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When Choosing AI for RCM, Is In-House Better Than Outsourced?

Analysis  |  By Jasmyne Ray  
   September 11, 2024

Does it really matter who develops the solution as long as it gets the job done? Let’s weigh the pros and cons.

The AI market is continuously expanding, with vendors tailoring their solutions to specific pain points. Some hospitals and health systems develop solutions in-house, while others look to outsourced products..

Payers are currently outpacing providers in their use of AI and automated solutions for revenue cycle and finance operations. However, Bill Arneson, director of business operational transformation for Moffitt Cancer Center, believes that the healthcare sector will catch up.

“I think it will level the playing field and there will come an equilibrium where the payers and the hospitals are keeping each other in check so no one is out of bounds,” he said.

When it comes to in-house development vs. vendor solutions, Arneson, who’s participating in the HealthLeaders Mastermind program on AI in revenue cycle and finance operations, believes it’s good to leverage both, but the best fit may vary by situation.

He prefers the in-house approach, which allows him to develop staff and add to internal knowledge that can be shared throughout the organization. This, in turn, also helps with security.

However, Arneson does note that in-house developers can be more expensive than partnering with a vendor and more time-consuming.

With vendors, he said, there’s much faster implementation, and their solutions are tailored to specific tasks and processes.

“If you have a vendor that’s very narrow in their scope, they’re going to be very good at the thing you’re hiring them to do,” he said. “You’re getting an expert and it’s very quick.”

A downside of working with vendors, Arneson continued, is being locked into a contract. Much like training and developing in-house developers, he also notes that it takes time to maintain positive relationships with vendors.

Moffitt leverages both in-house and vendors in their RCM operations due to the volume of work they have and the opportunity they have to scale their workforce per project.

“It’s a great thing that we can outsource and then our internal staff can do more development work or free them up for other things,” Arneson said.

The HealthLeaders Mastermind series is an exclusive series of calls and events with healthcare executives. This Virtual Nursing Mastermind series features ideas, solutions, and insights on excelling your virtual nursing program. Please join the community at our LinkedIn page.

To inquire about participating in an upcoming Mastermind series or attending a HealthLeaders Exchange event, email us at exchange@healthleadersmedia.com

Jasmyne Ray is the revenue cycle editor at HealthLeaders. 


KEY TAKEAWAYS

Payers are implementing AI and automated solutions faster than hospitals and health systems.

Having in-house developers build AI solutions enables organization's to develop staff and keep knowledge within the organization, which helps with security.

Vendor solutions can be implemented faster, but being locked into a contract can be limiting.


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