Hospitals Still Grappling With RCM Tech Infrastructure

Posted on May 18, 2018 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

While revenue cycle management isn’t the sexiest topic on the block, hospitals need to get it right or they won’t be able to pay their bills. One key element needed to accomplish this goal is a robust tech infrastructure that helps RCM specialists get their job done.

However, it seems that many hospitals are struggling to manage RCM data and pick out the right vendors to support their efforts, according to a report published by Dimensional Insight in collaboration with HIMSS Analytics. To conduct the research, the two organizations reached out to 117 senior-level decision-makers in hospitals and health systems.

According to the survey, more than two-thirds of health systems use more than one vendor for RCM. But that might be a bad idea. The research also found that organizations using more than one RCM vendor seem to face bigger issues with denials than those using only one RCM solution. Regardless, the execs said that denials were the biggest RCM challenge for health systems today.

Pulling together RCM data is a struggle too, respondents said. More than 95% of health systems reported that the way data is collected is a challenge. Also, nearly all respondents said that collecting RCM data from disparate sources is also difficult.

One reason why it’s tough for hospitals to put effective RCM technology in place may be that health information management directors and managers aren’t at the top of the influencer list when it comes to making these decisions.

When asked who the key stakeholders were in RCM. 91.5% said that the CFO was the most important, followed by the head of revenue cycle, who was ranked as important by 62.4% of respondents. Meanwhile, only 48.7% of respondents saw the health IT leaders as key stakeholders in the RCM environment. In other words, it looks like tech leaders aren’t given much clout.

When it came to technical infrastructure for RCM, respondents were all over the map. For example, 34.5% were working with an EMR and 3+ vendors. Another 12.1% used in EMR with one vendor, followed by 11.2% with 3+ vendor solutions, 6.9% using an EMR plus two vendors and 4.3% using two to vendor solutions. Clearly, there’s no single best practice for managing RCM technology in hospitals.

Not only that, some hospitals aren’t doing much to analyze the RCM data they’ve got. According to the survey, 23.9% said that 51 to 75% of the RCM process was automated, which isn’t too bad. However, 36.8% of hospitals reported that less than 25% of the revenue cycle process was driven by analytics. Also, roughly a third of respondents said that collecting data from diverse sources was extremely challenging, which can cripple an analytics initiative.

Taken as a whole, the report data suggests that hospitals need to improve their RCM game dramatically, which includes getting a lot smarter about RCM technology. Unfortunately, it looks like it could be a long time before this happens.