7 Emerging Healthcare Revenue Cycle Trends of Future

As we have seen that revenue generation for health services has been achieved by employing the healthcare revenue cycle, which makes the cashflow tasks easier. But this method too was the result of evolution and the outcome of using updated trends. It indicates that in the upcoming years, after passing from further evolution, the RCM industry will adopt advanced changes and it will develop a new form.

We name these changes as new trends that RCM is going to exhibit in the coming years. But what trends would it show? Here we have collected the top 7 trends that we will witness in the coming years.

Healthcare Revenue Cycle Trends

RCM involves the entire revenue generation process, from patient appointment booking to the collection of reimbursement. Each stage of the healthcare revenue cycle includes staff, technology, and some experience to conduct the process. Since technology has hit almost every industry of the world, RCM has also gone automated, and for the same reason, new trends have emerged. These trends impact RCM, either positively or negatively.

Among a number of trends, here are common 7 RCM patterns that hospitals will use in their procedures:

1. Implementation Of Artificial Intelligence

There is a specific code for every single health service or consultation, when sums up it becomes a thousand in numbers. One won’t be able to recognize each code for every health service. So there’s a huge chance of missed revenue due to claims rejected as a result of mismatched code. 

Furthermore, claim applications require an audit, that can help identify the lost revenue. But the problem is that most of the times auditing can be conducted after the application has been processed and before auditing the claim might already be rejected and you’d lost the revenue.

In order to avoid all this situation, artificial intelligence is going to show its implementation in the healthcare revenue cycle. AI will perform most of the manual tasks. Research has also found the success ratio of implementing AI to be 90%.

2. Enormous Spend On Healthcare Burdens The Patient

Healthcare sectors in the United States spend more on their service than in any other country. Though this spending makes them provide updated services, it may cause a huge burden on patients. The more you’ll spend as a health practitioner, the more you’ll expect the patient to pay, while on the other hand, the patient is unable to pay such massive bills.

This lead to concerns over spending on the healthcare revenue cycle in such a way that it doesn’t feel burdensome on patients. Here are 3 ways to make it possible:

• Bill Transparency: To make the patient aware of the service he will take, each hospital must provide a charge master sheet in healthcare revenue cycle, along with mentioning each service and its costs.

• (CDHPs) Consumer Directed Health Plans: This plan integrates the medical bill deductibles with tax accounts, which patients consider the best alternative to paying bills upfront. But the ratio of its implementation has seen a decrease due to the delay in enforcing new taxes.

• Convenience: In order to help patients with medical bills in the healthcare revenue cycle, hospitals must provide multiple payment methods. This will help them better consider their suited options and choose one that seems fit to their needs.

3. Surprise Medical Bills

Surprise bills – a nightmare of every patient, had seen a hike a few years ago. This started the debate in many countries to restrict hospitals to send surprise bills to patients.

However, many countries passed some laws in which the bill can be disputed. If the payer is verified as the real owner of the bill, he will have to go through a settlement process with hospitals and insurance payers. Due to the same reason, we are going to see variations of these bills implemented in the coming years, with a single purpose to help patients get rid of surprise medical bills.

4. Telemedicine

The term itself signifies that telemedicine means giving health services by the means of telecommunication methods. Many hospitals have already employed this method during the healthcare revenue cycle. But still, the number of non-using ones is high. Soon they will too work on this method and make patients’ lives simpler.

Telemedicine saves you from facing a number of difficulties when you have to get any health service. No need to travel to the doctor and wait for hours sitting in the waiting area. Just dial the number and ask for a recommendation after telling the doctor about your condition. 

5. New Role Of CFO

Most hospitals hire their separate CFO (Chief Financial Officer). They typically work to find ways to save hospital costs to grow their financial health. But now, they mostly perform research work to develop such a cybersecurity method that protects the patients as well as the hospital’s data.

As CFOs are required to pick a suitable cybersecurity software or method, they must have technical knowledge in order to excel in their field in the future.

6. ICD-11 Update

The World Health Assembly introduced the 11th version of the International Classification of Diseases (ICD-11). This contains 55,000 codes, 76% higher than the previous ones.

ICD-11 is more advanced. One of the biggest features of this version is that it is entirely electronic which makes healthcare revenue cycle management much easier to conduct. 

But even after its introduction, many hospitals are unable to perform medical coding based on this version. Though they are trying, they need to speed up in the coming years to prevent revenue loss.

7. Outsourcing

Healthcare revenue cycle management services have been outsourced by many health practices to minimize their burden. With the help of outsourcing, they don’t have to spend on hiring extensive staff and employing costly systems. Hospitals can focus more on making their health service better, instead of banging their heads to get the claims accepted.

In the future, medical coding and RCM companies will surely see a hike in their revenue as they make revenue collection for hospitals easier.

Recommendation

By studying the above 7 healthcare revenue cycle trends, you can now predict the future of RCM, in which direction will it go, and what the things that need to be spent time on are. If you are a health practice, either big or small, follow these trends in order to stay ahead of the curve and mark yourself safe from the negative impacts of evolution.