3 Revenue Cycle Trends Taking CFOs By Storm

"Hope is not a strategy," says one CFO.

The HFMA Annual Conference tackled all things finance this year, but one area that seemed to dominate discussions? The revenue cycle. From payer woes to strategy improvement, here are a few key trends that were top of mind at the event.

Payers Aren’t Playing Nice

No big surprise here: payers are playing by their own rule book.

Almost every discussion at HFMA this year mentioned payers in some capacity. That’s because they’re causing more issues for health systems than ever before. Denial rates have been increasing year over year, and reimbursement can take up to three months or longer.

Heavily capitalized payers are becoming more and more common, and they’re often playing hard with health systems, from using AI to inaccurately automate denials to bringing reimbursement to a stand-still.

Several sessions spoke about the importance of partnering with the right payers and emphasized the importance of transparency in these partnerships.

Executive leaders said don’t be afraid to go out of network and use other hard ball tactics to push back on payers.

You need systemwide revenue cycle participation

With revenue cycle management being a major topic this year, executives shared what is working at their health systems.

One session discussed the importance of the relationship between CFOs and the revenue cycle team.

There must be a certain level of trust in this relationship in order for both departments to thrive. CFOs should not have to micromanage the revenue cycle but should be there for guidance and eliminating barriers.

One session discussed the concept of physicians being more involved in revenue cycle decisions. Afterall, physicians are the ones with the medical degree and are the ones experiencing the operational issues firsthand in their work.

RCM has a lot of room for improvement, and hope is not a strategy

Just about everyone thinks they have the solution to revenue cycle problems. 

The reality is there is no one size fits all solution and executives will have to examine the specific needs of their organization to identify opportunities for improvement.

Often, health systems rely on dozens of vendor support to manage their revenue cycle. One study presented at a session cited that the average health system uses about 40 vendors to support RCM efforts.

There’s a number of solutions and support out there, but finding the right one will take meticulous tracking of revenue cycle. “Hope is not a strategy,” said one CFO during a session.

A few leaders shared their insights on where they think the revenue cycle may be five years from now, saying that the department will likely be far more automated. But leaders warned to not get too carried away.

Standard processes shouldn’t be automated, many said. Revenue cycle teams should look towards investing in the right technology to improve RCM efforts and ensure that the technology benefits the specific mission-critical components of their organization.