Practice Management News

Third of Hospitals, Systems Don’t Use Revenue Cycle Automation

Most of these hospitals and health systems have never used revenue cycle automation, but plan to do so by the end of 2021.

Revenue cycle automation

Source: Getty Images

By Jacqueline LaPointe

- About one-third of hospitals and health systems do not use revenue cycle automation, according to a new survey.

The survey commissioned by AKASA was conducted through the Healthcare Financial Management Association's (HFMA) Pulse Survey program and received responses from 587 chief financial officers and revenue cycle leaders at hospitals and health systems across the US.

About 30.4 percent of the survey respondents have never used automation in revenue cycle operations, while 2.8 percent no longer use automation.

The remainder—66.8 percent—are either currently using automation or in the process of implementing automation for revenue cycle operations. These respondents also tended to be from health systems versus hospitals and from larger organizations.

In fact, respondents from organizations with $1 billion to $10 billion in net patient revenues reported the most use of revenue cycle automation, the survey found.

Barriers still exist to revenue cycle automation, the survey results indicated. But more hospitals and health systems plan to leverage automated tools in the near future regardless of size or organization type.

Over half of hospitals and health systems that do not currently use revenue cycle automation (51.8 percent) plan to do so by the end of the year, the survey showed. Another 10.6 percent of hospital and health systems leaders also said revenue cycle automation was a priority prior to 2021.

However, 37.6 percent of respondents not currently using revenue cycle automation still say implementing the technology is not on their to-do lists in the future.

Responses were statistically consistent across organizations of all sizes based on net patient revenues and regardless of organization type (e.g., hospital or health system), researchers stated.

The survey also found that adjustment posting and billing edits were the top areas where revenue cycle automation is currently being leveraged, followed by claim status.

Additionally, the survey showed that 30 percent of hospitals and health systems using revenue cycle automation require two or more vendors to manage the process.

Although, most of these organizations (38.5 percent) use just one vendor to do all steps of the automation process and 31.5 percent do not use external consultants or vendors at all. The latter respondents said they have an internal team dedicated to automation.

Moving forward, researchers anticipate revenue cycle automation adoption to increase as hospitals and health systems focus on building resiliency after the COVID-19 pandemic.

These organizations suffered massive financial losses last year—to the tune of $323 billion, according to estimates from the American Hospital Association (AHA). And the Association is now projecting hospitals to lose another $122 billion in 2021 as organizations continue to overcome pandemic-related revenue losses and expenses.

Researchers also expect hospital and health system leaders to “pursue revenue cycle automation with more urgency and greater purpose” in light of their quest of resiliency.

With this in mind, they predicted hospitals and health systems to invest in more solutions that are purpose-built for hospital and health system revenue cycle automation.

In the survey, an overwhelming majority (91.9 percent) of respondents said it is important or extremely important for automation tools for revenue cycle operations be specifically designed for revenue cycle management in healthcare.

Researchers also said artificial intelligence and machine learning capabilities will be more widely available for revenue cycle operations. Although, the vendor market will have some work to do highlighting the differences between the two analytics strategies since more than half of hospital and health system leaders in the survey do not understand the difference.

Revenue cycle automation implementation will also need to align with the move to remote work, which is something more hospitals and health systems are considering making permanent moving forward.

Automation tools will need to be deployed remotely with limited or no need for staff shadowing, researchers stated.

“With revenue cycle automation firmly in place within two thirds of the healthcare market, it is clear that automation is here to stay,” Malinka Walaliyadde, co-founder and CEO of AKASA, said in response to the survey’s findings. “The opportunity going forward for provider organizations is to expand their ambitions and scope for automation within the revenue cycle.”