3 Issues Revenue Cycle Leaders Will Have to Battle in 2020

Firsthand experiences from the country's most innovative revenue cycles will be shared next month in West Palm Beach, Florida.

This article appears in the January/February 2020 edition of HealthLeaders magazine. 

What issues keep revenue cycle executives up at night? As the HealthLeaders' revenue cycle editor, I will moderate discussions and hear firsthand experiences of successes, challenges, and the latest ideas coming out of the country's most innovative revenue cycles at the HealthLeaders Revenue Cycle Exchange at Eau Palm Beach Resort & Spa in Palm Beach, Florida, on December 9–11.

Here are three topics I'm expecting to hear from leaders as they gather next month.

1. Getting real about artificial intelligence

For revenue cycle leaders, there isn't a day that goes by without hearing about artificial intelligence, whether it's Mayo Clinic's pilot project to use AI-powered predictive models for denials or how Avera Health used AI-powered technology for outstanding claims to accelerate cash flow by $20.6 million within 18 months of implementation.

"I don't think anyone would be not interested in the topic of AI, because I do believe that's the future," says Karen Shaffer-Platt, vice president of revenue cycle at UPMC.

However, much of what revenue cycle leaders say they hear about AI isn't real-world case studies and success stories. Instead, they say they hear sales pitches promising—and perhaps overpromising—the latest and greatest AI solutions and tools.

But how well do these tools really work? And how are revenue cycles around the country using them to solve day-to-day problems?

I want to hear which revenue cycle leaders are using AI, what they're using it for, and what the technology can truly achieve.

Read more: How Using AI Automation for Outstanding Claims Accelerated Cash Flow by $20.6M

2. Good, old-fashioned team building

With so much focus on things like AI and automation, it's easy to lose sight of another key ingredient for revenue cycle success: Great employees.

"Over the years, we've focused on tech solutions but haven't spent a lot of time talking about team building and ways to celebrate success," says Charles Brown, senior vice president of revenue management at Tower Health.

For instance, to recruit and retain the best workforce, revenue cycle leaders say that hospitals and health systems must be ready to offer employees great salaries, benefits, a satisfying career ladder, and a flexible work environment, including, in some cases, the opportunity to telecommute.

Brown says team building is especially important since organizations are often going through growth spurts and acquisitions and developing teams during such times can be an added stressor.

Plus, increasing automation for mundane tasks means that revenue cycle employees will be expected to handle more complex responsibilities that cannot be automated, say revenue cycle experts.

Read more: How Implementing a Career Ladder Improves Coder Accuracy

3. Taking the stress out of high out-of-pocket costs

High out-of-pocket costs are a reality for patients, whether or not they have health insurance.

"Healthcare bills can be confusing and people should be able to focus on their healing," says Steve Scharmann, vice president of revenue cycle at Dignity Health, a part of CommonSpirit Health.

That's why healthcare providers are doing everything they can to de-stress the patient billing experience. For example, Dignity Health's partnership with OODA Health consolidates and streamlines patient billing for a more "retail-like" experience.

And it's not only uninsured patients who face high out-of-pocket costs.

"It's not just self-pay, but now it's also 'self-pay after insurance,' " says Shaffer-Platt. "It's almost two separate departments."

With that in mind, it can be important that revenue cycles offer every possible option to make the patient financial experience easy and relatively painless.

Failing to offer options likeinterest-free payment plans, online self-service, and other innovative payment arrangements and methods will force patients to vote with their legs and take their healthcare business elsewhere.

Read more: Dignity Health, OODA Health Talk Payment Pilot Expansion

The Revenue Exchange is one of six healthcare thought-leadership and networking events that HealthLeaders holds annually. Our Revenue Cycle Exchange gathers leaders to share insights and ideas with other revenue cycle VPs and leadership with the same challenges. To inquire about the HealthLeaders Exchange program, email us at exchange@healthleadersmedia.com.