What’s Revenue Cycle Management Going to Look Like in 2025?

Healthcare IT Today recently partnered with CorroHealth on an e-Book called The Road to 2025: 5 RCM Trends that Are Shaping the Future of Healthcare.  The e-Book is full of great insights into how the world of revenue cycle management (RCM) is changing and what healthcare organizations need to know to be prepared for this changing world.

Needless to say, revenue has been top of mind for every healthcare organization as we felt the seismic impact of COVID on revenue.  No doubt some were hit harder than others, but every healthcare organization I’ve met has had to prioritize revenue cycle management.  However, the e-Book mentioned above focuses on some areas that probably aren’t getting talked about enough.

The first one for me is how the role of coders, clinical documentation improvement specialists, and RCM specialists is going to change between now and 2025.  We all know the revenue impacts of these professionals, but how often do we think of them as an important part of our care strategy?  The short answer is not enough and that could be a problem as we head towards 2025.

Go and read the full e-Book for all the details, but it highlights two extremely important points.  First, prior authorizations can be a major blocker to care and so having people and technology that can effectively manage prior auths is going to have an important impact on care.  Second, as we continue our slow shift to value based care, the role of revenue cycle management changes.  Today, RCM is often at the tail-end of the process.  In value based care, the revenue team needs to be involved much earlier in the process to ensure proper reimbursement for the care being given.

The next area of interest in the e-Book is embracing AI in the RCM process.  It’s impossible to look at RCM in 2025 and not talk about the impact of AI and its subcategories: machine learning, predictive analytics, robotic process automation, NLP, etc.  Many health systems are already deploying these technologies and this chart shows how broadly they’re being adopted:

It makes sense that revenue cycle is where AI starts to have an impact in healthcare.  RCM has a lot of monotonous processes and there can be a huge impact on revenue quickly.  The question every healthcare organization should be asking is are they and the vendors they’re using keeping up with the latest technology and AI?

Plus, it’s worth noting that all this application of AI is about leveling up revenue cycle professionals and augmenting what they can accomplish.  It’s not about replacing them.  This was described well by Neal Somaney, Executive Vice President at CorroHealth.

RCMs impact on care and AI are the two big changes we see coming down the pipe for RCM by 2025.  Revenue cycle professionals will start to have a bigger impact on the care patients receive and AI will augment the work being done as it replaces the mundane and monotonous areas of RCM.  What would you add to what you see happening with RCM by 2025?  Let us know in the comments or on social media.

Be sure to download the full e-Book: The Road to 2025: 5 RCM Trends that Are Shaping the Future of Healthcare to see all the details about RCM’s road to 2025.  Plus, it talks about the impact of the great resignation on RCM.

CorroHealth is a proud supporter of Healthcare IT Today.

About the author

John Lynn

John Lynn is the Founder of HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.

   

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