By Richa Jain, Digital Marketing Manager, PCH Health (an Exela Company)
LinkedIn: Richa Jain
LinkedIn: PCH Health
The healthcare industry has become more technologically advanced and futuristic in recent years. Physicians today are more open to technology adoption than ever before. According to the AMA, there has been a rise in the adoption of digital tools and technologies such as augmented or artificial intelligence or remote care tools.
Looking at the massive amounts of complex financial processes, the need for an efficient and more patient-centric system cannot be denied. But what does the future have for RCM? Do you know how several innovations are driving this change?
Well, take the example of a patient who can process claims in real-time just when he steps out of the clinic. Isn’t it a dream? Well, it has become a reality thanks to the innovations happening around.
However, let’s not forget that the change comes with its own set of challenges. So how can healthcare providers ensure that they are not only adopting the new technologies but optimizing and leveraging them for maximum efficiency? The answer lies in embracing and understanding the trends shaping the future of RCM. Let’s explore:
Five RCM trends reshaping healthcare beyond 2024
- Advances in artificial intelligence
Integrating AI in RCM is not a futuristic concept anymore; it’s the current reality. According to a report, 70% of healthcare professionals, including payers, providers, and HST groups, have already implemented or are actively considering implementing generative AI capabilities. In the future, the role of AI in RCM is forecasted to expand, particularly in processes such as pre-certification and coding.
For instance, AI can help providers identify and analyze denied claims, enabling them to make more strategic decisions in the future. Moreover, AI can streamline payment workflows, enhancing accuracy and reducing the workload.
Patient engagement is another area where AI can make strides. AI-driven chatbots and other tools can revolutionize how patients interact with their billing processes. It can further help improve patient experience and streamline the billing process.
- Value-based payment models
Value-based reimbursement is going to be a fundamental shift in how healthcare providers are paid for their services. Instead of traditional fee-for-service models, value-based models directly link payments to the quality and effectiveness of patient outcomes.
During this approach, data collection and documentation become paramount to illustrate the value delivered by healthcare providers.
To succeed in this reimbursement model, RCM must focus on key areas such as capturing and reporting comprehensive patient care data, treatment outcomes, and patient satisfaction. Accurate coding and documentation of patient progress, care, and services provided is crucial for justifying reimbursement claims.
- Cybersecurity measures for financial data protection
Safeguarding financial and patient data has always been a significant challenge for healthcare practices. Cybersecurity vulnerabilities pose a substantial threat with chances of data breach.
This fear has prompted an increase in security measures. As we move forward, healthcare practices are increasingly investing in data security, just as they do in other operations. Organizations are going to prioritize integrating encryption protocols, advanced threat detection, and stringent access controls into their processes and systems.
- Cloud-based solutions
Cloud-based RCM systems provide healthcare organizations with centralized data, automated billing, coding, and payment processes, and optimized workflows.
Moreover, these solutions facilitate real-time collaboration with stakeholders, ensure regulatory standards and compliance, offer predictive analytics for better decision-making, and enhance financial performance and operational efficiency.
Initially, cloud adoption was not encouraged due to security reasons. However, with robust security protocols, encryption, and compliance measures now integrated with the solutions have skyrocketed adoption.
- Telehealth & remote RCM
In revenue cycle management, telehealth and remote RCM are the new trends that are going to revolutionize healthcare services. As telehealth becomes more substantial, healthcare providers are incorporating virtual care billing and reimbursement processes.
This trend is about integrating telehealth billing into existing RCM workflows. It incorporates submitting claims, verifying insurance coverage, and processing payments for remote monitoring and virtual consultations.
By automating billing processes and streamlining administrative tasks, remote RCM and telehealth can reduce manual efforts, minimizing billing errors and improving efficiency.
Conclusion
In an era where healthcare costs are rising continually and patient expectations for seamless experience are growing, embracing these state-of-the-art technologies is a strategic move. As we approach the future, those who are keen on a tech-forward approach will be better positioned to thrive in an increasingly competitive world.