The pandemic has created intense cash flow pressures for many health systems.
To deal with these pressures, financial leaders must reduce cost-to-collect while improving revenue cycle efficiency.
During an AKASA-sponsored workshop at the Becker's Hospital Review 12th Annual Meeting, Scott Becker, founder of Becker's Healthcare and partner at McGuireWoods, facilitated a discussion with AKASA’s Ben Beadle-Ryby, senior vice president of sales and customer success and co-founder and Amy Raymond, vice president of revenue cycle operations. They talked about the application of automation to revenue cycle operations.
Four key takeaways:
1.) New automation approaches are the key to reducing cost-to-collect. Over the last decade, cost-to-collect metrics have been relatively stagnant. According to. Beadle-Ryby, "Cost to collect for most organizations hovers around 2.5 to 3 percent of patient revenue. We've tapped out the value of rules-based automation systems." To address more complex revenue cycle scenarios, organizations need more sophisticated approaches that go beyond the limitations of basic robotic process automation (RPA).
AKASA's Unified Automation approach leverages an "expert-in-the-loop," which creates resilient automation. "Problems often arise in areas where RPA is too brittle," Raymond said. "In those cases, our expert-in-the-loop jumps in to answer the question. Customers see completed workflows, and simultaneously we train our algorithms and get them back on track for future success."
2.) Automation must align with the key performance indicators that organizations care about. AKASA delivers value in the form of virtual full-time equivalents (FTEs) that can handle eligibility checks, prior authorizations, claims coding and edits, as well as claim status, denials, appeals and rebills. "Within a year, AKASA was handling about 20 FTEs' worth of work at one of our customers," Beadle-Ryby said. Other customers, according to Beadle-Ryby, have experienced reductions in AR days and improved write-off performance.
3.) Solutions like AKASA shift humans to the most important patient-facing tasks. Every day, revenue cycle teams must prioritize their work based on available staff. Automation expands the workforce. "Your team members can work on things that they couldn't get to before. Automation also enables them to work at the top of their skillset, using critical thinking during conversations with payers. By asking the right questions, revenue cycle team members serve as advocates for patients," Raymond said.
4.) Many revenue cycle automation vendors overpromise and underdeliver return on investment. "Automation is a hot topic," Beadle-Ryby said. "I'd encourage every organization to pressure test vendors in a couple of areas. Do they have the technical chops to make this work? That means a deep bench of engineers, machine-learning experts and AI PhDs. Also, do they have the case studies to back up their claims? It's critical to ask those questions upfront." Automation can't do everything in the revenue cycle. Some areas can be automated and deliver massive gains, but others still need to be solved by humans.
The workforce of the future will be a combination of automation tools and human resources. "It's much more streamlined, and you can upskill people in a more efficient way. In the years ahead, we're excited about emerging automation opportunities in the clinical revenue cycle space, as well as non-revenue cycle areas with resource-intensive roles like supply chain, HR, registry management and more," Beadle-Ryby said.
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