According to recent research, Artificial Intelligence will transform the way doctors, hospitals, and healthcare systems identify, collect, and manage their revenue cycle over the next three years.
According to the same research, AI in healthcare organizations is evolving from day-to-day use to strategic integration within their systems. Almost two-thirds of health system executives reported using AI in some revenue cycle capacity and nearly all of them expect to be using it within the next three years. However, familiarity with AI and its impact differs a great deal between executives, IT, and revenue cycle leadership, in addition to budgetary, security, privacy, and accuracy concerns surrounding AI adoption. AI is suited to transform revenue cycle management- from improving the end-to-end revenue cycle and claims accuracy, to denial reduction, clinical insights, level-of-care prediction, and more, only for providers who understand it and know how to use it to their advantage. But this can only happen when executive stakeholders are aligned on the strategic deployment of AI and the measurement of success.
The research centered on the decision-makers in healthcare– from the executive, financial, revenue cycle management, and IT departments across the U.S. healthcare systems. The key research findings are listed below:
Almost all U.S. hospitals intend to start using AI across the revenue cycle by 2023. Around two-thirds of the respondents (65%) said that they currently use AI in RCM, compared to the 89% in RCM roles. However, only 12% of the participants believe their AI implementations to be mature at present, but 35% expect their implementations to be early mainstream/fully mature by 2023.
There appears to be a glaring gap in opinions surrounding healthcare AI. The reported usage of AI in RCM is only 48% among non-technical executives compared to 63% in the IT sector, and 89% by those in revenue cycle roles. Furthermore, 78% in RCM roles are satisfied with their current use of AI, compared to just 46% in the IT sector and 25% of non-technical executives. 86%
of those in RCM roles see value in using AI in RCM, compared to just 52% in IT roles and 44% of executive and financial decision makers. The disparities in the above statistics suggest the need for RCM leaders to better communicate AI’s effectiveness at improving financial outcomes and the ROI of their AI investments. That is the only way healthcare can fully capitalize on the transformative powers of AI.
While AI is making possible a whole host of improvements, the approach is tactical and not end-to-end. Among the hospitals currently using AI in the revenue cycle, most of them cited driving patient and payer payments (83%) and cash flow (80%) to be the biggest improvements and eligibility/benefits verification (72%) and patient payment estimation (64%) we’re said to be the most common applications. However, respondents expect prior authorization (68%) and payment amount/timing estimation (62%) to become the leading applications by 2023. On the whole, providers expect an overall increase in the use of AI across all revenue cycle functions, pointing to an evolution toward a strategic end-to-end approach.