The pandemic underscored the role digital health tools play in connecting healthcare systems with patients during challenging times. Hospitals nationwide had to adapt to evaluate patients while limiting unnecessary visits. As a result, digital health tools including patient access platforms, telemedicine apps and remote patient monitoring devices exploded. Digital health investment surged from $8.2 billion in 2019 to almost $30 billion in 20211, proving the pandemic was fertile ground for digital health innovation and adoption. The rush to adopt digital health tools led to a proliferation of market entrants, many needing more infrastructure and engagement to deliver on their promised outcomes.
“During the pandemic, there was an insatiable appetite for any digital tool that helped to provide care in a covid friendly manner. But in a largely post-pandemic world, these exuberant purchases are now taking a toll, and executives are taking notice.”
— Ed Marx, CEO Divurgent2
As the frenzy subsides, executives need to evaluate their pandemic purchases. Many have expressed dissatisfaction with existing tools. In a recent Panda Health survey, for example, only 47% of health systems said they were ‘very satisfied’ with the performance of remote patient monitoring solutions3. Health system leaders have tough decisions about where to continue vs. stop investment. They need to determine whether or not they saw value with covid era investments.
In the same way remote monitoring tools changed the landscape of patient care, advancements in machine learning and intelligent automation are transforming revenue cycle management. And with clear metrics, including cost to collect, A/R aging, and account resolution, the demonstration of ROI to hospital leadership can be clearly articulated.
Cumbersome processes and manual workflows have long plagued revenue cycles. Making administrative functions more efficient allows hospitals to reinvest in patient care and foster growth. With inefficient revenue cycle processes, valuable time, money, and staff are wasted on redundant or manual tasks. This diverts attention and resources away from patient care initiatives and limits the hospital’s ability to expand services, upgrade facilities, and invest in advanced in both people and technology.
“An inefficient revenue cycle can lead to delays in billing and reimbursement, increasing the financial strain on a hospital. By optimizing the revenue cycle and streamlining processes, hospitals can allocate more resources towards patient care, improve the overall patient experience, and unlock funding for technologies with larger payback horizons.”
– Tye Cook, Senior Vice President of Strategy, Janus
Automation can streamline billing operations, reducing administrative costs significantly and freeing staff to focus on the most difficult claims that require human intervention to achieve resolution. Comprehensive technology tools optimize both front and back-end functions. Automation is applied to accelerate the prior authorization process. Ranking tools enable health systems to more efficiently work their A/R queue. AI and machine learning can identify the root causes of claim denials so steps can be taken proactively and ensure timely reimbursement – increasing revenue into the system.
Implementing revenue cycle technology requires thorough evaluation to identify solutions that best complement existing systems and keep teams in their native workflows within EMRs. Selecting a vendor with deep industry experience and expertise is critical. Vendors like Janus, who have many former Epic employees and revenue cycle experts on their team, can assist revenue cycle leaders in assessing their current processes and identifying areas for workflow refinement and automation across the end-to-end revenue cycle.
Health systems should look to reprioritize their digital budgets, giving precedence to proven revenue cycle technologies to achieve financial stability and enhance efficiencies. While patient monitoring and telehealth initiatives remain important, they should not overshadow the significance of optimizing the revenue cycle. Healthcare organizations can streamline billing operations, reduce operational costs, and improve their financial health with the right technology solutions and implementation strategies. Investing in these tools will help protect the hospital’s financial bottom line and keep them competitive.
Interested in learning more?
https://www.medicaleconomics.com/view/how-has-covid-affected-revenue-cycle-management-
https://www.wha.org/EducationandEvents/OnDemandEd/Documents/NonSecured/COVID-19-and-RCM
https://www.huronconsultinggroup.com/insights/strategic-revenue-cycle-actions-accelerate-cash-flow
1 Adriana Krasniansky, et al. 2021 year-end digital health funding: Seismic shifts beneath the surface. Rock Health (January 10, 2022). https://rockhealth.com/insights/2021-year-end-digital-health-funding-seismic-shifts-beneath-the-surface/.
2 Seth Joseph, “Under financial pressure, how are health systems prioritizing digital health investments.” (January 2023) https://www.forbes.com/sites/sethjoseph/2023/01/11/under-financial-pressure-how-are-health-systems-prioritizing-digital-health-investments/?sh=34b763f343c2
3 The Great Shakeup, Panda Health (June 2023). https://panda.health/wp-content/uploads/2023/06/Panda-Report-Great-Shakeup-June-2023.pdf