Since the onset of the COVID-19 pandemic, the healthcare industry has been upended, and we can be certain that 2022 will be a year of unprecedented change for healthcare organizations, particularly the revenue cycle. In order to overcome the impact, we must seek new ways to achieve efficiency and revenue cycle optimization, starting with automation.
What Led Us Here?
First, there’s the rapid transition to remote work as a result of the pandemic. Many organizations made the transition without a clear roadmap or job evaluation. Despite the rapid move to remote work, organizations touted the considerable gains in productivity and improvements in quality. However, those proved to be short-lived. Why? The productivity and quality gains were not the result of any intentional design and were the result of employee fear – fear of COVID-19, job loss and the unknown. Burn-out and competing work-life balance demands soon led to some of the most significant dips in productivity in 2021, with experts predicting even more significant deterioration in productivity in 2022.
Second, the “Great Resignation” has led to a workforce shortage across the nation – a record 4.5 million workers left their jobs in November 2021.[1] As city and state boundaries blurred with remote work, large health systems from higher-wage areas began to pick off employees by offering better salaries without requiring relocation. Others, primarily women and minority women began to self-select out of the workforce. One global study found that women did three times as much childcare as men during the pandemic – specifically an average of 173 additional hours.[2] These demands forced women to make difficult decisions about work, taking the number of women participating in the workforce to pre-1988 levels. Health systems are being forced to either increase the wages of administrative personnel or use expensive purchased services to backfill gaps in service.
Supply chain challenges contribute to the third critical issue. Production delays and workforce shortages will continue to cause upheaval in the supply chain throughout 2022. In addition to the shortage of COVID-related supplies, general supplies are also driving up the costs of doing business.
Building the Case for Automation
These issues are chipping away at an already small to non-existent margin for most health systems. While short-term fixes of using purchased services or increasing wages can help “bridge” the need for staff, it will ultimately drive up the cost to collect in the revenue cycle – this is unsustainable. Automation is the only solution that offers health systems a natural alternative to these complex challenges.
By implementing automation in revenue cycle management, organizations can optimize the process for tracking and collecting revenue while also maintaining a high level of quality care for their patients. This can mean increased financial efficiency and resiliency while also reducing denials and decreasing labor costs to accommodate a labor shortage. Robust automation for revenue cycle management helps to ultimately fortify operations, mitigate staff disruptions and protect the bottom line from jeopardy.
Many vendors will suggest that healthcare organizations can benefit from automation. For instance, many outsourced organizations implement robotic process automation (RPA) to process claims faster and with less staff. The goal for health systems should be to automate their processes rather than to continue to rely upon vendors for these services. Imagine a world where a health system could “touch” every claim and take appropriate next steps without the use of humans? This is possible and can be done by a health system rather than a vendor.
Organizations should methodically and purposefully evaluate the use of automation to address the COVID-19 challenges – in other words, health systems should resist the temptation to embark on automation without a well-defined roadmap. Creating an artificial intelligence (AI)-enabled revenue cycle roadmap will help the organization identify the most significant pain points, develop use cases and prioritize use cases by impact to the organization and ease of implementation. This roadmap will most likely span two to three years, as the journey to an AI-enabled revenue cycle will use subsequent use cases that build upon each other.
Revenue cycle organizations should embrace 2022 as the year of automation and begin their journey to an AI-enabled revenue cycle. As health systems embark on this journey towards automation, it should be done with a clear vision and roadmap, a focus on organizational change and a willingness to change how we do business. Windham Brannon is well-versed in revenue cycle optimization and the critical needs of many healthcare organizations and systems to embark on this journey. For more information on how you can embrace automation in 2022, reach out to Valerie Barckhoff at vbarckhoff@windhambrannon.com.
[1] Garcia, Eric. “Record 4.5 million ‘Great Resignation’ workers quit their jobs in November – what this means for Biden.” Independent. Jan. 5, 2022.
[2] Avi-Yonah, Shera. “Women Did Three Times as Much Child Care as Men During Pandemic.” Bloomberg. June 25, 2021.