Healthcare revenue cycle management (RCM) leaders are under incredible pressure right now. The rising cost of care, more restrictive payer reimbursement policies, patients having to take on a larger share of their care costs, and hybrid work and staffing challenges combine to make their jobs tougher and bottom line results more critical. The HealthLeaders Revenue Cycle Exchange event earlier this month in Arizona was very timely. In addition to attending some great sessions and speaking with revenue cycle leaders from across the country, several Flywire healthcare team members had the opportunity to conduct a roundtable discussion with execs from six mid/large-size providers and health systems about their RCM priorities.
The conversations at the event centered on how to run more efficient revenue cycles by improving the patient financial experience, increasing cost transparency and reducing operating expenses. Three specific themes stood out to our team:
1. Find ways to engage patients earlier in the revenue cycle management process
RCM executives are looking for ways to engage with patients earlier—ideally before they walk in the door—to help set cost expectations, prevent insurance denials and avoid surprise billing. They believe that the more the patient understands up front about their financial commitment, the more compliant they will be in the payment cycle. They also understand that delivering on that will require access to more accurate pre-service care estimates and greater transparency from payers about specific treatment coverage and the share patients will be responsible for. One provider shared that they had started doing calls with patients pre-service to set up partial payments. In just 6 months they collected $2 million in pre-service payments.
Patient financial literacy is also part of the early engagement discussion. Several execs felt providers were being unfairly blamed for surprise billing and high treatment costs. In addition to making patients aware of the cost drivers of different treatments, they also want to help them understand how insurance coverage is decided, and the different patient payment options available for remaining balances.
2. Managing distributed, hybrid/remote workforces ups the ante to automate
There was also a lot of talk about hybrid work and staffing challenges in finance and revenue cycle management. With more staff demanding to work remotely, and qualified staff getting more difficult to find, executives are being forced to rethink their revenue cycle workflows. Overall, RCM execs expressed more flexibility and openness to hiring hybrid staff.
Industry consolidation is also influencing the way people work – and the need to blend different work cultures and sometimes manage workforces that are distributed across the country. To that end, there was a lot of discussion about managing remote staff effectively and the automation tools they need to do their jobs properly from afar in a distributed organization. There was also an interest in finding the right technology tools to free up revenue cycle staff to focus on more interesting and important work. Some are also looking at what roles they could fill with a digital solution.
3. Meet patients where they are with technology and automation
The discussion of technology was not limited to hybrid work. RCM execs are looking at any way they can use digital tools to make the patient financial experience faster, easier and more accessible. How that takes shape at different providers will vary of course. One exec talked about its 100% digital RCM process. Others insisted on the need to make paper statements available to a subset of their patients that prefer them. Conversely, younger patients don’t want paper statements, and they don’t want to talk to anyone on the phone. It has to be all digital for them. So, providers are finding ways to adapt — with the mindset of whatever makes it easier for the patients to pay their bills.
Chatbots and virtual assistants were also top of mind. RCM execs know they will need to do something at some point – but how and what it looks like is less certain. A few reported implementing AI-driven bots for simple tasks, but the majority were just dipping their toe in the water. Overall, there was a lot of uncertainty and hesitation. The consensus was that there are areas bots can add value, e.g., answering basic questions early in the process, but they are not ready to be applied broadly across the RCM process, and may very well never be. RCM is highly personal – 10 patients might represent 10 completely different financial paths. Providers will still need humans to support patients on the financial side, at some level, for the foreseeable future.
For more information on trends in revenue cycle management:
- Read our recent report on “Why patient payments should be a key priority for CFOs.”
- Download our survey of healthcare IT leaders “Behind the EHR: Healthcare’s hidden heroes of patient experience.”
- Learn 4 areas that will impact patient collection processes in 2024