August 13, 1876, was an absolutely historic day in the history of classical music. On that day, several hundred people, among them crowned heads of Europe and leading composers and music critics from across Europe, gathered in the small town of Bayreuth in northern Bavaria to experience something that had never been presented before: a festival focused on a massive tetralogy of four operas being presented within one week as a single musical entity, and all written by Richard Wagner, who already dominated German opera. Wagner, an outrageous and frankly amoral person, had entranced King Ludwig II with his music, to the extent that Ludwig financed the building of a special theater solely to present Wagner’s works—an unheard-of phenomenon in itself.
But during that week, Wagner’s greatest achievement, “The Ring of the Nibelung”—in German, “Der Ring des Nibelungen”—focused the eyes and ears of all Europe, with its 16-plus hours—across four operas, “Das Rheingold,” “Die Walküre,” “Siegfried,” and “Götterdämmerung”—and its incredible story of gods, giants, dwarves, flying warrior-maiden demi-goddesses, and, yes, humans. Wagner—who had already mesmerized opera audiences with his previous successes—“Rienzi,” “Der Fliegende Holländer” (“The Flying Dutchman”), “Tannhäuser,” and Lohengrin”—created something entirely new in his “Ring”—a sprawling narrative across four operas, the longest of which, “Götterdämmerung,” lasts more than six hours with intermissions. Yet rather than length, it is the compositional innovation involved that utterly astonished audience members that week in August of 1876. No more arias or anything even like arias, but instead, vast, flowing stretches of singing, with continuous scenes lasting as long as an hour with no breaks. Wagner ended the division between aria and recitative in German opera, and paved the way for the dissonances of twentieth-century music, and more modern operatic dramas. Indeed, despite its staggering length, the “Ring” remains a towering artistic achievement, with absolutely magnificent moments of musical drama; indeed, many music critics consider it the greatest work of classical music ever written.
Now, here’s the rub: Wagner, weighed down by debt, legal problems, and personal problems, reached a point about midway through his composition of the music of the “Ring” (he had already written the text of the tetralogy years before), actually gave up on the project, leaving the hero Siegfried “sitting alone in a forest,” in 1857. Wagner was hoping to score “easy wins” with two operas he had in mind, but those—“Tristan und Isolde” and “Die Meistersinger”—both ended up requiring years to compose and get produced, so it was only through the support of Ludwig II that he was able to return to his “Ring” project, after a gap of 12 years—a ginormous gap for any musical composer. All told, 26 years were to pass from the moment in 1848 when Wagner began writing the libretto for the tetralogy, and 1874, when he completed the score to “Götterdämmerung.” There is nothing like the “Ring” in all of classical music, and one can only be grateful that Wagner persevered and came back to his hero Siegfried in the middle of the forest.
Perhaps no challenges are so heroic or extreme in U.S. healthcare today, but what is true is that there are many challenges that are requiring huge amounts of time and effort to try to resolve. In our cover story in this issue, we look at the challenges facing revenue cycle management (RCM) leaders, and the potential of technology to help them overcome those challenges.
In our cover story in the July/August issue, we spoke with leaders at health systems, as they move forward to advance their leveraging of robotic process automation (RPA) tools, automating many of the most routine and non-conceptual tasks in the revenue cycle management area, while beginning to dip their collective big toe into the swimming pool of actual machine learning (ML) and artificial intelligence (AI). As the cover story notes, what those leaders are finding is that, yes, indeed, progress is being made towards leveraging the most advanced RPA tools to solve problems related to staffing, while at the same time beginning to implement actual AI and machine learning tools in revenue cycle management processes, in order to optimize the use of humans and reduce overhead costs. Among the areas being looked at very actively for AI implementation are revenue integrity and coding.
Over time, too, health plans will be helping provider organizations to work collaboratively to implement AI-based tools to streamline the claims adjudication process, which everyone agrees needs massive reform and reengineering.
It’s going to be a long road, but everyone also agrees that it’s a worthwhile journey on which to embark. And who says there won’t eventually be some revenue cycle heroes who will emerge in healthcare’s future?