More than 1 in 5 Revenue Cycle Leaders Outsource Outpatient Services

A survey finds that organizations outsourcing their revenue cycle management are generally very satisfied with the outcomes.

Among revenue cycle leaders who manage their inpatient revenue cycle management (RCM), 22% outsource some of their outpatient or ancillary services, according to a survey conducted by the Healthcare Financial Management Association (HFMA).

The poll, done on behalf of XIFIN, gauges the interest in and opportunity to outsource outpatient RCM for more efficient processes, which has the potential to ease administrative burden and improve outcomes.

In addition to more than one in five leaders outsourcing some of their RCM, 12% of respondents want to employ this approach in the future. When they do, the survey found that organizations are generally very satisfied with the outcomes.

To gather the data, 302 HFMA members were given a 21-question online survey in 2021, with 157 sending in complete responses. Respondents varied in hospital size, from fewer than 100 employees (6%) to 10,000 or more employees (31%).

According to the responses, the top three business drivers that guide the approach to outpatient RCM are patient experience, process optimization, and revenue generation.

The most challenging aspects of RCM not currently addressed by people, processes, technology or services are denials and appeals management, prior authorization, and payor relations.

In analyzing the data, the authors of the survey note that the respondents show a significant need for more efficient and effective RCM and reporting optimization.

"There is pressure on hospital teams to effectively manage expanding outpatient sources of revenue and expenses," said Bill Voegeli, HFMA head of custom research and president of Association Insights. “Many of today's healthcare financial and RCM teams lack the necessary time, information and/or staff resources to fully understand the opportunities or implications for RCM automation beyond their electronic health record (EHR).

"Our research with XIFIN gives credence to the notion that healthcare finance professionals will benefit by staying up-to-date about ways to optimize the growing area of outpatient RCM and gives RCM executives insight into new avenues for optimization."