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Rev Cycle Leaders Double Down on Their Dissatisfaction With Automation and Payers

Analysis  |  By Jasmyne Ray  
   November 09, 2023

Revenue cycle leaders are currently meeting to discuss insights and pain points, and two major challenges have already emerged.

Some of the nation’s leading revenue cycle leaders are gathering at the Umstead Hotel and Spa in Cary, North Carolina for the HealthLeaders’ 2023 Revenue Cycle Technology Exchange where their dissatisfaction with automation and payers were in the hot seat.

The revenue cycle leaders said they have been struggling to keep up with rapidly innovating and evolving technological solutions, developing digitalization strategies, and managing ever-present payer challenges including denials and prior authorization.

Organizations are all jumping aboard the automation train, but struggling to find the technology or solutions with the capabilities to complete or streamline the tasks they need. Some providers are finding that their organization’s solution is unable to evolve to accommodate the rapidly evolving issues throughout the rest of the sector.

Photo courtesy of HealthLeaders. Associate content manager Amanda Norris leads the master panel sessions at the 2023 Revenue Cycle Technology Exchange. 

In fact, an attendee survey conducted at the beginning of Thursday’s event allowed the 35 leaders to voice their revenue cycle concerns and observations. Automation efforts are going strong, with about 34% claiming their organization has 10-25% of operations fully automated, and almost 28% said they have automated 25-50% of their operations.

However, when asked about their level of satisfaction with the tools and technology their organization currently runs, only one attendee said they are very satisfied, while over 51% said they were either disappointed or very disappointed with their current technology.

While the majority of the attendees show some amount of dissatisfaction with their technology, they aren’t giving up.

Prior authorization was overwhelmingly selected as the area within revenue cycle that leaders would be most interested in fully automating by the end of 2024, and mostly in an attempt to streamline processes with payers.

Aside from these pain points, more topics were brought to the forefront of the event.

During the exchange kickoff, Kim Rometo was able to provide an outside, yet insightful, perspective to the conversation surrounding the use of AI.

As senior vice president and chief innovation and technology officer for the Atlanta Hawks and State Farm arena, Rometo provided examples of how her organization has used AI to analyze game strategies, modernize fan communication, and develop sports content and how these strategies can be utilized in the revenue cycle.

"There is immense potential for generative AI and automated solutions in healthcare, from streamlining tasks to increase operational efficiency, flagging patient biases, and even counteracting payer algorithms or solutions that make it difficult to approve claims," Rometo concluded.

We’ll be back with more Rev Tech Exchange coverage including highlights from panel discussions featuring Savanah Arceneaux, director of pre-service and financial clearance at Ochsner Health and Jonathan Benson, assistant vice president of patient financial services at Atrium Health.

The HealthLeaders Exchange is an executive community for sharing ideas, solutions, and insights. Please join the community at our LinkedIn page.

To inquire about attending a HealthLeaders Exchange event, email us at exchange@healthleadersmedia.com.

“There is immense potential for generative AI and automated solutions in healthcare, from streamlining tasks to increase operational efficiency, flagging patient biases, and even counteracting payer algorithms or solutions that make it difficult to approve claims.”

Jasmyne Ray is the revenue cycle editor at HealthLeaders. 


KEY TAKEAWAYS

Leaders voiced their struggles with rapidly innovating and evolving technological solutions, digitalization strategies, and payer challenges.

Prior authorization was selected as the area most leaders were interested in automating.


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