Mar 21, 2023

13 Revenue Cycle Management Trends That Will Define the Future

Revenue Cycle Management Trends That Will Define the Future

The world is constantly evolving, and so are the processes that govern medical reimbursement. Healthcare providers are recuperating from a historic global pandemic in which whole service lines were set aside to accommodate physicians to concentrate on preventing the transmission of a fatal disease, Coronavirus.

Meanwhile, the healthcare industry has been undergoing a digital transformation. The clinical drive toward EMR implementation to meet Significant Usage requirements has resulted in even greater difficulties on the commercial aspect of nursing. These formerly laborious procedures have a considerable effect, and medical professionals are increasingly focused on streamlining operations and improving performance.

Every one of these phenomena, as well as others, have an influence on clinicians, and when taken together, they will usher in a brand-new era of Revenue Cycle Management. The way healthcare companies adapt to these developments is critical to their financial success. Discussed below are the top RCM trends that will decide the future course of growth in this sphere:

Growth of Telehealth

Telehealth has now been valued at $250 billion. Telehealth will be around here for an extended period of time, given the growth of Coronavirus cases by leaps and bounds. The Centres for Medicare and Medicaid Services has added telehealth protocols to the latest clinician fee structure for various services.

Executives in charge of the revenue cycle management must keep a careful eye on these developments as telehealth regulatory rules change frequently.

Home-Based Prospect of Healthcare

Considering 75 million inhabitants born between 1946 and 1964, accounting for roughly 30 % of the United States population, the tomorrow of the health sector lies in residence. The home and community-based ecosystem include private nursing practices, non-clinical healthcare, and companionship activities.

Revenue cycle management, supervisors, and employees will have to deal with different situations in their revenue cycle as medical professionals embrace residence and society-based treatments into the healthcare service loop.

Rise of Psychological and Psychosocial Health Clinics

According to Mental Health America, approximately 19 % of individuals, more than 50 million American individuals, had a psychiatric disorder in 2019, right before the pandemic. Approximately 4.5 % of individuals had severe suicidal ideation. A significant depressive episode has been reported in up to 15 % of teenagers.

Dedicated SaaS revenue cycle solutions focusing on psychological and behavioral care are increasing. It is anticipated that the RCM for psychological and psychosocial establishments will necessitate specialist software and qualified RCM personnel in the coming.

Introduction of Medicaid Health and Wellbeing Regulations

Organizations and health providers must now check and record information regarding business hours and Medicaid patients’ health-related behaviors when submitting claims. The revised Medicaid rules require health professionals to educate their denial handling team and collections personnel.

Empowering Providers with Wearable Gadgets

Wearable technology like smartwatches is becoming a component of a linked healthcare ecosystem while care moves to the household, transmitting physiological information in no time, offering insightful information on individuals, and assisting physicians in providing precise diagnosis and care.

Rise In Consumerism

The rise of protection of consumer’s interest in the healthcare sector has a number of ramifications for how the treatment is given. This megatrend weaves together issues including pricing clarity, no unexpected charging, e-health, branded healthcare delivery mechanisms, and much more.

The revenue cycle management executives must rethink their cash flow in terms of the customer and assist them by offering patient-friendly invoicing, digital statements, and adaptable financing options, among other things.

Shift to Work from Home

Although the pandemic had an apparent and disastrous effect on medical sector reimbursement by closing down services, the outbreak also sparked another key change: work from home. The rise of the remote working trend has brought with it a slew of new issues, namely the need to quickly integrate new digital solutions, greater confidentiality and availability controls, and worries about efficiency.

To increase corporate efficiency, RCM Managers and supervisors should consider investing in process optimization and performance measuring solutions for their employees.

AI is Revolutionising the Revenue Cycle

Artificial Intelligence is gradually but permanently making its way into the Revenue Cycle Management hood. But times are moving, and they are happening rapidly.

Service providers have enhanced payer’s interface use, smart payment processing, and automated updates to transfer employees to denial handling. Automation is increasingly assuming the role of SaaS-based systems that can be accessed at any point in time and from any location.

Booming Significance of Analytics

Analytical tools will aid in the elimination of mistakes, the identification of fundamental causes, the automation of RCM workflow, the identification of personnel training requirements, and the reduction of rejections.

Predictive analytics may increase the efficacy of a facility’s revenue cycle management team by providing information ranging from RCM KPIs to the operating efficiency of team players.

Improving Labour Efficiency

Organizations must invest money into corporate workflow and electronic governance solutions to boost organizational efficiency as labor scarcity worsens. Workforce output can be monitored more accurately, and efficiencies may be driven with enhanced workflow.

A rising number of revenue cycle management executives see the requirement to boost productivity by implementing initiatives like expanding agent hours on the network, creating more efficient work queues, and close screening of employee productivity.

Ballooning Financial Activity

In these years, the revenue cycle management service provider sector has experienced significant financial movement. The world is seeing a lot of convergence in the network operator industry, with innovative businesses getting high valuations.

Only the Strongest Automation Platform Will Survive

Like other industries, the healthcare sector is also swiftly shifting to the tech-optimized side of platforms.

Corporations that can provide competitive automation infrastructure pricing and a comprehensive solution embracing technology to tackle real-world concerns in all the tiers of revenue cycles will be ahead in the race.

Outsourcing Coverage to be Expanded by Providers

In the future, it is expected that providers will expand their outsourcing coverage and thus, improve the efficiency of their functioning.

Healthcare providers are increasingly focusing on healthcare support programs like CDI, Virtual Nursing, and Virtual scribing after demonstrating competence in RCM activities.

Final Thoughts

Revenue cycle management is evolving as enterprises approach a new age in the medical sector, one that includes work from home, patient commitments, increasing security and compliance requirements, and digitization.

Healthcare businesses can stay ahead of the changes with revenue cycle software and services while assuring optimal revenue collection. Flexible and smart solutions can help simplify and assist successful claims addressal to keep enterprises going in the face of adversity.

Also read: Why Telehealth Should be a Long-term Care Mode in the Healthcare Sector



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