HIMSS Analytics recently released its 2016 RCM Denial Management Essentials Brief, a study of the U.S. hospital denial management market. Essential Briefs are market research studies focused on identifying salient topics in the healthcare IT space that highlight mind share, market share and market opportunity of specific healthcare software technologies.
The 2016 RCM Denial Management Essentials Brief research finds adoption of a vendor-provided denial management solution remains relatively low. Those without a specific vendor solution rely upon solutions built internally or with manual processes that meet their current needs. Despite the low adoption rate, respondents indicated a high level of satisfaction with their vendor provided denial management solution and would recommend the solution they use to a colleague. This detail underlies the benefits of automating the claims and denial management process, which include identifying root causes of denials and contributing to the reduction of denial write-offs.
The 2016 Essentials Brief: RCM Denial Management Study offers insight from 64 hospital executives, clinical, financial and operational department heads and IT personnel on their current denial management solution usage as well as future plans for denial management solution adoption.
“Given the complexities around submitting claims and the labor associated with managing denials, it came as a surprise that more organizations have not automated the denial management process through a vendor-provided solution,” says HIMSS Analytics Director of Research, Brendan FitzGerald. “The move to value-based care and alternative payment models will not happen overnight. Until those models are tested and implemented, healthcare organizations will continue to focus on current processes, and automating the denial management process could greatly enhance collection efforts.”
Highlights of the 2016 study include:
- Current and planned adoption of RCM denial management solutions
- Vendor market share, mind share and market opportunity in the denial management solution category
- Study respondents currently with a denial management solution revealed relatively high satisfaction with their vendor-provided denial management solutions.
- Among the top benefits realized by providers utilizing a vendor-provided denial management solution are improved reporting capabilities and the ability to set low-balance denial thresholds.
- Many organizations still utilize an in-house built solution or a manual process for denial management.
For more information, view the brief at HIMSS Analytics.
