Month: May 2024

Technology has changed rapidly in the last five years, and workplace tech is no exception. The revenue cycle management industry in particular has experienced immense growth and change, and keeping up with the newest and most useful pieces of RCM tech and trends is a constantly moving target. Let’s explore some of the top tech trends impacting RCM this year. 

Artificial Intelligence (AI) 

AI is revolutionizing RCM by improving efficiency and accuracy. It helps automate routine tasks like coding, billing, and claims processing. AI can analyze large volumes of data to identify patterns and predict issues, helping with financial forecasting. This predictive power helps in reducing denials and improving cash flow. Moreover, AI-powered chatbots enhance patient engagement by providing quick answers to billing inquiries and other frequently asked questions, saving valuable staff time. There are also healthcare organizations exploring AR generated authorization letters, medical appeals and post-procedural instructions for patients.  

AI has lots of potential uses, but many healthcare organizations are hesitant to embrace it. Larger healthcare organizations that have their own data managers and IT teams may be able to dedicate the staff time and budget to adopt AI technology, but smaller or more rural healthcare centers may struggle to keep up. Analyzing your own capacity for adopting AI into workflows is an important first step to taking full advantage of this new technology. Look for ways AI can integrate into your repetitive daily tasks and consider the time and money that would need to be dedicated to implement an AI process. Exploring this new RCM technology has the potential to greatly improve overall collections and move time-consuming, repetitive tasks off the desks of your skilled staff, giving them more time to focus on big picture planning and providing the best patient care possible. 

Automation 

Automation streamlines RCM processes, reducing manual work and errors. According to some reports, one-third of prior authorizations are completed manually, and two-thirds of hospitals haven’t automated any part of their denials management processes. Using technology to automate key parts of your RCM workflow can eliminate some of these time-consuming tasks, which not only reduces manual errors, but also creates an improved work environment for your team.  

Robotic Process Automation (RPA) handles repetitive tasks such as data entry, appointment scheduling, and patient follow-ups. This technology not only saves time but also ensures consistency and compliance. By automating these tasks, staff can focus on more strategic activities, improving overall productivity and allowing both providers and administrative staff to focus on patient care.  

Automation can also help address staffing issues. According to one survey, 80% of billing departments surveyed reported a turnover rate of 11 – 40%, significantly higher than the national average of 3.8%. Additionally, this survey found that 70% of respondents believed that staff shortages exacerbated their denial rates. Utilizing automation to streamline your workflows not only leads to fewer errors and less rejected claims, but it also helps reduce your staff workloads, helping your staff be more efficient without burning out. This tech has the potential to improve the wellbeing of your staff, decrease turnover, and increase the amount of revenue you collect overall. 

An important note on AI and Automation: Any tool must be vetted carefully before you adopt it to ensure that it complies with HIPAA regulations and protects the privacy of your patients. Your security and the security of your patients should be one of your top priorities as a healthcare organization! 

Value-Based Medicine 

While it is definitely more of a model than technology, Value-based medicine is changing the landscape of healthcare, especially in the FQHC world. It is shifting the focus from quantity to quality of care. This model rewards healthcare providers for positive patient outcomes rather than the number of services provided.  

For RCM, this means new ways of billing and reimbursement. Providers must track and report quality metrics accurately. Technology solutions that integrate clinical and financial data are essential to succeed in this model. Think critically about the journey your patients go on once they begin an interaction with your organization and look for ways to make that journey smoother and more engaging. A positive patient experience means they are more likely to be involved in their own healthcare decisions and they are more likely to engage with your organization when it is time to gather some of the vital outcome data. Make sure you have the needed tech to produce simple, easy to read billing statements and to communicate with your patients int he way they want to be communicated with (text, phone, email, snail mail). 

Telehealth’s Influence 

Telehealth has become a staple in healthcare delivery, and its influence on RCM is significant. Telehealth services require specific billing codes and reimbursement rules, and your RCM team should be prepared to address these virtual encounters. Technology platforms that support telehealth must seamlessly integrate with RCM systems. This integration ensures accurate billing and compliance with regulations. Telehealth also expands access to care, potentially increasing patient volume and revenue, and provides patients with quality care and convenience. While this technology isn’t exactly new, it has become a preference for many patients, and embracing this care-delivery method is almost a requirement in 2024! 

Blockchain 

Blockchain technology has been a topic of conversation for several years now, and it offers a secure way to manage patient data and financial transactions, which can help keep patient data sage throughout the revenue cycle. Its decentralized nature ensures data integrity and transparency. In RCM, blockchain can streamline claims processing by providing a single source of truth. This reduces disputes and speeds up reimbursements. Additionally, blockchain enhances data security, protecting against fraud and cyber threats. There can be a significant financial cost to startup this technology, but a conversation with your IT technicians will help you understand how and where this new technology fits into your revenue cycle. 

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In 2024, technology is driving significant changes in revenue cycle management. AI and automation are improving efficiency and reducing errors. Value-based medicine is changing billing practices to focus on patient outcomes. Telehealth is expanding access to care and influencing RCM processes. Blockchain is enhancing data security and streamlining transactions. By embracing these tech trends, your organization can optimize your RCM and improve financial health while providing the best patient care possible. Staying updated with these technologies is crucial for success in today’s healthcare landscape, and identifying the technology that fits your unique needs means you can grow your programs and services by working smarter, not just harder. 

Healthcare organizations, especially Federally Qualified Health Centers (FQHCs) have a unique role in promoting community well-being. FQHCs were founded as part of the civil rights movement, and their missions focus around creating healthy communities across all demographics, and especially for underserved populations.  

But every organization in the healthcare space has an impact on their community. Beyond providing medical care, they can impact environmental sustainability and social responsibility. Integrating these areas into your healthcare programs not only benefits the community but also strengthens your organization’s mission and values. 

The Intersection of Healthcare and Environmental Sustainability  

Healthcare facilities provide invaluable services to their communities, but they also generate substantial waste and consume significant energy. By becoming more aware of the environmental impact your health center is creating, you can focus on improving your environmental sustainability. Here are a few ideas to help reduce your environmental footprint: 

• Implement Green Practices: Adopt energy-efficient technologies, reduce waste, and encourage recycling. This may sound like a huge change, but simple steps like using LED lighting, installing energy-efficient HVAC systems when it’s time for an update, and implementing internal recycling programs can make a big difference. Start small and open up the conversation to your team – ask them what environmental issues matter the most to them and what ideas they have to make a difference. You may find key team members that are willing to take the lead in implementing some of these green practices internally. 
• Sustainable Procurement: Source supplies from environmentally responsible vendors. Choose products with minimal packaging, reusable options, and opt for ones made from sustainable materials. 
• Green Building Design: This isn’t an option for every healthcare organization, but if you’re running a capital campaign to construct a new facility, consider including green initiatives into your funding and requests. Whether constructing new facilities or renovating existing ones, opt for green building standards. LEED certification, for example, ensures that buildings are environmentally friendly and resource efficient. Even if you’re not doing a complete rebuild or remodel, consider environmentally friendly options as you do regular repairs and updates. Things like replacing old windows with recycled glass and incorporating low water use fixtures are great ways to make an impact! 

Promoting Social Responsibility at your Health Center 

FQHCs are founded on the idea of addressing inequities in healthcare, and all healthcare organizations are dedicated to improving health outcomes for their patients, regardless of demographic and socioeconomic status. Addressing social determinants of health with your programs and partnerships can increase your reach beyond the doors of your healthcare organization and into the daily life of your patients. 

• Community Outreach Programs: Develop programs that target underserved populations. Mobile clinics, health fairs, and educational workshops can bring healthcare services to those who need them most. Looking into adding a mobile unit to your healthcare organization? Check out our webinar on Mobile Unit Billing for best practices. 
• Partnerships with Local Organizations: Create opportunities to collaborate with schools, non-profits, and local businesses in your community. These partnerships can address issues like food insecurity, housing, and education, which are critical to overall health. They can also connect your organization with community leaders that understand the programs and services that will create the most impact. 
• Employee Volunteerism: Encourage staff to volunteer in the community. This not only benefits the community but also boosts employee morale and engagement and fosters teamwork. Build regular volunteer days into your annual calendar, and ask your employees what causes they would most like to get involved in. 

Building Community Beyond Health Outcomes 

Healthcare organizations can take an active role in shaping their communities by supporting initiatives that promote sustainable development and social equity. The primary focus of your organization is the health of your community and your programs and services, but finding ways to support holistic health beyond your inpatient services and specialties can result in long-term positive outcomes for the neighborhoods you serve. 

• Support Local Agriculture: Partner with local farms to provide fresh, healthy food options for patients and staff. This can be in break rooms, lobby snacks, or even a food pantry if that fits into your mission. Providing local food supports the local economy and promotes healthier eating habits. 
• Invest in Public Health Infrastructure: Advocate for and invest in community infrastructure, such as parks, bike lanes, and public transportation. These investments promote physical activity and reduce pollution. The goal is not to distract you and your team from their main mission, but instead to look for causes you can openly advocate for in-person or on social media. Finding a cause you can rally behind shows your patients that you are invested in your community’s wellbeing. 
• Education and Advocacy: Educate the community about the importance of social responsibility. Host events, create educational materials, and use your platform to advocate for policies that promote a healthy environment, healthcare accessibility and social equity. 

Healthcare organizations have a profound responsibility to their communities. By integrating environmental sustainability and social responsibility into their healthcare programs, they can build healthier, more resilient communities. Exploring ways that these initiatives fit into your mission builds connection with your community and helps you and your team address health outcomes from the big picture, which moves your mission forward and creates a healthier future for the people you serve.