Top revenue cycle trends
We take a look in our crystal ball at what the year ahead holds for the RCM industry.
With the constantly evolving healthcare landscape, providers are facing multiple challenges, including labor shortages, escalating costs, and declining reimbursements. To overcome these obstacles and in a tight economy, healthcare executives must adopt innovative strategies and technologies. There are a number of key trends and solutions that are reshaping Revenue Cycle Management (RCM) and medical coding in the industry.
Embracing Remote Job and Outsourcing Strategies -- Healthcare providers are grappling with a shortage of skilled professionals across many areas at the same time. Exploring remote and outsourcing strategies are important approaches to mitigate the effects of the labor shortage and provide access to specialized expertise.
Unlocking Efficiency with Automation, AI and ML in Billing and Coding -- Automation technologies, such as Artificial Intelligence (AI) and Machine Learning (ML), offer potential to streamline tedious and repetitive billing and coding tasks. By leveraging these technologies, healthcare providers can reduce human errors, enhance accuracy, and expedite the revenue cycle process. Additionally, automation frees staff and resources to focus on more complex and patient-centric responsibilities.
Consolidation and Private Equity Investments -- To meet the growing demand for high-quality healthcare services as the population in the US ages, private equity investors are increasingly investing in the consolidation of large healthcare systems, home care, durable medical equipment (DME) services, and urgent care chains. Consolidation provides economies of scale, facilitates resource sharing, and enhances service offerings, ultimately benefiting patients with improved access to comprehensive care.
Prioritizing Denial Prevention and Billing Compliance -- Being as efficient as possible is taking rewed focus. Healthcare providers must prioritize denial prevention and billing compliance to optimize revenue. Proactive measures to minimize claim denials, along with adherence to billing regulations, can significantly impact the bottom line. Effective utilization of technology can increase coding accuracy, resulting in more accurate billing with reduced denials, leading to increases in revenue as much as 20% for some providers.
Emphasizing Patient Transparency and Experience -- Patients are seeking greater transparency in healthcare services and their out-of-pocket expenses. To address this demand, healthcare providers are focusing on innovative solutions that enhance patient access and overall experience. Improved communication, user-friendly portals for billing inquiries, and clear breakdowns of costs are all ways providers are looking to improve patient satisfaction and loyalty.
Value-Based Care and Wellness Chains -- Value-based care is shifting emphasis from quantity to quality, as healthcare providers focus on delivering high-quality outcomes and patient satisfaction. This shift has led to the emergence of wellness chains across the United States, promoting healthier lifestyles and subsequently positively impacting healthcare demand.
As the healthcare industry continues to evolve, Revenue Cycle Management and medical coding will play an important roll in increasing financial stability and providing improved patient care. Through automation, transparency, collaboration, and innovation, healthcare leaders can navigate the challenges to shape the future of healthcare delivery.
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