Hospitals Looking Beyond EHR to Improve Revenue Cycle Performance

Hospital Revenue Cycle ManagementOver 60 percent of hospitals and health systems are not realizing optimal value from their EHR system, causing the organizations to collaborate with other vendors and outsourcing companies to improve revenue cycle performance.

That was a finding from a new Navigant analysis based on an executive survey conducted by Healthcare Financial Management Association (HFMA), which polled 108 chief financial officers and revenue cycle executives from hospitals and health systems across the country.

The survey found that more financial executives believe the challenges of EHR adoption are equal to or outweigh the revenue cycle performance benefits. Sixty-two percent of respondents in this year’s survey said the scale hasn’t tipped in favor of revenue cycle performance versus 56 percent in 2018.

Furthermore, over one-half of the respondents said their hospital or health system cannot keep pace with EHR upgrades or underuse functions already available within the system, Navigant reported.

“It was anticipated that EHRs would be the main driver of broad performance improvement, but that has not occurred in many cases,” Timothy Kinney, managing director at Navigant, said in the press release. “Instead, providers are now taking other steps, including looking outside their organizations to collaborate with external entities and leveraging advanced technology solutions, and they’re seeing successes.”

The survey showed that 46 percent of financial leaders have already engaged with external entities, such as an outsourcing company and other health IT vendors, to decrease revenue cycle costs and increase economies of scale.

EHR vendors have notoriously lacked the revenue cycle management capabilities providers want. Providers have complained that EHRs are a major barrier to accurate and efficient charge capture, and the solutions do not integrate with practice management systems, making revenue cycle management more difficult.

Hospitals and health systems are looking beyond their EHRs to resolve challenges associated with the systems, the survey showed. Executives also reported investing in solutions to improve the patient financial experience.

Forty percent of respondents said their organization is offering comprehensive financial counseling and payment plans, while 32 percent are using online portals for price estimates and patient bill payment.

Addressing the patient financial experience remains a top priority for financial executives in this year’s survey.

Patient financial responsibility is steadily climbing. The amount patients owe for healthcare increased 12 percent from 2017 to 2018, following an 11 percent increase the previous, research from TransUnion showed.

Eighty-five percent of respondents to the HFMA and Navigant survey said the increase in patient financial responsibility will continue to impact their organizations. About 81 percent of executives from last year’s survey and 92 percent from the 2017 survey said the same.

Health IT is helping hospitals and health systems navigate both revenue cycle performance and patient financial experience challenges, the survey uncovered. The majority of financial executives surveyed (69 percent) anticipated increasing their organization’s IT budget over the next year.

IT investments will primarily help drive revenue cycle performance improvements, the survey indicated. Eighty-seven percent of respondents said they are most focused on technology-related capabilities to improve future revenue cycle performance.

Specifically, financial executives are looking to improve revenue integrity in the future. For the third consecutive year, respondents ranked revenue integrity as their top focus area, followed by EHR optimization and physician and clinical documentation.

Hospitals and health systems are seeking more advanced IT products to support their top focus areas. The survey found that 17 percent of financial executives said predictive analytics, artificial intelligence, robotic process automation (RPA), and other advanced technologies have decreased revenue cycle costs and increased economies of scale.

“New technologies leveraging RPA, artificial intelligence, and machine learning have unlocked significant opportunities to reach previously unattainable levels of revenue cycle performance,” said Kent Ritter, a director at Navigant. “As we’ve learned with EHR implementations, there are no silver bullets. These tools are not ‘plug and play,’ and the ability to integrate operational and technical expertise remains key to provider success.”

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