Survey: CFOs, RCM VPs Facing Severe Cost, Staffing-Shortage Challenges

June 30, 2022
A new nationwide survey of CFOs and vice presidents of revenue cycle management commissioned by R1 RCM is exposing very significant cost, staff-shortage, and operational challenges

A new nationwide survey of CFOs and vice presidents of revenue cycle management (RCM) has found those senior finance executives in hospitals, medical groups, and health systems struggling mightily with a range of challenges, including increasing operating costs, shrinking revenue margins, and severe labor shortages. Those are among the key findings in a survey commissioned by the Salt Lake City-based R1 RCM company, and executed by the London, England-based Censuswide research firm, of CFOs and vice presidents of revenue cycle, that was released on June 29, with 205 senior finance executives responding.

What are finance executives’ top concerns? The survey, released in R1’s “2022 Mid-Year Healthcare Financial Trends Report,” found the following results: increasing costs, 25 percent; risk of recession, 22 percent; shrinking margins, 21 percent; reimbursement issues, 17 percent; 17 unidentified revenue leakage, 13 percent; and “no concern in particular,” 2 percent.

And which phenomena are their own organizations experiencing right now? The following results were gleaned: clinical deficiencies due to the labor shortage, 33 percent; data/cybersecurity threats, 33 percent; operational deficiencies due to the labor shortage, 30 percent; issues with price transparency compliance, 29 percent; lowered patient volumes due to COVID surges, 28 percent; navigating value-based payments, 28 percent; increasing expenses due to increased patient acuity, 27 percent, and supply chain issues, 22 percent.

Asked how things are going in terms of their 2022 revenue goals, 46 percent of respondents said “We are behind on these goals,” while 40 percent said “We are on target to meet these goals,” and just 8 percent said “We are on track to exceed these goals,” while a further 5 percent were unsure.

Intense labor shortages cited

Importantly, fully 48 percent reported experiencing a severe labor shortages in their RCM/billing departments, while 34 percent are experiencing a moderate shortage, and 10 percent are experiencing a mild shortage, while only 8 percent reported experiencing no shortage at all. Meanwhile, among those organizations experiencing RCM/billing department labor shortages, 41 percent of respondents cited the percentage of department roles currently vacant in their organizations as being between 51 and 75 percent of positions, while 36 percent cited them as being between 25 and 50 percent of positions. Just 3 percent cited a shortage of employees above 75 percent, while 8 percent cited a level below 25 percent, and 12 percent were unsure.

Asked whether they expected their labor shortage to improve or worsen by the end of the year, 76 percent expected their situation to improve, while, only 15 percent expected it to worsen. Meanwhile, 8 percent expected it to remain the same.

What solutions are respondents most focused on for the second half of the year? The results were as follows: finding a strategic RCM partner, 28 percent; adopting new software/technologies, 26 percent; eliminating redundant systems, 24 percent; and attracting/retaining RCM talent, 21 percent.

Further, when asked to what extent they agreed with this statement—“I feel there is/will be additional strain on our RCM operations (including scheduling, registration, coding, billing, service, etc.) as more patients return for elective health appointments”—66 percent strongly agreed, and 30 percent somewhat agreed, while only 1 percent somewhat disagreed, and only 2 percent neither agreed or nor disagreed.

What kinds of strains of the RCM department, including scheduling, registration, coding, billing, customer service, etc., are negatively impacting the patient experience? Here’s what survey respondents said: 49 percent cited care delays due to insufficient capacity; 48 percent mentioned patient billing errors due to lack fo experienced staff for coding, claims, and reimbursement; 45 percent cited long hold times for scheduling and customer service calls; and 44 percent cited cancellations and reschedulings due to staff shortages.

On its website, R1 describes itself as “a leading provider of technology-driven solutions that transform the patient experience and financial performance of hospitals, health systems, and medical groups. R1’s proven and scalable operating models seamlessly complement a healthcare organization’s infrastructure, quickly driving sustainable improvements to net patient revenue and cash flows while reducing operating costs and enhancing the patient experience.”

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