At this week’s HealthLeaders Revenue Cycle Technology Mastermind session in Savannah, RCM executives talked about how technology is altering their profile and requiring them to work more closely with administrative and clinical leaders.
Key Points
- SRCM leaders from nine different health systems attended this week’s Mastermind event in Savannah, which was held immediately before the HealthLeaders Revenue Cycle Technology Exchange.
- RCM departments are changing as a result of AI, which also helps managers redefine employee roles and collaborate with other C-Suite executives on enterprise-wide strategy. Executives must learn how.
- AI tool can improve clinical and administrative tasks, just as other C-Suite members need to understand how AI may improve RCM.
It is much harder to make sure that everyone is on the same page, but everyone agreed that AI is revolutionizing RCM and will be crucial in boosting output and outcomes. This entails educating (and sometimes retraining) RCM staff to manage new workflows and expectations, as well as collaborating with clinical, financial, and administrative leaders to assess the return on investment (ROI) of a new tool for numerous departments.
Allyson Keller, vice president of Piedmont Healthcare’s Patient Connection Center, stated, “It’s about changing the old idea that revenue cycle management is just about the money.”
By highlighting how AI can improve the healthcare system’s financial performance, the RCM department has regularly raised its profile. However, RCM executives are facing new challenges in integrating that potential with the health system’s overall plan as they integrate technology into traditional processes to improve operations. For example, change has sped up to the point where plans that are five years long are no longer practical and are being replaced by plans that are no more than one to three years long.
Executives must evaluate new technology quickly due to the shorter time frame. Common strategies to attain short-term ROI include locating a clinical tool with a rev cycle value or talking with clinical leaders about how a technology that improves the rev cycle can also improve clinical operations.
That’s challenging. Several executives, including Beth Carlson, VP of Revenue Cycle and Chief Revenue Cycle Officer at WVU Medicine, and Joann Ferguson, VP of Revenue Cycle at Henry Ford Health System, echoed the significance of having clinical advisors on the RCM team. Among others, Steve Kos, Senior Director of Revenue Cycle Application Support at Baptist Health in Jacksonville, Florida, talked about the value of revenue cycle informaticists and how they differ from clinical informaticists. They pointed out that without those connections, it can be difficult to approach clinical leaders.
The problem is exacerbated by the healthcare delivery system’s historical silos. Finance and revenue cycle executives focus on the money, IT stays concentrated on technology, and clinicians focus on their areas of expertise. According to Lynn Ansley, VP of Revenue Cycle Management at the Moffitt Cancer Center, just as RCM executives may not fully understand clinical operations, clinicians generally lack the knowledge necessary to navigate the financial or administrative realms.
But AI is changing that notion. It enables—some might even say necessitates—the cooperation of different medical procedures. In addition to enhancing clinical workflows and outcomes, clinical leaders need to comprehend how the newest technological tool or platform impacts IT and RCM. Given this, the CEO and CFO would be interested in an ambient AI tool that could also find coding opportunities and optimize patient handoffs.
Additionally, as AI replaces traditional RCM tasks, RCM executives are being forced to develop new job descriptions for their staff members, which may include taking on more patient-facing responsibilities. The idea that AI can help clinicians spend more time with their patients and less time in front of a computer is also advantageous to RCM executives and their staff. This opens up opportunities to work with payers and providers to improve prior authorizations and reduce denials. Additionally, it makes it possible to work together with patients to comprehend better and handle their financial obligations.
However, it redefines RCM. According to ZoomCare’s VP of Revenue Cycle Management, Evan Martin, “AI is taking what has always been a transactional process and giving it a human face to the patient.” RCM has expanded beyond the hospital’s back offices, and its staff and management are no longer confined to doing mathematical calculations.
In the end, this is all about making better decisions about patient care, as one participant noted.
