Understanding the Claims Lifecycle: A Step-by-Step Guide
Grasping the details of the claims lifecycle in healthcare is crucial for getting timely reimbursements and maintaining financial well-being. As...
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Since 2020, the healthcare industry has been hit hard by staffing shortages, with an estimated 20% in workforce reduction. Labor shortages are affecting all areas of healthcare organizations, not just clinical.
A recent HFMA survey of healthcare finance leaders found 100% respondents with at least one open revenue cycle role, and nearly 20% with more than 30 vacancies. Staffing constraints in healthcare finance can also lead to inefficiencies that reduce reimbursement and delay payments. As a result of RCM staffing challenges, 48% of finance leaders reported more billing errors and 29% are struggling with issues related to price transparency compliance.
Moreover, health systems and hospitals face tighter margins and more missed revenue opportunities as they struggle to fill clinical and nonclinical roles. Unsurprisingly, many finance leaders consider this a top challenge to address.
The following emerging trends in healthcare revenue cycle management (RCM) offer hope to executives needing to combat staffing shortages.
Automation takes significant manual labor out of the revenue cycle, and in some cases, complete workloads requiring FTEs. According to a Deloitte report, a typical robotic process automation (RPA) implementation yields an average of 20% FTE savings.
As such, automation should be a key strategy for your organization this year. Health systems are investing in automated systems, analytics, RPA, artificial intelligence (AI) and machine learning to offset revenue cycle staffing challenges. These technologies work together to automate repetitive tasks, freeing up employees to take on higher-value work.
Automation is also driving reductions in human error and measurably improving bottom lines. In a recent report, CAQH forecasts $16.3 billion could be saved through workflow automation in U.S. hospitals.
Integrating contextually relevant reference materials directly into workflows empowers staff to maximize their financial recovery efforts. Leading health systems are pioneering this approach by embedding medical billing and coding training content directly into workflows, solidifying core competencies and supporting staff transitioning to new roles.
In today's healthcare landscape, driving revenue cycle innovation hinges on adopting a human-centric approach and setting staff up for success.
Many healthcare organizations rely on multiple RCM vendors, creating data silos and significant interoperability and workflow issues. Increasingly, health systems are moving to consolidate with end-to-end RCM platforms to improve workforce efficiency and analytics.
Approximately 66% of revenue cycle leaders report their organization will invest in an end-to-end revenue management platform in the next 24 months. When evaluating an end-to-end revenue management platform, it’s important to look for a technology that offers frictionless delivery, platform integration and performance tracking throughout all stages of the revenue cycle.
Despite tight margins and missed revenue opportunities, emerging trends in healthcare RCM present promising solutions for executives grappling with staffing challenges.
Need more tips and strategies to address staffing shortages? Download our guide!
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