In the healthcare industry today, there’s a lot of buzz and hype surrounding automation. Large healthcare networks, medical facilities, and RCM service providers looking to achieve a more efficient, robust revenue cycle are eager to invest in automation technologies.
All this excitement is understandable. Any technology that can free employees to focus on more complex, high-value tasks—and make revenue cycle operations easy to scale—holds great promise for improving providers’ financial health.
Given the financial and market pressures providers now face, and the potential top- and bottom-line benefits automation technology can provide, there’s no question that automation is the future of revenue cycle management (RCM). The question healthcare executives should now be asking is, “Are the practical benefits and ROI available, here and now?”
They are, as long as you take a practical approach to investing.
In this post, I’ll share my recommendations for how you can maximize your tech investment. But first, let’s delve into the three main types of automation technology and how they can improve RCM.
3 Automation Technologies that Are Revolutionizing RCM
“There is no doubt that technology has transformed the world of revenue cycle. [ . . . ] The automation of processes not only saves time, it reduces the chances of errors to allow for a steady stream of revenue and cash collections.”
Megan Zannetti, VP of Revenue Cycle, Graham Healthcare Group
Automation has the power to streamline and improve revenue cycle performance and lower operational costs by taking unnecessary manual touches out of the process and redirecting valuable knowledge workers to even higher-yield tasks. Here’s how current automation technologies work—often in interrelated fashion—and how they impact RCM.
Robotic Process Automation (RPA)
RPA can be easily programmed and deployed to interact with software applications just as human workers do. Designed to handle repetitive rule-based tasks, RPA can help reduce errors in the revenue cycle and ensure more uniform revenue cycle processes.
Example use cases: RPA can be used to automate status inquiries or reduce payer hold times for A/R agents when calls are still warranted.
“I do think [RPA] has tremendous potential to expand within healthcare . . . and the primary use case that I see is in [the] revenue cycle.
I worked for a third-party claims organization for about 15 years. [I]t could be easier to train a fleet of robots who are doing repetitive activities and similar activities than it may be [to train] a large human staff. And so I see there being tremendous potential not just for the ability to accommodate change, but because there are a lot of rules-based activities within the revenue cycle process as well.”
A.J. Hanna, Executive Director, Ascension Ministry Service Center
Artificial Intelligence (AI)
AI is a field of study within computer science that strives to create intelligent machines that work and react like humans and become smarter over time. Speech recognition, visual perception, language translation, and decision-making are among the most common applications.
Example use case: AI can be used to model and predict availability of important resources such as access to a payer representative when gaining prior authorization or following up on a claim. While the various forms of automation technology can lessen our need to call payer IVRs, when a call is warranted, we want to undertake that task in the most efficient manner possible.
“The capabilities of AI and other technology-based tools to improve data accuracy and process efficiency and support overall financial improvement for the revenue cycle present compelling cases for organizational investment.”
Data Analytics (“Big Data”)
Big Data Analytics is the complex process of examining large and varied data sets, or “big data,” to uncover information such as hidden patterns, previously unknown correlations, market trends, and customer preferences. This data science helps providers make informed business decisions.
Example use case: Big Data can be used to better understand your patients’ behaviors and preferences with regard to your ongoing engagement with them through calls, portals, email, text, and social media. Armed with this information, you can ensure your patient engagement strategy is responsive to the preferences of each patient while improving overall patient satisfaction.
“[D]ata analytics has and will continue to play a significant role in efficient and profitable management of health systems. [ . . . ] Operational efficiencies and cost reduction through analysis of performance metrics can be achieved from the front-end contact center to back-end offices, and everywhere in between. [C]ountless organizations have increased profitability through revenue cycle optimization.”
Deloitte report, “The future of artificial intelligence in health care” (2019)
4 Tips for Maximizing Your Investment in Automation Technology
While automating RCM processes can help address major operational and financial challenges, automation must be applied intentionally to ensure you realize its benefits. The following practices can help ensure your tech investment delivers the greatest possible return.
1. Identify high-value opportunities.
What are the real business problems you’re facing? Where are your operational needs, inefficiencies, and gaps? Any new automation solution should align closely with them.
To identify process improvement candidates, focus on tasks that are high volume, rule-based, and repetitive—i.e., work that shouldn’t require manual touches.
As current candidates are monitored for success and new candidates are identified in an ongoing closed-loop process, you can continue to ease friction in the revenue cycle, create a virtuous cycle of improvement, and accelerate your revenue gains.
2. Look for ways to “reskill” your most important asset—your people.
Don’t think of automation as a way to generate ROI by simply reducing head count. Instead, look to unlock the talent you have and improve employee satisfaction and engagement at the same time.
With the support of automation technology that frees them from routine tasks, your employees can focus on more high-yield, productive work. They’ll also have the insights and tools they need to make better-informed business decisions. As your existing workforce becomes more informed, effective, and impactful, they’ll deliver more value to your organization.
3. Aim for higher-than-linear yields.
The application of automation technology shouldn’t be determined simply by the task at hand. It should also be applied in the context of current business conditions: time, talent, expected yield, and budget.
The relationship of technology to yield is NOT linear. More technology may not be better. Your organization’s progression across the technology axis (see below) will be determined by yield targets you’ve deemed acceptable.
Your business challenge is to achieve yields in the green bubble above—in other words, well beyond a simple linear investment. To do so, you should follow the tips I’ve previously outlined: 1) attack and automate the right problems; and 2) free up resources to move to higher, more productive endeavors.
4. Be forthright about asking for practical solutions.
Many technology providers offering automation solutions tout exciting new capabilities and features such as RPA, neural networks, machine learning, data analytics, and AI. Your challenge will be to navigate these many options to apply the right technology to the business challenges you’re currently targeting.
Be wary of optimism and hype. These technologies are amazing, but according to experts, they are still in their infancy. You deserve practical solutions that are a precise match for your requirements and goals.
Ask your technology provider to help you align automation with practical, proven results. By creating this practical momentum, you can then launch into new use cases as your ROI unfolds and the technology continues to mature.
Success Story: Automation on the A/R Front Line
For GetixHealth, long payer hold times and a lack of visibility into agent performance were two major barriers to revenue cycle optimization. But a simple EHR complement, within the first hour of its use, changed everything. Download the success story below to learn how GetixHealth slashed hold times and increased claim follow-up efficiency by 60%.
GetixHealth Increases Claim Follow-up Efficiency by 60%
Learn how this leading RCM provider transformed its collection team's performance with the addition of a simple EHR complement.
Disclaimer: Ontario Systems is a technology company and provides this infographic solely for general informational and marketing purposes. You should not rely on the content of this material for any other purpose or as specific guidance for your company. Ontario Systems’ advice, services, tools and products described herein do not guarantee compliance with any law or industry standard. You are ultimately responsible for your own company’s actions and compliance efforts. Because everyone’s situation is different, you must consult your own attorneys, accountants, and/or other advisors to obtain specific advice on your company’s compliance, legal, tax, regulatory and/or other business needs. Despite Ontario Systems’ efforts to provide current and up-to-date information, you need to recognize that the information contained herein may become outdated quickly and may contain errors and/or other inaccuracies.
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Healthcare providers are struggling to contend with COVID-related financial challenges and a growing work-from-home trend that’s complicating workforce management. To successfully adapt to these realities and improve their financial health, providers must identify and address revenue leaks, lost opportunities, and missing capabilities on the back end of their revenue cycle.
Two of the biggest productivity drains on the A/R front line—long payer hold times and lack of visibility into remote agent activity—are preventing providers and their RCM partners from kicking revenue recovery into high gear. Fortunately, there’s a simple EHR complement from Ontario Systems that tackles these and other A/R issues head on.
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