As hospitals and health systems navigate operational and financial recovery amid COVID-19, many leaders are thinking about what’s next for revenue cycle management (RCM). During the virtual 2020 Cerner Health Conference, revenue cycle leaders Joe Fifer, president and CEO of Healthcare Financial Management Association (HFMA); Mandie Brzon, senior director of revenue cycle at Ascension; and Joe Polaris, senior vice president of product and technology at R1 RCM, shared their thoughts on the future of consumer engagement, accelerating opportunities with partners and the post-pandemic outlook. Here are some highlights:
Q: What types of efficiencies are you seeing across today’s health care revenue cycle?
Fifer: Technology such as artificial intelligence and process automation is driving a lot of the efficiencies in revenue cycle. So much that involves human intervention and manual processes can be automated. I think we’re on the cusp of seeing a significant change that will likely reduce the size of our revenue cycle workforce in the next few years.
Polaris: The ability to apply machine learning and AI to automate repetitive and even complex tasks is a big opportunity for greater efficiency and better processes. It will free up staff for higher-order problem solving and more direct patient concierge-oriented services. We also have the chance to create efficiencies through digital self-service. We can bring touchpoints like scheduling, intake and payment to a patient on their mobile device for a more seamless consumer experience.
Q: How is the industry rethinking health care from the perspective of the patient across the continuum of care?
Brzon: Leveraging machine learning and automation enables health care providers to enhance the patient financial experience in new and greater ways. We can balance the digitizing of patient access points while still providing personalized care when people walk in the door.
Over the past couple of years at Ascension, we've developed our consumer products team and engaged more consumer researchers to help inform our decisions, which has helped us get outside of that traditional revenue cycle bubble. It’s been extremely valuable in our process for designing tools and technologies that create a better patient experience.
Q: How does Cerner and R1’s recent partnership to deliver revenue cycle outsourcing services help providers create a more seamless consumer experience?
Polaris: Cerner and R1’s collaboration was built on the principles of providing more value, a better experience and more efficiency for patients, clients and communities. It’s a complementary relationship: Cerner makes a great technology platform and has a huge amount of data to be leveraged, and R1 comes to the table with direct accountability for performance and direct ownership of the operations.
Our experience interacting with millions of patients every year enables us to collectively build technology and product roadmaps that are consumer-centric. Now, we have the scale to bring those products to life in a tightly integrated way that’s built around the workflows our clients and patients find most necessary and useful.
It's one thing to have great technology; driving meaningful adoption is the hard part. In order to move toward an efficient, digital self-service model that supports price transparency and makes care more accessible, we must help our patients see the value of interacting with us in a digital way.
With the pivotal changes in health care currently underway, the critical importance of driving change on the front lines can't be overstated. The Cerner/R1 partnership’s great technology at scale – and our ability to invest in furthering that technology – will help us create this change so our clients can be successful in the upcoming months and years.
Brzon: As we've looked at how to address consumerism at Ascension, our operators have historically initiated the solutions to problems. Now, the revenue cycle culture has shifted, and we start with our consumer team. We’re no longer designing processes and modes of operation around what we can do, but rather what provides the most flexibility for our patients as consumers. We’re bringing our Cerner and R1 partners and our essential technologies team to the table to say, “Okay, here's our solution requirements; here's our product requirements. Let's go see how we make this happen.” It’s been a transformative pathway for us.
Q: If you had a crystal ball, what technologies do you anticipate bringing the greatest change in health care?
Fifer: One of the biggest game-changers is the whole world of telehealth or virtual visits. At the beginning of the pandemic, literally on a dime, health care facilities were able to transition many of their services to a virtual setting. I’m still amazed at how rapidly it all fell into place. I know that a lot of the technology was already there, but most systems weren’t set up for the massive volume. Now, we're starting to figure out what processes need to be refined for the long-term because telehealth is here to stay. The pendulum started at almost no telehealth and then shifted to nearly all telehealth, so I think it will land somewhere in the middle post-pandemic.
Polaris: We've talked for years about the concept that a patient should be able to pick up their mobile phone to search for a provider, book an appointment, onboard and manage their data, communicate with their care team, pay their copay and understand their out-of-pocket liability. The pandemic made it necessary to move quickly to virtual health to keep our patients and staff safe. We learned that we could do so much more with technology, so much faster than we ever believed before. I really hope that notion of being able to move quickly stays with us.
Q: Especially recently, economic and operational pressures have changed the health care financial system. How do you see things stabilizing and moving forward post-pandemic?
Fifer: The financial system is stabilizing, but that’s easy to say because everything was absolutely crazy earlier this year. What I hear from most chief financial officers is that much of their hospital revenues have recovered. If they’re still struggling, they’re readjusting. Some of the recovery has come through the Coronavirus Aid, Relief, and Economic Security (CARES) Act and the Paycheck Protection Program.
There’s a fair amount of fear and uncertainty going into 2021. Health care leaders are concerned about the long-term implications of this economic environment on insurance coverage, getting revenues back to pre-pandemic levels and managing the anticipated deteriorating payer mix on a relatively thin margin.
Polaris: We read about this concept of a K-shaped recovery, where the financial markets rapidly recover but things get worse for those who had the least financial resources or cushion in the event of an emergency. For those folks, frankly, the recovery doesn't feel real. The impact on unemployment and the uninsured proportion of the population is still real in a lot of the communities that we serve.
I'm really encouraged by the work of our collective teams at Ascension and R1 to ensure that everybody who comes through our doors in need of care ─ no matter their insurance status ─ is given full, proactive financial counseling to make sure they're connected with resources. There’s a way for every patient to get and afford the care they need, which is going to be crucially important for the next few years.