Payer processes, federal policies challenging hospitals: RCM firms

Each year, Modern Healthcare’s Revenue Cycle Firms Survey asks companies about the state of the industry and what they predict for the future. Click here to see the full results from the survey.

Here are five takeaways about the sector and the services clients are looking for. 

1. Denials management and accounts receivable performance services are universally on offer.

Litigation and wage garnishment was the service offered the least often by revenue cycle management firms that responded to the survey.

2. Hospital clients need the most help with payer processes.

Revenue cycle firms assist their clients with overcoming a wide range of obstacles. Two-thirds said hospitals are seeking help with cumbersome payer processes, while more than half said new federal policies (such as the No Surprises Act) are presenting challenges for clients.

3. Revenue cycle management spending has jumped.

Half of the respondents said that hospitals’ spending on revenue cycle management services has increased over the past year.

4. The growth of value-based care isn’t affecting demand for services.

The vast majority of respondents said they hadn’t seen any changes as a result of value-based care. (Percentages for both pie charts do not add up to 100 because of rounding.)

Not a Modern Healthcare subscriber? Sign up today.

5. Artificial intelligence is on the rise.

Jeffrey Nieman, CEO of Charlotte, North Carolina-based revenue cycle management company Meduit, noted AI's potential to boost efficiency.

“By leveraging AI and automation, we have demonstrated that we can eliminate up to 40% of human work efforts. ... Given that our pilot cases show 40% automation capability, we see significant opportunities to reduce reliance on labor," Nieman said in his survey response.