Revenue Cycle Automation Requires Two or More Vendors?
No one has to tell you the revenue cycle automation process is complex, and getting more so every year. That's why it'll come as no surprise that Healthcare Finance News is reporting that about 30% of health systems and hospitals are unable to manage their revenue cycle automation efforts without at least two vendors.
The numbers were gathered via the Healthcare Financial Management Association's Pulse Survey program, fielded between May 19, 2020 and June 22, 2020 among 587 chief financial officers and revenue cycle leaders at various health systems.
Another 30% have built internal automation teams, but the same report says that more than 76% of those organizations are large – with $1 billion or more in net patient revenues.
Regardless of the solution used to automate revenue cycle tasks, the process generally involves three steps: observing and documenting workflows, programming the technology to perform the work as documented, and maintaining the solution as inputs and variables in specific processes change.
The article goes on to report that it is not uncommon for business process consultants to take care of the first step while going with with a technology vendor to manage the second and third steps involved in implementing automation solutions.
When asked how many consulting firms and vendors they currently use to automate their revenue cycles:
- 38.5% said they use one vendor who can do all three steps of the automation process
- 31.5% said they don't use external consultants or vendors, instead deferring to an internal team who handles all of the steps themselves
- 19.6% use two vendors, one of whom handles multiple steps of the automation process
- 4.9% use three vendors, each of whom handles a different task
- 5.6% use four or more vendors
Reviewing the findings from the survey, we are able to find commonality with the "Start Small for Real Results" approach for implementing AI in healthcare that we recently covered in Modernizing RCM with AI.
Ori Geva, Co-Founder and President of Medial EarlySign, provides the following advice in an article from Health IT Today:
The benefits of pursuing smaller projects are clear, allowing models to be tested and tuned with existing systems to optimize for increased scale in the future. Dividing the challenges into smaller baskets and implementing them on a project-by-project basis can enable us to work smarter, learn faster, and affect real change. It’s not just about technology and who has the greatest algorithm, it’s about finding a more productive solution. Ultimately, it’s about bringing AI down to earth.
While managing multiple vendors is a tall task on its own, it's a necessary ingredient in achieving the desired result of automating RCM. Automation of the entire revenue cycle would require a major overhaul of processes and technology for hospitals and healthcare systems that is simply not feasible. Therefore, hospitals and healthcare systems need to take the approach of identifying processes fraught with manual tasks such as remittance processing, and smoothing that hurdle by teaming with a technology vendor like OrboGraph, which specializes in automating processes with AI technologies.
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