of regulation and COVID, healthcare systems are increasingly focused on how to increase net revenue and cash while enforcing a lower cost to collect. The answer? Automation. Becker offers five insights for how HC systems can acquire and maximize automation: During an October webinar hosted by Becker’s Hospital…
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OrboNation Newsletter: Healthcare Payments Edition – November 2021

In case you missed it, over the past month, we have published incredible content on our OrboNation Blog and Modernizing RCM with AI. Review the latest OrboNation Newsletter online or via PDF download.
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estimated solution pricing from OrboGraph.