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The determination to overcome recent challenges like reduced patient visits and tighter margins is now paying off for providers with a promising transition from survival mode to revenue growth, as highlighted in Kaufman Hall’s March 2024 National Hospital Flash Report. With operating margins improving, leaders are increasingly able to concentrate on revenue enhancement strategies.
This shift has encouraged the need to prioritize investments in technology that boost operational efficiency and improve patient loyalty because it can help organizations provide a better patient experience and protect against network leakage.
Senior leadership is spearheading this momentum, recognizing that technology is not just an enhancement tool, but a vital component for survival and growth in today’s complex healthcare landscape, where patient care and regulatory demands are continuously evolving.
Based on survey results of 92 healthcare RCM and finance executives in FinThrive’s 2024 RCM Transformative Trends Report, here are the top technology investments healthcare organizations are making to accomplish their financial goals.
Electronic prior authorization (PA) solutions
As mentioned earlier, organizations are strategically prioritizing investments that drive revenue growth by enhancing operational efficiency and elevating the patient experience. So, it’s no surprise that electronic PA solutions have risen to the forefront of healthcare investments, with 41% of finance leaders identifying them as the top priority.
- Efficiency
Electronic PA promises a substantial reduction in the time taken for prior authorization requests, which is crucial given that only 6% of Medicare Advantage plan requests are denied, while 13% of claim denials are related to prior authorizations. By streamlining this process, providers can help ensure a smoother experience for patients, leading to quicker treatment times. - Automation
By automating the determination and status checking processes, healthcare providers can effectively reduce both PA and claims denial rates, which ultimately leads to better health outcomes for patients. This efficiency not only benefits the providers but also enhances the patient experience, fostering trust and satisfaction.
Recent data indicates that less than 60% of the market currently leverages electronic PA solutions, highlighting a substantial opportunity for growth and improvement in this area.
Robotic process automation (RPA)
With ongoing staffing shortages and the manual burdens associated with financial clearance and status checking, RPA has become a critical investment for healthcare organizations. RPA can efficiently handle high-volume, low-complexity tasks that are common in revenue cycle management (RCM), freeing up human resources for more complex and value-added work.
As a result, it’s no surprise that 33% of respondents tabbed RPA as a top investment priority.
- Cost savings
Automating essential tasks such as validating patient eligibility, correcting insurance data and managing Medicare document requests can lead to significant cost savings for healthcare organizations. These savings can then be redirected towards improving patient services. - Productivity gains
Automation has the potential to reduce the time spent on manual PA tasks by an average of 12 minutes per transaction. This acceleration can reduce delays and improve patient satisfaction and outcomes.
RELATED CHECKLIST: The Right Way to Automate Healthcare RCM
Denials management solutions
Denials management is another critical area ripe for technological intervention. Hospitals and health systems are losing millions of dollars annually due to claim denials, prompting executives to prioritize investments in advanced denials management solutions that can tackle this critical challenge head-on.
- Proactive issue resolution
Artificial intelligence-based tools can identify the root causes of denials and facilitate bulk appeals based on historical data and trends. This approach allows healthcare organizations to address potential issues before they escalate. - Streamlined processes
By gathering necessary documentation from the Electronic Health Record (EHR) and diligently monitoring appeal statuses, these solutions help in reducing the manual effort involved in managing denials. This efficiency not only saves time but also enhances the overall revenue cycle.
According to FinThrive research, 57% of respondents are prioritizing denials management in 2024, with nearly 30% planning to invest in dedicated solutions to address this issue.
RELATED INFOGRAPHIC: Cracking the Denials Code: Enhance Healthcare Financial Performance
Other noteworthy investments
In addition to the primary trends outlined, there are several other noteworthy investments that healthcare organizations are prioritizing in the coming months:
- Real-time eligibility solutions (23%)
These solutions ensure that coverage information is accurate and up-to-date, significantly reducing the risk of claim denials due to eligibility issues. - Underpayment recovery solutions (22%)
Tools designed to help recover underpayments can significantly boost revenue by recouping lost income - Clinical documentation integrity solutions (20%)
Ensuring that clinical documentation is accurate and comprehensive not only helps in better coding and billing but also enhances patient care and safety. - Insurance discovery solutions (18%)
Identifying all potential sources of insurance coverage can help reduce the financial burden on patients and providers, ensuring that patients receive the coverage they are entitled to. - Patient estimation solutions (18%)
Providing accurate estimates for patient bills enhances transparency and improves patient satisfaction by reducing unexpected costs.
The top planned technology investments for healthcare organizations reflect a strong focus on efficiency, automation and improved patient care.
To stay ahead of the curve, leaders must continue to invest in these innovative solutions. By doing so, they not only streamline their operations but also set themselves apart in the industry, ready to meet the challenges of the future and achieve long-term success.
Interested in learning more about your peers’ top strategic goals and how a surprising shift is impacting all organizations – big and small? Stay ahead of your competition with timely insights in our 2024 RCM Transformative Trends Report. Get the full report here.
