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Leaders Say Efficiency, Not Finances, is Top Rev Cycle RPA/AI Benefit

Analysis  |  By Alexandra Wilson Pecci  
   October 14, 2021

More than 80% of leading health systems that are using RPA/AI say their primary reason for investing in the technology was improving financial performance, but once the technology was in use, they said efficiency was the top benefit.

The reasons that leading health systems initially invest in robotic process automation (RPA) and artificial intelligence (AI) for revenue cycle management are slightly different than the benefits they report after actually using the technology.

That's one of the key takeaways from "The Promise of Robotic Process Automation and Artificial Intelligence in Revenue Cycle Management," a study by Waystar and The Health Management Academy that surveyed 50 health systems executives

More than 80% of leading health systems that are using RPA/AI say their primary reason for investing in the technology was improving financial performance.

But once the technology was in use, the primary benefits were different. In fact, increased revenue capture was actually the third (out of four) most important benefit to RPA/AI.

Instead, 91% of leading health systems currently using RPA/AI for revenue cycle management said that efficiency was the top benefit, over both cost reduction (82%) and increased revenue capture (74%).

According to the survey, RPA and AI usage remains inconsistent across the various parts of the revenue cycle and adoption rates are still very low.

It found that of the leading health systems that are currently using RPA/AI:

  • 14% are using it for denial management
     
  • 28% are using it for payment posting and reconciliation
     
  • 40% are using it for claims management (statusing)
     
  • 10% are using it for revenue capture/integrity
     
  • 28% are using it for coding
     
  • 22% are using it prior authorization
     
  • 18% are using it for patient estimates
     
  • 28% are using it for eligibility verification
     
  • 6% are using it for patient registration

However, 64% of those surveyed plan to pursue these technologies within the next three years.

The report authors note that "the areas of RCM that are more aligned with AI capabilities, such as denials management, currently have lower rates of reported RPA/AI use…For example, when looking at diagnosing denials, only 38% of those who use RPA/AI technologies reported using predictive analytics to identify risk and the problem."

They survey also showed that the use of RPA/AI hasn't resulted in mass layoffs as many once feared.

Although 82% of leading health systems reduced their RCM workforce following the implementation of RPA/AI, 62% of executives reallocated staff to different roles while less than a quarter reported eliminating active positions. Additionally, less than 25% of LHS reduced their RCM workforce by more than 10%.

Alexandra Wilson Pecci is an editor for HealthLeaders.


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