How Digital Innovations Are Helping Revenue Cycle Management Turn a Critical Corner

There’s little doubt that healthcare’s golden age of technology has arrived, accelerated in part by COVID-19. From telehealth platforms to remote patient monitoring technologies, digital innovations allowed hospitals to pivot quickly and transition most patients to virtual care models early on in the pandemic.

The same can be said for revenue cycle management (RCM). It, too, is experiencing a digital renaissance, which comes at a fortuitous time. As hospitals resume normal operations and revive elective surgery volumes back to pre-pandemic levels, they are grappling with fewer revenue cycle staff due to cuts made before and during the pandemic. What’s more, they face stiffer competition, nationally, with increasing demand for revenue cycle staff, including billing and coding professionals, many of whom are now part of a growing remote workforce. As revenue cycle work volumes rise, many organizations cannot hire staff back because of the steep financial losses suffered during the pandemic. In a May 2021 Annals of Surgery article, researchers estimated US hospitals lost $22.3 billion at the peak of the pandemic, March through May 2020, due to canceled elective surgeries, predicting a median recovery time of one to two years.

As a result, hospitals are tapping artificial intelligence (AI), robotic process automation (RPA), bots, and other technologies to fill in gaps, drive out waste, and reduce costs across the revenue cycle by finding data anomalies and improving processes, especially in crucial friction areas such as denials management. Gartner predicts 50 percent of US healthcare providers will invest in RPA in the next three years to optimize costs and resources.