The RCM medical billing industry has undergone several changes since the beginning of the pandemic. While some changes worked temporarily, some rules have been changed permanently, keeping in mind the future of the American healthcare world. The rules reflect the need to close the gaps in health equity and deliver better patient care. Looking back at the period grossly affected by the pandemic, the revenue cycle leaders are looking into data analytics to decide on the future steps of the RCM medical billing industry.
Collecting and analyzing large amounts of data from a range of provider organizations provides insightful views into the industry, giving better results while taking the following steps forward. Several leading healthcare start-ups and data analytics companies have considered the topic of medical billing and provided some meaningful cognizance, which will dictate the industry’s future. Read on to know how the medical billing industry has changed in the last two years.
Effect of Covid-19 on RCM medical billing:
- According to Healthcare Financial Management Association’s (HFMA) Pulse Survey Program, Covid-19 has severely impacted the RCM medical billing industry in a multi-dimensional way.
- More than 50% of the participating healthcare systems and their revenue leaders said that the variable volume of claims was the most alarming issue.
- There have been several sets of new codes in the industry with various changes to the existing ones. This has led to a state of confusion for over 35% of the staff members in the billing team.
- With confusion over the coding guidelines, this section of the billing professionals has also complained of increased workloads due to unnecessary work redo.
- Around 35% of the respondents were also of the opinion that the organizations have undergone a severe decrease in staff productivity. At the same time, they were also clear that staff shortages were high.
- 32% of the revenue cycle professionals also sought layoffs and other staff reductions as the top reasons for decreased productivity.
Switching to Automation:
- The business dynamics have altered primarily due to the direct impact of the Covid-19 pandemic. Revenue cycle leaders are looking at new opportunities to rectify past mistakes and prepare themselves for a more resilient future.
- In the survey, around 75% of the health systems expressed their intent to switch to automation technology in order to cope with the changing dynamics of the RCM medical billing industry.
- In this scenario, larger health systems with >$1 Billion net patient revenue with existing automation functionalities said that they would be working further to automate more of the services.
- Though they were already on their path of digital transformation, they said that they had accelerated their speed of change to cope with the existing mechanisms and prepare themselves for any future crisis.
- Some provider organizations were also keen to build larger in-house revenue cycle management teams with permanent work-from-home provisions among the more extensive section of the health systems advocating for switching to automation.
- Over 25% of the provider organizations are working towards building remote working technologies for any future purpose though they are not in favor of going completely remote as of now.
- Between health systems and hospitals, the former is more inclined towards adapting their revenue cycle operations with the changing industry trends in 2021.
Current Use of Automation Technology:
- More than 66% of healthcare organizations and hospitals already use automation tools for their revenue cycle operations.
- The significant areas of usage of automation technology are payment posting, billing edits, and updating the status of the medical claim.
- More than 50% of the health systems currently using any such tools for RCM medical billing believed that they would like to see more of such advanced tools specifically designed to address the current pain points of RCM.
- Though a larger part of the respondents admitted to using automation tools for their organization, it was seen that the greater the organization’s net revenue, the greater is the chance of them using RCM tools.
- More than 80% of the health systems with more than $10 Billion revenue responded positively to the use of automation technology. However, 60% of the organizations with net revenue lesser than $500 Million admitted that they have not used automation before.
- While 30% of the organizations did not use automation in their regular RCM medical billing operations, more than 60% plan to deploy new tools by the end of 2021. In comparison, only about 10% had the intention to switch to new devices in 2020.
RCM Medical Billing Vendor Management:
- Over 60% of the provider organizations partner with revenue cycle management vendors to manage their medical billing procedures.
- However, there are differences in the management technique of the vendors depending on the size and type of healthcare organization.
- One-third of the healthcare organizations partnering with vendors admitted to working with at least two vendors to manage the process.
- Most of the organizations using multiple vendors said that they use different vendors for managing the various dimensions of the entire RCM procedure.
- Some organizations working with four or more vendors said that they do not function with an in-house team and delegate the entire work to outsourced professionals.
- Only close to 38.5% of the healthcare organizations said that they work with one vendor with a single point of contact who manages every aspect of the RCM medical billing process.
New Avenues in RCM Medical Billing
Provider organizations are looking forward to systems that have the following abilities to improve their RCM operations further:
- Ability to scale
- Ability to work remotely with lesser physical control
- Systems with faster deployments and ease of use
- The flexibility of the solutions to adapt to the changing avenues
- Simpler integration with the current workflow cycle
We hope this article helped you delve deeper into the statistical insights of the RCM medical billing industry in 2021. Please connect with us in the comment section below in case of any queries. Subscribe to our blog for regular articles on the medical billing industry. Follow us on Facebook, Instagram, Twitter, and LinkedIn for more.