AI and automation are helping reduce repetitive work for revenue cycle teams, pushing them towards greater capabilities for data literacy and problem solving, four revenue cycle leaders said at Becker’s 11th Annual Health IT + Digital Health + RCM Conference.
It’s a trend that Dayne Hoffman, vice president of revenue cycle at Kansas City (Mo.)-based Children’s Mercy; Sandra Lood, vice president of revenue cycle management at Santa Barbara, Calif.-based Cottage Health; Penny Jefferson, RN, director of clinical documentation integrity at Sacramento-based UC Davis Health; and Patrick McDermott, chief revenue officer at Danville, Pa.-based Geisinger, all expect to accelerate.
A bold prediction
Mr. McDermott predicted the future and said he could see a typical 1,000-person revenue cycle team decreasing to around 300 as staff are paired with AI agents.
‘The organization structure that we all have right now is the greatest impediment to innovation,” he said. “We have to completely change it … it’s going to be skinnier and it’s going to be shorter.”
Mr. McDermott also suggested that fully remote work in the revenue cycle can undermine creativity, collaboration and camaraderie for teams. “My motto is 100% remote is a losing strategy,” he said.
He also threw in a quote from Canadian former ice hockey player Wayne Gretzky which he called “pertinent” to our current times.
“Don’t skate to where the puck is, skate to where the puck is going.”
From function to mission
At Children’s Mercy, Mr. Hoffman said the system is six months into a 12-month stabilization period after an Epic implementation.
“We haven’t really established new roles,” he said. “What we’ve been really focusing on is transitioning to what I call mission-driven versus function-driven attitude and demeanor.”
Mr. Hoffman said Children’s Mercy is emphasizing skill sets like data intelligence, data fluency and being able to know how to understand the kind of literacy within the AI space.
For Cottage Health, the system is also more focused on “data literacy” and a “process improvement mindset” over just experience, with the system now questioning job descriptions prior to backfilling positions.
“That’s the next thing we’re really looking for, is those process improvement mindsets that candidates have,” Ms. Lood said. “It’s small testaments of change that will lead to big impact.”
Clinical documentation integrity growing scope
Ms. Jefferson said at UC Davis Health, clinical documentation integrity can now impact denials, prior authorization and utilization review.
“These roles have all evolved in the last two to three years, to where they’ve gone from regular CDI reviews to being very much subject matter experts in looking at the records and … helping do some root cause analysis on denials,” she said.
