Survey: Providers Struggling to Leverage Tech Power for RCM

June 26, 2017
Providers find themselves challenged to maximize the benefits of innovative technology to better manage uncompensated care and revenue integrity, according to a new survey from the Healthcare Financial Management Association (HFMA) and Navigant.

Providers find themselves challenged to maximize the benefits of innovative technology to better manage uncompensated care and revenue integrity, according to a new survey from the Healthcare Financial Management Association (HFMA) and Navigant.

The survey, which was released at the start of HFMA’s conference this week, held annually, included responses from 125 hospital and health system chief financial officers (CFOs) and revenue cycle executives. When asked which revenue cycle capability their organization is most focused on for improvement over the next year, 79 percent of respondents suggested technology-related capabilities, including business intelligence analytics, electronic health record (EHR)-enabled workflow or reporting, revenue integrity, and coding and physician/clinician documentation.

To this end, however, nearly three out of four executives say their RCM technology budgets are increasing, with 32 percent suggesting an increase of 5 percent or more. Among them, 77 percent of small hospitals (less than 100 beds) and 78 percent of medium-sized hospitals (100 to 500 beds) are projected to increase spending, according to the survey data.

But despite budgets being on the rise, providers are struggling to leverage the power of technology— and EHRs in particular—to drive process improvement and long-term success. The survey found:

  • 51 percent said their organizations cannot keep up with EHR upgrades or fail to maximize functional, workflow, and reporting improvements.
  • 41 percent do not have a method to track the effectiveness of their technology enhancements.
  • 21 percent attempt to identify cost reductions through vendor consolidation.

What’s more, although revenue integrity—internally ensuring that revenue is accurate in coding, appropriate in charge capture, contains reasonable pricing for services that are being provided, and complies with laws and regulations—was cited by 22 percent of respondents as the top RCM focus area for the coming year, just 44 percent say their organizations have established revenue integrity programs. Those providers with revenue integrity programs are achieving significant benefits, including increased net collections (68 percent) and charge capture (61 percent), and reduced compliance risks (61 percent).

Further, consumer responsibility for healthcare costs will continue to affect providers, and there are opportunities to more holistically educate patients and predict their propensity to pay, according to the research. More than 90 percent of respondents believe that the increase in consumer responsibility will continue to affect their organizations. Among them, almost twice as many rural executives (58 percent) believe that the impact will be significant, as compared with urban respondents.

And, providers are starting to access more consumer-friendly means to enable patient payment, with 93 percent of respondents offering an online payment portal and 63 percent offering cost-of-care estimation tools. But leveraging innovative technology is again proving to be a challenge: just 14 percent of respondents use advanced modeling tools for segmenting and predicting propensity to pay, with fewer than one in four using a data source or external partner.

“Healthcare providers are actively searching for technologies which advance the quality, efficiency, and fiscal viability of care delivery in order to respond to ongoing reimbursement and resource constraints,” Mary Beth Briscoe, CFO of UAB Hospital and UAB Medicine clinical operations, said in a statement. “As new technologies are implemented, it is critical to understand and plan for linkages across clinical and financial activities to optimize workflow and reporting in both environments. By adopting a holistic approach to technology evaluation and design, providers should benefit from automation, scale, and process improvement, thus positively impacting quality and financial outcomes.”

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