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 by the Healthcare Financial Management Association (HFMA), they have outsourced for some ancillary and outpatient RCM processes.
As reported in RevCycle Intelligence, outpatient services expanded and staffing shortages increased during the COVID-19 pandemic, causing revenue cycle leaders to increasingly turn to automation and outsourcing to fulfill their RCM responsibilities.
Nearly 22 percent of respondents that manage inpatient RCM services themselves reported outsourcing some of their outpatient RCM services, while 12 percent want to take this approach in the future.
Almost 10 percent said they would like to outsource all of their outpatient or ancillary RCM services in the future while maintaining their own inpatient RCM processes.
The most common outpatient services healthcare leaders outsourced were anesthesiology, gastroenterology, and urology. Respondents were most likely to consider outsourcing RCM services for remote patient monitoring and medical devices, internal medicine, and radiology and imaging.
Satisfaction is High
The study noted general satisfaction with outcomes among organizations that outsourced RCM services. Also, leaders who outsourced one function were more likely to outsource more services.
“There is pressure on hospital teams to effectively manage expanding outpatient sources of revenue and expenses,” Bill Voegeli, head of customer research at HFMA and president of Association Insights, said in the press release.
“Many of today’s healthcare financial and RCM teams lack the necessary time, information and/or staff resources to fully understand the opportunities or implications for RCM automation beyond their electronic health record. Our research with XIFIN gives credence to the notion that healthcare finance professionals will benefit by staying up-to-date about ways to optimize the growing area of outpatient RCM and gives RCM executives insight into new avenues for optimization.”
Meanwhile, a quarter of respondents reported that their outcomes fell below their objectives for process optimization, operational efficiency, and technology requirements and alignment. Outsourcing these services might help improve the success rate of these functions, the study suggested.
Healthcare RCM Outsourcing Market
According to a press release from Technavio, healthcare RCM outsourcing market growth will accelerate at a compound annual growth rate (CAGR) of 7.75% between 2022 to 2026 -- indicating that more healthcare providers are looking to outsource their RCM functions. With a plethora of companies to choose from, healthcare providers need to carefully consider what functions will be most beneficial for them.
For functions like EOB processing -- vendors like RMS specialize in this -- streamline the process from receiving to payment.
Then there is choosing the right medical lockbox vendor. Healthcare providers need to consider the technology being utilized by these vendors -- particularly now that patient responsibility and payments are growing, according to Josh Berman of Linchpin Healthcare.
Healthcare providers need to ensure that their medical lockbox vendor is utilizing the latest artificial intelligence and machine learning technologies to process the checks that patients send in as payments. This will ensure that information extracted from the checks -- including amount (CAR/LAR), payor, and memo line -- is accurate and associates the payment to the right patient/claim, streamlining the AR process.
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